Chris Worfolk's Blog


Ironman VR1

April 8th, 2020 | Sport

With the triathlon season looking increasingly grim, World Triathlon Corporation has announced a series of virtual challenges, starting with Ironman VR1. This was a middle-distance format with a 5km run, 90km bike and 21km run.

You could complete them in any order starting from 6pm GMT on Friday and finishing at midnight on Sunday. They also had pro challenges with women racing on Saturday and men racing on Sunday. This only included the bike course, done inside on a turbo, via Rouvy.

I put in my 5km on Friday evening. A nice change to use my Nike Next%. Sub-24 minutes without having to push too hard. Then I got up super-early on Saturday morning (8am, things have been slack since the lockdown) and headed out for a loop of Rothwell, Tadcaster, Harewood and home on the bike. There are few cars about and I was able to get down on the aero bars for most of it.

Finally, a long, slow plod on Sunday afternoon for the 21km. I went back to my trusty Brooks Revenna and finished in just over two hours.

It would have been nice to have more than 48 hours notice this was taking place! And, in typical World Triathlon Corporation style, the technology is terrible: my login did not work, I got my confirmation email three times and it keeps saying “register for this event” long after I have completed it.

I didn’t win. I came 3,396 out of 5,320, with a total time of:

5:55:25

My splits were 23:37 for the 5km run, 3:29:47 for the 90km bike and 2:02:01 for the 21km run. Those figures are not accurate, though. First, I cycled 91.66km and ran 21.1km, and it takes the total time. But it also does not factor in elapsed time. I had auto-pause on on my Garmin, which would have pushed me over six hours if not.

Virtual Sunday Assembly Leeds

April 6th, 2020 | Humanism

Sunday Assembly Leeds has been on hiatus since last summer. However, given the current crisis, we decided to stage a virtual assembly.

The theme was “how do I stay positive?” during the current crisis. We had talks, songs from The Assembly Line (in the form of videos of our previous gigs), a moment of reflection and a section called positive news in which we looked at the good things coming out of the current situation.

I’ve been playing around with the setup. The camera on my iPhone is much better than the one in my Mac, so I got a phone adapter for my tripod and used my phone as the main camera. I used my Aftershokz has headphones slash microphone. This freed up my laptop to control the webinar. The final thing you need to sort out is lighting, and angling myself between the window and a studio light seemed to work well.

What is the law regarding exercise during COVID-19

April 4th, 2020 | Sport

I’ve seen a lot of confusion about what we can and cannot do, exercise-wise, during COVID-19. That’s not surprising because what the law says, what the government guidelines say, and what Michael Gove has suggested are all different. In this blog post, I’ll break it down.

You can read Coronavirus Act on Parliament’s website. Which you probably should do, because I have no legal training and am in no way providing any kind of indemnified legal advice.

Can I go outside to exercise?

Yes. In order to leave your home, you need a reasonable excuse. The law (in England) then lists these reasons and includes “to take exercise either alone or with other members of their household”.

Can I go outside to exercise with other people?

Not unless you live with them, as the law says you can only go either alone or with members of your household.

Can I go out more than once per day?

Yes, you can. The law does not prohibit this.

However, where possible, you should avoid this. The government guidelines (which are guidelines, not laws) ask us to keep it to once per day and while it is not illegal to go out more, it makes sense for us to follow the guidelines.

Note that this specifically applies to England: in Wales, you are legally limited to going out once per day for exercise.

Is there a limit as to how far I can go?

No. You can go as far as you want. Neither the law nor the government guidelines, place any restrictions on distance.

That said, it makes sense to stick to your usual routine. If you try a 200-mile ride for the first time and end up exploding and needing someone to come pick you up, that is someone else having to travel.

Do I have to keep it to a maximum of one hour?

No, neither the law nor the government guidelines specify any kind of limit.

I think this may have come from a press briefing where Michael Gove said he expected people would be running for 30 minutes to an hour and encouraged people to stick to their regular routine.

Sticking to your regular routine makes sense, as explained above, so if you don’t usually exercise for more than an hour, I wouldn’t start now. But if you usually do long runs and rides, you are free to continue doing so.

Can I travel somewhere to start my exercise?

Some people have been travelling to national parks to exercise in the middle of nowhere. Can you do this? Probably, but you probably shouldn’t.

The law says you can go out to exercise, and the government guidelines don’t explicitly ban driving to a park either, but the government has said that you should avoid doing this during press briefings.

The concern is that more cars on the road, means more potential collisions, taking up hospital resources. Therefore, unless there is a specific reason you cannot exercise from your home, you should start from your front door.

COVID-19: Running Vallance’s numbers

April 3rd, 2020 | Health & Wellbeing

Patrick Vallance previous said he thought the UK would need around 60% infection rates in order for a country to develop natural immunity. As discussed in today’s government press briefing, he’s also quoted as saying 1 death represents 1,000 cases, confirmed or not. This is just a rule of thumb as we do not have enough data to know for sure.

Based on those numbers, we would be looking at around 36,000 deaths in Italy, 28,000 in Spain and 41,000 in the UK. It should be noted that, as previously discussed on the blog, we don’t really know what the death rates are, but some people have placed it higher. Anyway, that disclaimer over…

If we assume the midpoint will line up with the peak (and I don’t know if that is the case), there is some good news on the horizon. Based on current death rates, both Italy and Spain would reach their peak in 5 days (which is from yesterday, because it’s yesterday’s WHO data, so 7 April).

The UK is more difficult to predict. Based on the current death rates, we wouldn’t hit the peak for another 40 days. But, that death rate is likely to continue to increase further as it has been doing all week. If it doubled, that would half the time to 20 days (still a pretty grim prospect).

There is a bunch of stuff that could throw this off. Valance’s numbers could be incorrect. The peak may not lead up with the midpoint. And the social distancing may slow down the whole process, or even move us back to a containment phase if things went spectacularly well.

COVID-19: Where are the green shoots?

March 31st, 2020 | Health & Wellbeing

Today’s government spoke of “green shoots” and the idea that things might be getting a little better in the number of infections, which will have a knock-on effect later down the line. Unfortunately, that “down the line” could be a long way away.

This graph includes today’s provisional figures for Italy, Spain, UK, France and the US.

Italy and Spain are still rising, and while deaths per day are not increasing, they’re not decreasing, either. Italy is now three weeks into its lockdown. Most other countries, including France and the UK, seem to be following the same curve. The UK is still ahead of Italy at this point and by an increasingly large margin.

If the US figures are accurate, they have had the worst single day of any country without this entire crisis. But their reporting is a bit patchy, so it’s plausible that some of the deaths from yesterday were only recorded today.

The case for ending the lockdown

The COVID-19 pandemic is one of the major challenges of our time. Many of us would advocate for evidence-based policy: we should let science guide us on the best course of action. Unfortunately, a complete lack of evidence for our current approach means the way forward is unclear.

The evidence for the lockdown

At first glance, it seems self-evident that implementing a lockdown will reduce deaths. If we all stay at home, it will reduce the transmission of the disease. In theory, this should allow us to spread the disease out over a longer period, and thus avoiding the healthcare system becoming overwhelmed.

Unfortunately, the evidence does not support this view. A Cochrane Review from 2011 concluded “there was limited evidence that social distancing was effective, especially if related to the risk of exposure.”

At the moment, we don’t even understand how dangerous COVID-19 is. As Dr John Lee notes in his article in The Specator, the lack of testing means the mortality stats are meaningless. We’re comparing deaths to confirmed cases, but the untested cases are anywhere from three times as many to three hundred times as many if a recent study by Oxford University is to be believed.

This is confounded by COVID-19 being a “notifiable disease”, meaning that a death could be reported as COVID-19 when a patient actually died of something else. This seems highly plausible given the average age of COVID-19 deaths is 79.5.

As Professor John Ioannidis points out, due to the lack of evidence, the policies we implement could hinder rather than help.

School closures, for example, may reduce transmission rates. But they may also backfire if children socialize anyhow, if school closure leads children to spend more time with susceptible elderly family members, if children at home disrupt their parents ability to work, and more. School closures may also diminish the chances of developing herd immunity in an age group that is spared serious disease.

Even if we somehow did concede there was some evidence for social distancing, we do not need to confound this idea with a lockdown. You can implement social distancing: such as getting people to work from home and banning large gatherings, without implementing a lockdown in which nobody is allowed to leave their house.

Further, even if social distancing did turn out to reduce infection rates overall, we need to look specifically at how it affects the elderly and vulnerable. It could be that young healthy professionals can lock themselves away and avoid infection, but those who require carers coming in and out of their home, or those who need regular medical appointments, cannot. Another example of how social distancing can harm, rather than hinder because the natural immunity we would otherwise develop from the age-groups at the least risk is never built up.

Ultimately, then, the evidence for social distancing is not substantiated. It could be that the models from Imperial College London are correct. But they may also be utterly incorrect. And that is serious as I will explain below.

Social costs of a lockdown

A lockdown is a serious thing in itself. It violates both Article 3 and Article 13 of the UN Declaration of Human Rights. If you are a Brexit-voter who supported leave because you were tired of human rights, you might like the sound of that. But most of my friends are fellow lefties who quite like human rights.

You could argue that is worth it temporarily to protect public health. And maybe it is. But we need to take all of the consequences into account.

These vary from the (arguably) mild: people have had their lives put on hold. They are not allowed to do the things they enjoy, like seeing the people we love. And doing the things we love: whether that is music festivals, triathlons, pub quiz nights or basically any hobby that doesn’t involve sitting on your sofa.

And continue up to the very serious:

  • Children are being stripped of their education. It’s impossible to expect parents to homeschool to the standard of professional teachers, and so much of education is the social education of interacting with peers and the school system.
  • Some children only get hot meals in school.
  • University students who are paying £9,000 per year tuition fees are not receiving their education
  • The cost to people’s mental health of being socially isolated and not going outside as much.
  • The resulting increase of suicides.
  • The transfer of healthcare resources from other conditions to COVID-19. Doctors and dentists are no longer offering appointments and operations for non-life-threatening but nevertheless debilitating conditions have been cancelled
  • The tidal wave of anxiety from people wondering whether they have a job tomorrow, or already having lost their job
  • The self-employed who find their income has suddenly disappeared and that they are not eligible for government support (which covers nowhere near 95% of self-employed people as the Chancellor claimed)
  • The already-overstretched police services admitting that they will only be investigating the most serious crimes because they will be too busy enforcing the lockdown
  • The domestic abuse victims who we have locked in a building with their abuser, and given their furloughed abuser nothing better to do than sit around and drink.
  • Drug and alcohol users who are in recovery but now more likely to relapse.

These are really, really bad.

People who have flouted the social distancing rules have rightly been called callous towards more vulnerable members of society. But we need to be careful not to fall into the same trap. To dismiss the social costs because our mental health is not suffering, because we have not lost our job, or because we don’t have children who spend years working exams they are now not allowed to take, nor even say goodbye to their lifelong school friends, is a privilege many other people in society do not enjoy.

As Lee puts it, “the moral debate is not lives vs money. It is lives vs lives. It will take months, perhaps years, if ever, before we can assess the wider implications of what we are doing.”

Weighing up the costs

Some young people have died from COVID-19 and that quite rightly tugs the heartstrings. But emotion is very different from evidence. And the evidence from Oxford University shows that the average age of those dying is 79.5.

Life expectancy in the UK is 81. That’s a loss of a year and a half, which is a serious and significant difference. I would be heartbroken if I lost my grandmother 18 months prematurely.

But we have to weigh that against the real and serious damage we are doing to everyone in society. Imperial’s modelling, which has formed much of the basis of the current strategy, predicts that social distancing and lockdowns will have to continue intermittently but indefinitely while we wait for a vaccine. Said vaccine will take at least 18 months to develop, even if everything goes smoothly, and that is before we even start the even bigger hurdle of global immunisation.

If we truly are looking at a 2+ year timescale, the cure would seem worse than the disease. With the average life expectancy of a COVID-19 victim only being 18 months, the majority are likely to die of natural causes in the meantime, doomed to be cremated at a funeral that nobody is allowed to attend.

Worse still, it may be that, as many commentators have predicted, social distancing and lockdowns are not sustainable for such a long period of time. As a result, the pandemic will continue to flare up and kill just as many people, and all our suffering will have been in vain.

If the pandemic magically goes away in the next 12 weeks, then you can make a solid case for the lockdown. And let’s pray that it will. But if not, and we have to keep the suppression methods in place until the vaccine arrives, or they simply fail, we will have wasted more of everyone’s lives than we saved for the 0.25-1% of people who, already at the end of their life, had it cut slightly shorter.

Ultimately, we do not know what the correct answer is. A lack of testing and a lack of data means the conclusion is unclear. And yet, based on that, we are implementing a policy with dire consequences for education, mental health and quality of life.

Editing notes: reflecting back, I’m not sure 81 is a fair assessment of life expectancy. Although it is the average life expectancy in the UK, once you reach 79.5, you are likely to live longer than 81. How we adjust for this is unclear, though. The ONS suggests that a 79-year-old will live another eight years. But this is for a typical person, and we know that most people survive the virus but that rates of mortality are particularly high for people with underlying health conditions. Therefore, in order to adjust, we would need to know the life expectancy of a 79-year-old with underlying health conditions. Unfortunately, that is data we do not have.

The digital clinic

March 29th, 2020 | Business & Marketing

They say that the necessity is the mother of all invention. With the impending COVID-19 crisis looming, we decided it was finally time to make virtual appointments part of Leeds Anxiety Clinic’s offerings.

That was easier said than done. Because of the social distancing recommendations already in effect, and Amazon having halted warehouse shipments, the few webcams that were available had all been panic-bought by other people. Luckily, we were able to beg and borrow the equipment we needed until we could get our own.

We’re still playing around with how to produce the best quality experience, both in terms of the technical setup and the differences between delivering therapy face-to-face, where you can easily scribble a diagram or analyse holistic body movements, and delivering it digitally. Early efforts are working well, though.

COVID-19: The curve starts here?

March 27th, 2020 | Health & Wellbeing

At first glance, yesterday’s figures do not look too bad. Both Italy and Spain seemed to have stopped shooting up. But the provisional figures from today (Friday) mean that they are both going to set new heights tomorrow.

It’s a bad day for France and the UK, too, who both had record days.

Here is the other big change: I have also started tracking Netherlands. Why? Because Netherlands are sticking hard to the herd immunity strategy. This was mentioned in the UK and, depending on who you believe, was always a side-effect of the plan, or the plan until Johnson’s critics spooked him into adopting the current approach. Tracking Netherlands may provide some evidence as to how effective the lockdowns are.

Let’s look at total deaths.

The first thing to explain: I have now capped this at 60 days, rather than expanding it as the dataset grows. This makes it easier to see the curves in the early days. It does mean we are now missing the past five days from China. But the line is basically flat (they are still having a handful of deaths per day, though).

Second thing: I have included the UK’s provisional figures from today in the report. That makes the graph look much scarier. We are the blue line. Until this point, we could hold out some hope that our line would follow the green line (China) and not the red line (Italy). But at this point, it looks like we are accelerating on “the European trajectory” as we could call it.

And, to state again, the UK is ahead of almost every other country was on day 15. This includes Italy. Spain is the only exception, who are way ahead of everyone. Ignore the single dot from Netherlands, that is erroneous data. Currently, they are roughly in line with other European countries.

Swimming 3km

March 27th, 2020 | Sport

I’ve been working super hard on my front crawl since September: getting in the pool three times a week, every week, and relentlessly doing drills. It’s going well. In February, I reached 3km continuous.

Unfortunately, now all the pools are closed so everything has come to a halt. Lakes are too cold, and there are movement restrictions anyway. Let’s hope that better times are on their way soon.

COVID-19: UK by region

March 26th, 2020 | Health & Wellbeing

It was a bad day for Spain yesterday who reported more deaths than Italy. Italy, on the other hand, maybe showing signs of levelling off. The UK had a fairly good day, but that may be due to underreporting: the BBC said the timeframes were chopping and changing, which might explain why we had few deaths yesterday but over one hundred today.

Here is the new graph for today. It shows cases across England broken down by NHS region, with the separate nations (Scotland, Wales, Northern Ireland) also getting their own slice of the pie.

A third of the cases are in London. But that is not abnormally high: they have 13% of the population and the most international travellers passing through. Still, might make you think twice before taking the tube. Otherwise, it is fairly well spread out across the country.