Peter Anthony McMahon

My father dies of Covid – a reflection

Little did I expect at the beginning of the Covid pandemic that my own father would succumb to this virus. But just over a week ago, he died in hospital of Covid-19 related pneumonia.

This was given on the death certificate as the primary cause of death. Being an 83 year-old, there were other underlying conditions including COPD (chronic obstructive pulmonary disease), gradual onset of dementia and E.coli, which he’d more than likely contracted in the care home – leading to his collapse.

My father had been a heavy smoker up until ten years ago but giving up had given him a new lease of life. However, his lungs were impaired and in 2012, he’d punctured one of them falling off a ladder.

Two weeks before his death, he collapsed at the care home where he’d been resident for nearly two years. Those of you with elderly parents or other relatives know only too well that the final years are punctuated with repeat falls and trips to hospital. But this time, I sensed it was a lot more serious. Though I didn’t know he had Covid.

Covid at the care home

The virus had ripped through the care home with 32 staff and residents being infected in a four month period from October 2020 to January 2021. I was eventually rung in January to be informed of this by the care home manager.

It also emerged that the GP (family doctor) was unwilling to give vaccinations on site for at least four weeks. However, the GP then relented and my father received his first Covid jab a week before collapsing.

What amazes and frankly distresses me about the care home situation generally is the refusal of about 20% of care home staff nationally to be vaccinated for ‘cultural’ and – yes, believe it or not – ‘medical’ reasons. Think about this – staff refusing to be vaccinated and then looking after your loved ones. I call that negligence.

At the hospital, he displayed all the signs of Covid infection but there was some uncertainty at the outset. However, a swab test came out positive after he’d been there for a week.

In the days that followed, he seemed to be resisting the worst of the virus. So much so that medical staff thought he could be transferred to an intermediate facility and then sent back to the care home. The E.Coli was presenting the great challenge and the difficulty he was experiencing with swallowing food. But my father seemed to be defeating the Covid virus.

This turned out to be very wrong.

DISCOVER: Covid today and TB yesterday – diseases in history

That turnaround moment

A week to ten days after being in hospital, the information given from the ward led us, as a family, to believe that he’d displayed once more what we called his ‘bounceability’. Time and again, the old man had looked ashen-faced and positively deathly only to claw his back to the land of the living.

So, we seemed set for another bounce.

The only thing I’d noticed was his dementia getting a little worse. This manifested itself in various vaguely paranoid ideas involving shadowy conspiracies against him. All pretty standard stuff I’m afraid to say. But it was still possible to engage him in rational conversation once you got through some initial nonsense.

What started to overturn the optimism were the daily reports to me by the doctors that indicated the antibiotics weren’t working and that he was becoming more delirious. I was assured, though, that the objective was still to get him back to the level he’d been in when he was admitted to hospital. Not perfect – but stable.

However, on the Sunday evening before his death a new doctor came on the line and asked me whether I fully appreciated the seriousness of my father’s condition. I was flabbergasted. I knew the antibiotics hadn’t been working and that he’d ingested material into his lungs.

But now I was told that if I wanted to come on to the ward and see him, Covid restrictions would be lifted. That could only mean one thing. I asked for some candour. And I got it. The doctor told me that the problem with swallowing was linked to the dementia – he was forgetting how to do this basic human task.

He’d now developed ‘aspiration pneumonia’ and was not conscious. In combination with his underlying conditions, it was doubtful he’d make the night.

But then he did.

All through Monday my father clung on. His breathing now becoming the classic ‘death rattle’. And even though he wasn’t particularly religious, I agreed to a chaplain giving last rites. I’m an atheist myself but the thought of him being entirely alone in his final hours overrode that consideration. A bit of ritual and company seemed right.

There are many awful decisions to make as the clock ticks to the end of a life. The doctor posed the question to me – do we try and cure or do we manage the situation? I opted to manage the situation knowing full well that there was no cure. A Rubicon had been crossed in health terms.

He died at 01:20am on Tuesday morning. As agreed, I was phoned. Amazingly, I’d fallen asleep. But then found myself at my desk emailing family, writing death notices for the newspapers and even, I kid you not, amending the Ancestry.com website. The things you do to stay sane in that moment!

Within 48 hours, I had the death certificate in my hand with Covid-19 related pneumonia as the primary cause of death and COPD as the secondary.

Already, I’d had to deal with funeral arrangements. We’d decided, because of Covid, for my father to go directly from the care home to a crematorium and the ashes to be delivered to my home. Then later in the year, we’d have a service when the pandemic had lifted.

Now, I had to redirect the undertakers to the hospital. And then discovered that because of a Covid backlog, my father wouldn’t be cremated for nearly a month. So, suddenly, I was having to find out where his body would be kept. Whose fridge? The hospital to begin with – and then the crematorium – it turned out.

Disconnects in the health service

I’m a huge supporter of the National Health Service (NHS) in the UK. But those of you who’ve had to process your ageing loved ones through the system – will have lost your rose-tinted spectacles on the way. I should mention that both my parents worked in the NHS – my mother in a psychiatric hospital for thirty years. So we were an NHS family!

The plus sides of the NHS include having access to top medical care from paramedics, nurses and doctors free of charge. I was having lunch with my father when he had a stroke in 2018. The ambulance arrived promptly and the London hospital brought him back from the brink.

The staff were amazing and selfless. And I would say the same of the doctors in my father’s last few days. Always keen to update and keep me informed. Plus a pleasant and understanding manner.

So what about the downsides?

Well, the inability to share data in the NHS is mind boggling. With my mother, she would turn up from the care home (with advanced dementia) for a hospital appointment, after developing cervical cancer, and another hospital or the GP wouldn’t have sent her file in advance.

This wasn’t a one off. And it begs the question – can’t all this data be shared on these curious modern devices called computers?

I was also asked on two occasions – in an ambulance after my father had suffered a stroke and a week before my father died when he was in hospital – whether my father was allergic to penicillin. Now, I knew he was. But I bet a lot of people might not be able to answer that question.

Why on earth don’t we have a central database with this information accessible via our NHS numbers? Answer: because some people think it would infringe our civil liberties. So the next time you’re given an antibiotic that takes you to death’s door – thank your local libertarians.

Care homes

If we’d got my father into sheltered accommodation earlier, it would have been a godsend. But he’d experienced several falls at the home he’d lived in for fifty years, most of them with my mother. The GP’s records showed these falls and no sheltered accommodation provider would accept him. So – he had to go straight into a residential care home with nursing care.

The cost – about £1500 a week. Goodbye savings! I can only liken it to pulling a plug on his bank account. And for a man who saved diligently and was terrified of going overdrawn, he protested furiously at paying out this money. But we prevailed on him as a family that he should have the best even though it was our inheritances going up in flames.

From Spanish flu to Covid

After my mother died in 2016, I’d got my father involved with Ancestry.com. We opened an account and I began to plunder his grey cells for details on the family. And what a mine of information he turned out to be! In fact, he’d been doing a whole load of research for years as well as being able to churn out names and stories from memory.

At the time, he was at the very early stages of dementia. I’d certainly recommend something like family tree research as a great way to engage those whose brains are at risk of degenerating. Apart from anything else, I became totally addicted to Ancestry.com as we made some amazing discoveries together. So, keeping him mentally active wasn’t a chore – but good fun.

One of the things we uncovered were relatives who died of diseases like tuberculosis and the dreaded Spanish flu. The latter was the Covid equivalent of the years immediately following the First World War. My grandfather’s sister was one of those who sadly died of Spanish flu aged 29.

Final thoughts

This Covid pandemic has taken us all on quite a journey. Not a physical one but into our own minds and our closest relationships. I had no expectation that it would claim my father. And I’ve seen friends and acquaintances contract Covid but mercifully pull through. But it’s changed all of us.

How we emerge from this horror is anybody’s guess. I used to worry that every day would be like the next until the grave. Now, I’m craving normality and routine stuff like going for a walk, shopping and popping down the pub.

In recent years, digital strategists blathered about the virtue of ‘disruption’. You don’t hear so much of that anymore. But the virus has disrupted us. In our families, Covid has robbed us of loved ones. In our communities, it’s blighted the prospects of the young. And in our wider societies, it’s devastated entire sectors like retail and hospitality.

Covid came to visit me this month – and now I’m mourning a much loved father.

Walking through Lockdown London with a visor!

On 3 June 2020 I left my home for the first time since mid-March. I live in the London borough of Southwark, just south of the river Thames, and we had distinguished ourselves early on as having one of the highest rates of Covid infection in the capital. So – I was very strict about lockdown and quarantine.

The only reason I left my home today was that back in February, I’d started root canal surgery and it was left with a gaping hole in my molar. That got infected and so I had to dash to the dentist and get the surgery finished off.

So what to say about Lockdown London on 3 June. Well, despite all the reports that quarantine has all but collapsed, I found a city that was eerily deserted still. Yes, there are more cars and construction workers – but no office staff.

I didn’t see a single person in a suit in the middle of town. Even though I walked down Fleet Street and Chancery Lane – centre of the legal community. Not a single arrogant, over-paid lawyer in sight! 🙂

DISCOVER: Coronavirus and panic in history

London is not a stranger to plague and lockdown as I’ve mentioned on the blog. In 1665, we had a Great Plague which involved King Charles II and his court fleeing the city for Oxford. Much to the annoyance of Londoners. They took the full force of the disease while their social betters were miles away.

Then there was the Black Death where the bodies piled up in huge pits – stricken with the bubonic plague. Incidentally, these plague pits are dug up every so often and others lie under your feet in the most unexpected places. Like a supermarket in Whitechapel I won’t mention, for example.

This virus hasn’t been on the scale of 1665 or the Black Death. Nor the many cholera and typhus outbreaks that hit the city over the centuries. And I suppose our response has been more sophisticated – though at present, most Londoners I know are not hugely enamoured of the politicians.

Anyway, I didn’t feel at enormous risk today with my visor. But the lockdown has forced many business sectors in London to rethink their models. Do we need so many offices? Do we need all these hotels? How will transport work with social distancing?

And it’s going to change the way we interact. A year ago, pre-lockdown London was booming. Previously derelict areas of the city were becoming terribly chic and crowded with hip young things. And now?

Coronavirus – lessons of past plagues

Coronavirus has been a huge shock. But history is brimming with pandemics and plagues. So, what can we learn from them?

Here’s the bad news first.

Diseases like Coronavirus have an amazingly long history

Viruses have been part of our evolutionary history since we stood on two feet and spread out of Africa. Viruses are not strangers – they have been with us for millions of years – and more than likely, will be with us forever.

Coronavirus isn’t a wholly new phenomenon or a moral judgment on our species – as some seem to suggest (on Twitter for example) – it’s just the latest manifestation of a long running phenomenon.

Here’s the really freaky thing – because of the way in which viruses hijack our cells and mess us up – they have probably played a role in our evolution as a species. So close is our relationship to viruses, that they could even be manipulated in the future to cure cancer or genetic disorders. Small comfort now.

But while the Coronavirus is taking a terrible toll – we could one day harness viruses to be a force for good. Basically instructing a virus to do something useful in our bodies instead of harming us. That’s the science of tomorrow – so what about the impact viruses have had on us in history.

Ancient Greek history – disease with a Coronavirus like impact

A catastrophe like a plague can be absorbed by a civilisation in otherwise robust health. But at a critical moment, it can have a devastating impact. The trouble is – pandemics in history often seem to occur when or because of a broader crisis. So – we know that ancient Athens was racked by plague in 430BC at the height of the Peloponessian War – which killed the great Greek leader and statesman Pericles.

Pericles – died of plague

Plague after plague in the Roman Empire

History shows us that the greatest empire of them all could succumb to the equivalent of Coronavirus and its might and majesty provided no cure.

The Roman Empire saw two huge plagues at turning points in its history. The Antonine plague of the second century AD came at the end of a period of relative stability but now the eastern frontier with Persia was becoming increasingly problematic. And it’s possible that returning soldiers from those battlefields brought the disease back into the heart of Rome.

In the following century, the Plague of Cyprian (recorded by a bishop called Cyprian) bore all the hallmarks of an influenza-driven pandemic. Cyprian wrote about fevers, the passing of blood and aching limbs. When all factors are taken into consideration, it seems the Romans at that time succumbed to an Ebola type of disease. It came at a time when the empire was divided and at war on many fronts – when its usual reserves of vitality were severely depleted.

Spanish Flu – a Coronavirus type pandemic in history

Today in 2020, the British prime minister Boris Johnson contracted the Coronavirus. But he’s not the first leader of the United Kingdom to have fallen victim to a pandemic. In 1918, the news was hushed up that the then Prime Minister Lloyd George – who had just led the country to victory in World War One – had contracted the deadly Spanish Flu.

I was never told about this studying the “Great War” as a child in the 1970s. Britain had just beaten Germany after a four year war and the establishment didn’t want anybody to know that the Prime Minister was flat on his back in bed attached to a ventilator. Ironically, he may have picked up this disease during the many celebrations at the end of the war. And tragically, the Spanish Flu ended up killing more people than died in the trenches.

David Lloyd George – British leader who got deadly flu

The tragedy of HIV/AIDS

The societal impact of a virus can ultimately be positive despite the terrible human cost. HIV/AIDS was an appalling illness that ripped through the gay community in the 1980s. I knew two men who died of AIDS and that was immensely tragic. But the virus forced gay identity to the top of the media agenda. Initially that was a negative. Gay people were accused of spreading a plague.

But within the gay community it built a gritty determination and anger to break through and demand tolerance and acceptance. And among the wider population, gay people went from largely invisible to highly visible. Families were forced to realise that a son, father or cousin was gay – because they finally had the courage to come out.

The Coronavirus has up-ended our lives. There’s already a mass of academic content on how things will be different. The state looks set to play a bigger role. Populism in politics will be in the dock. Experts may come back into fashion. And so on. Let’s see!

Berlin museums shut because of Coronavirus, however…

I was in Berlin in February 2020 just before the Coronavirus struck and led to the city going on lockdown. It seems incredible that at the time of writing this, I was in Berlin three weeks ago and walked around the incredible Pergamon Museum – whose doors are now closed.

But – I don’t want you to be denied the amazing sights of the Pergamon Museum just because of this wretched virus. So luckily, I had my iPhone and captured the incredible Roman gateway that was shipped a hundred years ago from what is now Turkey to Germany. The Gate of Miletus was then reconstructed at the Pergamon Museum in a vast room.

Here it is and it’s truly stupendous in scale!