Morning All, - Such a gorgeous day. Mrs S and I were out walking alongside the river just before 0700. A frost but the lovely sun. C was wrapped up, I was in shorts as my summer dress sense is driven by my inner-Canadian. 7.5km as halfway to the planned turning point we looked at one another and simultaneously decided that our get up and go had got up and gone, so we pivoted to home and breakfast. I got back to see that I had left my painkillers and daily Modafinil sitting on the counter beside the starter I was feeding. No wonder I felt a bit sub-par. - In his latest attempt to swerve responsibility the Ginger Hitler has turned his big Orange Blamethrower onto the WHO and pulled US funding. I think he is struggling with the W in WHO. I know we shouldn't be surprised at anything that strange manchild does but he never ceases to amaze. I say this because he is largely responsible for driving thew worlds most advanced nation into such a bad state with Covid-19. In the sufferers of the fallout will be the pwMS. ------- MS Stuff ------- Life goes on. Or, life should go on. There is a growing concern in both the clinician and I imagine the patient community about the effect that the seemingly single focus on Covid-19. I was on a webinar yesterday with a consultant from Cornwall, Glasgow, an MS nurse from the Scottish Islands and a specialist neuropharmacist from London. It is fascinating to hear about the care of pwMS in remote communities and what they have to go through (time and expense) to make the simplest of clinic attendances. One chap has a 3-day roundtrip to get to an MS clinic. £400 fares on the aircraft, another £400 if you need someone to come with you. It puts queueing for a [parking space at the hospital and the egregious car-parking charges into perspective. They are pioneering telemedicine, especially now the Scottish Islands have 4g. The nurse did one clinic appointment with a fellow on his fishing boat. Beat that! Another has an iPad on a sort of robot machines that can be controlled remotely. The innovation and uses of technology in place in our remote regions has suddenly come under much greater focus. Expect to be taking part in some form of telemedicine sooner rather than later. - Another thread yesterday was infusions. There are several medicines that need infusing and all thew clobber that goes with it. Ordinarily, they are done in a hospital. Things are changing here too. In Cornwall, there has been oversight of some infusions happening at a GPs on the Scilly Isles. It still means a specially trained infusion nurse needs to be there. Still, cheaper than dragging the patients to a hospital in Cornwall. If you have infusions then expect to see adaptations to the way they are conducted. The drug makers are concerned (for their bottom line I am sure) but are also being proactive in offering trained infusion nurses to do it in non-traditional locations. Travelodge anyone? - About a virus that isn't Covid-19. Epstein Barr Virus (EBV) is being seen as having a greater likelihood of involvement in the contraction of MS. Read more hear in a guest post on the Barts blog. https://multiple-sclerosis-research.org/2020/04/ebv-and-ms/ - Natalizumab - moving to extended interval dosing doe to Covid-19. Read more here: https://multiple-sclerosis-research.org/2020/04/mscovid19-natalizumab-extended-interval-dosing/ -------- Social Stuff -------- Not a big deal for some, I understand. I managed to secure a v rare delivery slot with Shipton Mill. My neighbour and I booth bake so have stocked up with several 16kg bags of strong four and a selection of 1kilo bags to experiment with. It was produced a great deal of happiness and stress relief. I intend to come out of lockdown baking the most marvellous sourdough. It ain't bad now but we can make it better. I have also called my starter Paul after my best man as I want to give it every encouragement to thrive. Just soothing to watch, let alone as a bread guide. https://www.youtube.com/watch?v=OAH28Hm81FQ&t=1168s - The press chatter is turning slowly to lifting the lockdown. My view has been informed by more believable people than politicians and it is likely they'll try and lift it in stages but, even with the effect of the warmer weather (not good for the virus) there will be a resurgence of infection. A so called second-wave. This Harvard study suggests it will never go away entirely and social distancing is going to become a regular feature of life. vhttps://science.sciencemag.org/content/early/2020/04/14/science.abb5793 - I have it on good authority that the GP interview will be released tomorrow. Later today I will interview Ruth Dobson, a neurologist in London and on Saturday (because that is what he wants) the doc who has tried most meds, Brandon Beaber MD, about future research, MS and Covid-19. - Stay safe, stay well and if you haven't yet got the hang of handwashing, it was nice e-knowing you ;)