Are we nearly there yet ...

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Dr Peter Fletcher

Consultant Care of the Elderly Physician, Gloucestershire Hospitals NHS Foundation Trust

Looking back over the last 12 months I think I had been sensing progress. A year ago my piece from December 2020 was written in celebration of the Parkinson’s Academy’s ability to deliver our programmes despite the full lockdowns of 2020, at that stage 2 down and 1 about to start. And something had changed, on December 8th I received my first SARS-CoV-2 vaccination. There needed to be a game-changer and this was it.

By my piece from July 2021 we were increasingly fully vaccinated with plans for a flu vaccine in the autumn +/- a 3rd booster SARS-CoV-2 vaccination. Meanwhile positive daily case numbers were in just 3 figures. We had wrapped up MC38.2A in March and delivered MC40.1 in May, both now hybrid. We had scheduled a Foundation MasterClass (41F) for September and MC40.2 for December, also hybrid and we had even managed to deliver Cutting Edge Science ‘live’ (or at least also hybrid) and incredibly successfully in October..

Cutting Edge Science for Parkinson's Clinicians, October 2021

As 2021 draws to an end and I write this sitting at the back of the class of MC40.2 listening to Annette Hand discussing research, I am incredibly proud of what we have achieved. Our sister MasterClasses continue to thrive and there are more to come.

So why am I slightly apprehensive? I guess because the elephant in the room continues to be the rise in Covid-19 cases. Sure they seem to have plateaued. However they have done so at ~ 50,000 per day with all that means for knock-on effects. Moreover the plateau is only a plateau if the numbers are truly stable but we have yet to understand the full impact of the omicron variant and probably won’t until Christmas/New Year 2021.

So what can we and our patients do? Critically we should all have 3 vaccinations plus a flu vaccine. Crucially we should avoid possible sources of infection. My patients are not great Clubbers but do want a Christmas this year, so they are avoiding risk beforehand to achieve that goal. They/we should stay well. Build resilience through sensible diet and exercise. Reduce falls risk also through exercise but also for example an annual eye-test. To take a positive approach to ‘things that can be done’ is one way of addressing our patients’ understandable resurgence of apprehension.

January 2022 will be challenging. Never the less while we are taking 2 steps forward/1 step back we are going forwards. I think most of us realised in March 2020 that it would take at least 2 years for this epidemic to become endemic. What is stopping that is that the epidemic remains pandemic. In a pandemic the ‘p’ metaphorically stands for ‘passport’. A pandemic travels across continents so we’re not safe until we’re all safe. Progress yes and spring follows winter, another lovely metaphor, but I wonder if March 2022 might be a bit optimistic – spring may be a bit late next year.

Either way 2022 MasterClasses 42 (Advanced) and 43 (Foundation) and more are scheduled, we are currently thinking about our 5th Cutting Edge Science meeting (yes I know!!!) plus exciting news re our shiny new MasterClasses alluded to above will come in early 2022.

So let’s look forward, by staying safe, staying well and staying positive.

'The things you can't get from the books'

Parkinson's Academy, our original and longest running Academy, houses 19 years of inspirational projects, resources, and evidence for improving outcomes for people with Parkinson's. Led by co-founder and educational director Dr Peter Fletcher, the Academy has a truly collegiate feel and prides itself on delivering 'the things you can't get from books' - a practical learning model which inspires all Neurology Academy courses.