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25 November 2020
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The Greek myths, retold in English, were a small but memorable part of my earliest education. We followed the exciting journeys of Odysseus and the difficulties that he overcame, including the alluring sirens and the terrible Scylla and Charybdis. I recall that he stopped his sailors' ears with wax and had himself tied to the mast to avoid falling into the clutches of the sirens, but was almost lost in the whirlpool of Charybdis, while the six-headed Scylla gobbled up six of his sailors. At that age, for me, these were great stories but now, as memories fade, they come back into my head as occasionally useful metaphors.

I've been thinking of this while trying to get in the minds of our political leaders as they have been navigating our countries through the pandemic. All three of Homer's fearsome characters are there – populist temptations, intensive care rocks, and economic whirlpools – but ahead lies freedom and a return to something approaching normal (although in Odysseus's case this meant seeing off a pair of rivals for the affections of his long-suffering wife – who could they be?). As we approach the end of this terrible year, we must remember and remind our leaders that our destination is freedom from the daily threat of infection and death by the SARS-CoV-2 virus, but that until this is achieved there are more hazards to be avoided, and some of these sing sweetly.

The sirens' voices, as I write, are singing Have Yourself a Merry Little Christmas. We must remember what happened to Odysseus and those of his men who were munched up by Scylla. We must also remember that viruses are totally unsentimental, rather like Scrooge. 'Bah, humbug!' he said. They don't recognise holidays or even Christian festivals. They know only one thing; that, like the sirens, they require living cells for nourishment and the energy to reproduce, and SARS-CoV-2 is very good at finding them. If it finds you, it can kill you, but is more likely to kill your parents or grandparents. So, my advice to Mr Johnson and Ms Sturgeon is simple: for now, stop your ears and tie yourselves to the mast. Make no promises that you may have to break.

I am afraid that we are the sirens calling for a merry Christmas. But let's imagine that we are Odysseus's sailors, sailing through the rapids and approaching Scylla and Charybdis before reaching the calms beyond. To one side, the enticement of a happy family reunion, grandchildren and children coming out of school, university or workplaces, meeting grandparents who have been largely isolated for months, all hugging, singing, shouting across the table, tearing their parcels open and fighting over presents. On the other side, going out to visit neighbours, having drinks with friends, going to parties and having more drinks. On both sides, the vision of happiness fades when you consider the consequences – more infections, more deaths of the older ones.

To move again from Homer to Dickens and back, I don't feel comfortable acting as Scrooge, until I remember how that tale ended with him discovering his better nature, empathy for those who are less fortunate, care for those around him. We can avoid those dreadful rocks if we navigate carefully, and if we do so we now have a realistic prospect of a vaccine being available for most of us during the next year. So, here are some common sense guidelines for Christmas 2020, subject to any legal restrictions that may have been introduced by then:

• The only people who can mix without increasing risk indoors are those who have been isolated for two weeks or more, or those who have already been living together.

• The more people meeting indoors, the greater the risk. Face masks, properly worn, reduce this but do not eliminate it. Remember hand hygiene at all times.

• The longer you remain speaking to someone, the greater the risk if they are infected. Risks are higher in unventilated rooms.

• Older children are a particular risk to over 70s because they are likely to have been mixing with their friends.

• Singing increases risks, but suitably distanced outdoors should be safe if you avoid facing each other.

• The safest means of inter-generational meeting is by telephone or online.

• Good wishes are often best conveyed by an old-fashioned letter or card (and the elderly really like receiving these).

All risks are modified in relation to the overall risk of infection in your area. You will be able to find this on the Scottish Government website, expressed as cases per 100,000. For example, this week it is 83 in Edinburgh and 268 in Glasgow. Double it and you can get a rough idea of how many are likely to be carrying the virus. You can get some guidance also on whether it is going up or down from the Public Health Scotland website and the R (reproduction) number that I explained in an earlier article (6 May). At present, this is hovering around one, which means it is neither going up nor down – or rather that it is going up in some places like Glasgow and down in others like Edinburgh, and this is why restrictions keep getting changed.

A simpler approach is to look at the number of people being admitted to hospital and intensive care each day from the same government website; if by the time you read this it is going down, infective risks will be reducing. Unfortunately, England is, on average, behind Scotland and very unlikely to have control before Christmas.

When in early March I started writing these articles, I explained that whatever our government decided, I would not be using my ticket for the rugby international (6 March). It was the right decision and was followed later by government advice on avoiding crowds. In retrospect, if they had introduced lockdown earlier, many lives would have been saved. Now my wife and I have decided that we shall join our sons' families remotely on Zoom for Christmas. I think that many other prudent people will make the same decision and help to get the R number well below one by the time the vaccine becomes available. That way many more of us will survive to benefit from it, and each day we get more encouraging news on the likelihood of several effective ones becoming available next year.

Even if, ill-advisedly, our governments respond to the call to allow more freedom at Christmas, we should remember that taking advantage of this will definitely cause more of us to die of COVID-19 than would have otherwise, unless we all continue to behave very cautiously indeed. Ebenezer Scrooge's look at the past and visit to the future was what caused his change of heart. The future does indeed look brighter now, the waters ahead calmer; let's stop our ears to the sirens' song.

Anthony Seaton is Emeritus Professor of Environmental and Occupational Medicine at Aberdeen University and Senior Consultant to the Edinburgh Institute of Occupational Medicine. The views expressed are his own

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1
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COVID-19: the siren song of Christmas

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2
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