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President’s Bulletin: Stay Sharp!

Updated on: 29 Mar 2021   First published on 23 Dec 2020

Author:  Dr Alastair McKinlay 

The late Alan Rickman was principally known for his role as the sinister Professor Snape in the Harry Potter films, but before he took up his wand and robes, he was a memorably evil Sheriff of Nottingham in ‘Robin Hood, Prince of Thieves’. At one point, having stopped kitchen scraps for the poor and “merciful” beheadings, he departed with the bombshell order to “call-off Christmas!” It was apparently an ad-lib, but it seems strangely prescient now. The action taken by the UK Government and the Devolved Administrations at the weekend, has come as a huge blow to many people and their families but it is what it implies about the SARS-CoV-2  virus itself, that has frightened everyone. It certainly seems to be more transmissible, but whether this is associated with other changes in pathogenicity remains to be determined.

It was only to be expected. Viruses evolve and natural selection favours highly transmissible variants. Last year I was in the Galapagos, the beautiful natural laboratory that led Charles Darwin to the concept of natural selection. The implications of that insight affect all biological systems, but viruses more than most.

At the moment we do not know what the full implications will be for gastroenterologists and hepatologists over the coming months. More ill people with COVID; for sure. Pressure on beds; certainly. Less endoscopy and diagnostics; probably. If the vaccines remain effective against the new variant, then the control of the pandemic will remain on course. If tweaks are required, then it may take more time. All of which raises the question, “what we should do next?”

The health of the UK and our patients depends on a healthy NHS workforce. A significant percentage of new infections occur in hospital, so we must make sure that we as gastroenterologists, nurses, and health care professionals get vaccinated, and encourage others to follow suit.  It is essential both for our own safety, but also for the well-being of our patients.

We need to keep doing the simple stuff. Face, Space and Hands. Wearing a mask, keeping our distance and, even more difficult for most healthcare professionals, not working when we ourselves are ill. It is true that physical measures are not completely protective, and they are certainly not very technical or exciting, but they work against all known strains of COVID, and, we need to lead by example.

We need to show leadership, even if the hour seems very dark. The coldest hour is the hour before the dawn. Anyone who has been on call overnight knows that. Even if we do not know how effective the vaccines are against the new variants, we believe that they work against the older strains, so we should capitalise on that.

All pandemics end. The fact that we have not faced a challenge like this for 100 years proves, paradoxically, that pandemics cannot go on forever. This one will end. As professionals, we need to hold our nerve.

At times I have been overwhelmed by the way BSG members, consultants, associate specialists trainees, GPs, nurses, clinical scientists, physiologists and dieticians have shown fortitude and resilience in the face of such an exceptional threat. Leadership is not about being unafraid, or inappropriately cheerful. It is about holding onto the fundamentals, looking over the horizon and helping others to be strong.

It is about reassuring our trainees that they will catch up, and they will be needed more than ever. If new consultants need to continue training and mentoring after their appointment we will provide it.

It’s about staying sharp as professionals. The most dangerous blade is the blunt one. We need to maintain our knowledge and our professional coherence. So with uncertainty remaining around our annual meeting, and when we may be able to meet face to face, initiatives like BSG Campus are very important. Please consider registering and taking part if you can, not just for yourself and your own CPD as important as that is, but because of what you can bring to the event and the feeling that we are all in this together. Campus is a good way to stay sharp, to maintain collective and personal morale and get ready for the new norm.

So Christmas may be cancelled, but BSG Campus is open for business. Things may look dark, but the vaccines are here, and the new day will come. As a Society, we will meet again when it is safe, and we remain strong, even in the face of fear and uncertainty.

Alastair McKinlay

BSG President

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