Tag Archives: health

Passing the buck the right distance

Here’s something I don’t quite understand. It’s the responsibility of the National Health Service to provide a health service to the nation. Presumably, things like the sourcing of PPE, the purchasing of ventilators, the arranging of tests, and even, to some degree, the deployment of diagnostic phone apps, is their area of expertise. It’s what they do.

Now, these are not normal times, of course, and there’s always the complaint about insufficient funding, past and present. But I doubt that’s valid now since, presumably, the government would now happily write bigger cheques for the provision of these things. So I’m slightly intrigued that the NHS is complaining that the government isn’t providing them, rather than the other way around! Intrigued, though not surprised.

Now, clearly I’m missing something, because everybody else seems to think the government is responsible for medical supplies too. It could be that PPE supplies are primarily delayed because of something like customs and excise rules, in which case, yes, clearly the government is culpable.

Or it could be that the NHS is saying, in effect, “you underfunded us for years, so now that we have a big problem, it’s actually your problem! So there!” Government departments are presumed to be more competent at logistics than the NHS, when both are given sufficient funding, so we’d better hand it over to you, even though we’re the ones with the contacts and the contracts.

But I think it’s probably that the boundary between the government and public services is a sufficiently blurred one that, if you are senior enough in the NHS, your job title begins with ‘Minister’ or ‘Secretary of State’. This is very convenient, because it means that anyone who wants to complain about how things are going — to increase the ad sales in their newspaper, for example — can make it a political complaint, which is acceptable and even popular, rather than be seen in any way to be criticising the NHS, which would be suicidal.

So that raises the interesting question of where the boundary of blame can sensibly be drawn, while maintaining political correctness. Everyone is allowed to blame the Prime Minister and nobody is allowed to blame a nurse; so where does, and where should, the buck stop between the two?

To the extent that some people believe the UK Covid response has been badly handled, how do we hold the correct public institutions, or individuals, accountable when it comes to be reviewed? When the next health crisis comes along, should we expect the health service to handle the provision of health-related services, or the political party currently in power at that time?

I don’t know anything about the management hierarchy involved, but I’m guessing that, as you ascend it, you reach a point where the payslips no longer have an NHS logo on them; where NHS administrators become civil servants. A bit higher, civil servants become short-term political appointees. Are either of these the correct point for rational people to start assigning blame in the case of unforeseen medical emergencies? Should it be higher or lower?

More good analysis tools from the FT

I’ve talked before about some of the nice statistics the Financial Times is gathering about the epidemic, and the clear dispassionate way it’s presenting them.

Their latest tool gets more interactive, and lets you compare, in various ways, how your country is doing against others. I like three things about this in particular.

  • Firstly, you can choose a linear scale. Log scales are handy for scientific visualisation but are harder to grasp intuitively.

  • Secondly, you can get the numbers per capita, which I think is much more useful than absolute figures, though it doesn’t of course take into account population density, which is also important.

  • Thirdly, when you get the analysis in a form you like, you can capture that in the URL and send it to others: the inability to do that is a common problem in today’s over-Javascripty pages!

So you can do your own investigation and see that by some measures, your country is doing fairly well (cumulative cases compared to Spain):

And by other measures not so well (daily new cases compared to France):

You don’t have to switch countries to get different viewpoints, though. Suppose you wanted to make the case that the UK and France were pretty much neck-and-neck, you’d plot the absolute cumulative deaths on a log scale:

(Neither of these capture the fact that France has less than half the population density of the UK, but they’re still useful illustrations.)


Here’s another example:

Let’s display the same data about the UK and Italy in two different ways.

Do you want to make the UK (or its government, healthcare system, population, whatever) look reasonably good? Plot the cumulative cases.

Does your editorial policy or personal preference dictate that you want to make the UK government, healthcare system or population look bad? Then plot the same data as a daily rate (roughly the gradient of the above graph).

That’s the same data over the same period on the same kind of axes.

All of which illustrates why it’s good to have a tool where you can explore the data yourself. As long as you really do explore it and don’t just stop when you get the conclusion you want!

In the above examples, the images are links to larger versions: the links in the text take to the FT site where you can experiment to your heart’s content.

Spare a thought for the politicians

I am constantly bemused by the number of naïve people who want to blame politicians for all the evils of the world, and especially those medical evils that are besetting us at the moment. As I pointed out in an earlier post, this is happening in many, if not most, countries — which should immediately give any critical thinkers pause for thought — but let’s focus for the moment on the UK.

The NHS is, as the Guardian so nicely put it recently, “the UK’s unofficial religion”, so to question any aspect of its operation is blasphemy. If the health service were given free rein, clearly everything would be fine and sunny, so, as Epicurus would have wondered, “whence cometh evil?” Other religions usually deal with this problem by inventing the idea of devils, who exist to take the blame for the difficult problems raised by the belief system. Also to blame are heretics, who consort with them, don’t pay sufficient tithes to the gods, and should therefore be burned at the stake. In the modern world, we group these problematic actors together and call them politicians. (Oh, not the ones you voted for, of course. They are the priests.)

Anyway, since we don’t just have a two-party system, and not everybody votes, the majority of the population will probably disapprove of whichever party is currently in power. That party is therefore always an easy scapegoat for significant frustration. And the minister in charge of the particular challenge du jour is probably Beelzebub himself in human form. Certainly, any media outlet suggesting that is going to get higher advertising revenues than one that suggests the opposite, so it’s a meme that propagates by simple Darwinian processes.

But is that really fair?

Now, just to set the scene, let me emphasise that I’m no particular fan of our current government, and I didn’t vote for them. And yes, with hindsight, there are some things that they could have been done better. It’s easy to say that now. We must never forget that they are fallible humans, after all, with fallible advisors, and voted for by fallible people.

But if, like me, you didn’t vote for them, then try assuming, as a thought experiment, that the people you did vote for came to power in the election just a few weeks ago, and had this dumped on them. They would, I hope, if they were smart, have taken broadly the same decisions. Yes, they would. They would have had the same health service, the same civil servants, the same scientific advice from the same scientific advisors and, hopefully, would have followed it roughly as the current government have done. So they would have had the same outcomes.

There might have been variations — the advice they’re given by the experts isn’t unanimous, after all — which might have moved the infection curve forward or back by a week or two. But it probably wouldn’t have been a significant change (unless your politicians chose to ignore the scientific advice completely like a certain transatlantic President I could mention!)

This graph from the FT is a good way to see that most comparable countries to the UK are following a pretty similar trajectory; the UK peak is higher than most, but our numbers are dominated by London’s population size & density, and its transport infrastructure; neither of which are replicated in many otherwise comparable places. If you restrict your view to urban centres, Paris followed a pretty similar curve to London. France, however, has half the population density of the UK overall, and that’s probably a significant factor in limiting the spread on a national scale. And so on.

Anyway, let’s assume that your favourite party is in power and hasn’t done a significantly worse or better job, because they don’t have that many parameters to tweak. Where they might have made different decisions, these would have had other costs of their own: damage to the economy, significantly higher future taxes, closure of businesses leading to higher unemployment, etc. The best choice wasn’t necessarily obvious back then; managing this is almost always about having to choose the lesser of two evils. And now they’re being blamed by the media and everyone on Twitter for the shortage of PPE, tests, and ventilators.

I assume that those who are complaining have never actually set up a vast manufacturing and supply chain combined with an instant nationwide distribution network. You have? OK, well done. But let’s imagine, instead, that you’re a young guy — we’ll call you Matt — and you have no particular expertise in this area but have been put in charge of everything and suddenly had the world’s most difficult supply-chain problem for some time dropped in your lap. You have to try and sort out in days and weeks what would normally take those who do have lots of experience weeks and months.

Assuming you’re up to this superhuman task, let’s compound it with a few problems:

  • You work for a large, bureaucratic, inefficient and slow-moving organisation. You’re trying to organise this on behalf of and with the help of another large, bureaucratic, inefficient and slow-moving organisation.

  • Many of your key decision-makers are not in the office. Some of them are sick. Some are in intensive care. Including your boss.

  • Many of your lower-level staff are also off sick or have child-care issues to deal with because all the schools are closed. It’s a bit like trying to organise this during a Bank Holiday.

  • This is true of every single organisation you’re dealing with. And there are hundreds.

  • There’s a global shortage of materials needed to make your products. Many of those suppliers are just not operating at the moment. Sometimes their governments wouldn’t even let them sell it to you if they could.

  • There’s a global demand for the product itself. Everybody else is trying to buy it, as well as you. Not just everybody nearby. Everybody in the world.

  • You don’t actually work for or have any real authority in most of the companies concerned.

  • All of this is costing you way, way more than it normally would.

  • If you do manage to manufacture this product, then all the delivery drivers who might eventually distribute it for you are busy delivering other things.

  • Sorry, did I say this product? You’re actually trying to do this many times over, for a whole range of different products.

  • And every day, journalists are badgering you with questions about why you haven’t finished it yet – don’t you know people are dying out there?

Now, given all that, I don’t know about you, but I’m not 100% certain that, even if I were Secretary of State for Health, I’d actually be able to sort this out in the next couple of weeks so we can all go back to work.

Would you? OK, make sure you stand for parliament next time around, so we can elect you before the next crisis hits, and it can then be your name in the papers. Personally, I fancy that role even less than I fancy being a health worker with insufficient PPE!

Clapping to a different beat?

There have been a couple of evenings recently when UK residents have been encouraged to go outside and clap and cheer for all our wonderful health workers who are doing such a great job. This is, in many ways, a good idea, and I would have joined in, had I known about them in advance! (We’re a little bit isolated out here and so didn’t hear about them until the following morning.) It’s all rather cringe-worthy, but a significant proportion of my family work for the NHS, and a large number of friends, and they’re working very hard in difficult circumstances. Some of them have come down with coronavirus themselves. So, yes, I probably would have overcome my natural reserve and clapped, at least if anybody other than passing rabbits would have heard me!

I was interested, though, today, to come across this thread on Twitter where a large number of people, mostly who work for the NHS or in healthcare, were expressing their discomfort with the idea, for a variety of reasons.

They had various motives, but the key one seems to be that politicians who have voted against increasing NHS funding have no right to praise those who are now having to be heroes as a result, and certainly not to lead the public in praising them in this low-cost way.

Others say that anyone who voted for those politicians should also not be outside clapping.

My view is that anyone who is not willing to pay a substantially increased personal tax burden should also have pause for thought. I’m guessing that, to have the service we’d all like, we should be thinking of paying about £1000 per year more per family member. (And yes, people who choose to have children would, and of course should, pay more.) However, the country as a whole has been given the opportunity to make rather more modest contributions than that on more than one occasion, explicitly earmarked for such things as health and education, and has turned it down.

I base that £1000 figure, by the way, on the fact that Rose and I have to pay rather more than that for a basic level of private health insurance, on top of what we currently pay for the NHS. We are fortunate to be able to do that, but it’s not because we’re particularly wealthy. We’re clearly a very long way from being poor, but we work for a university and are still, most years, basic-rate taxpayers, not high-rate. So this is a significant chunk of our income, and it’s a luxury but also a kind of voluntary taxation: yes, we get much better service, but in exchange we don’t have some other luxuries, and it doesn’t free us from paying for the NHS: we do that too. But we’ve placed much less burden on it, over the years, than we would have done otherwise.

If, by paying that amount to the NHS, I could be confident of all of us getting the improved level of service, I’d be happy to do so! Instead, at present, we pay so that thing are a lot nicer for us, and a little bit nicer for others.

The problem is that under-resourcing, though clearly a significant challenge, is certainly not the whole story.

On all three of the last three times I’ve had to go to NHS hospitals because friends or family have been there, I have been struck by the many wonderful, cheery, helpful workers… but also by the quite extraordinary levels of administrative incompetence. I encounter employees who would never be able to keep a job if this were a commercial enterprise. I experience procedures which, if they were followed so poorly in a business, would quickly result in that business no longer existing. (Though to be fair, that’s often true of many public bodies.)

And this, I’m sad to say, has been my almost constant experience. On both of the last two occasions I’ve had friends or family staying overnight in hospitals, they have occupied a bed for a whole day longer than necessary. Why? Not because they were still sick, but because the doctor literally forgot to come and discharge them before going home at the end of his shift. Two different hospitals. Two different doctors. Two different patients. Same problem. Actually three doctors, because one friend was forgotten twice in a row, though I think one of them might have been the nurse’s fault. They are not just short of hospital beds for lack of funds!

And this malaise is not just in the area of patient care. I remember when, as a struggling startup company, we were trying to sell a product to our local NHS hospital. They liked it, they wanted to buy it almost immediately, the cost was trivial, but it still took them more than a year to go through their procurement procedures and write us a modest cheque. Even then — and this was explicitly explained to me — they only managed to get it to us because somebody persuaded the person responsible for the relevant account to stay for a meeting which finished after 5pm. He was annoyed, and made it clear, because he normally went home soon after tea-time, at around 4.30pm. For those of us working long hours and weekends to produce the product, we just had to laugh. I know from talking to other technology providers that our experience was certainly not unique. But that was then – what about now? Well, now, remember this story when you hear that they can’t get the supplies they need.

These are just anecdotes, of course – I have no knowledge of the bigger picture on any statistically-valid level. I speak only of what I’ve experienced. But I have certainly not exhausted my stories: those are just a couple of the more worrying examples.

So yes, I love the NHS. I’m enormously grateful for what they’re doing now. And yes, I wish it were better resourced.

But anyone who thinks that somebody else will pay for a better service for them is living in cloud-cuckoo land; we all need to be willing to stump up significant amounts of cash. How many of those people out there clapping think that the problems now being experienced are all somebody else’s fault?

Anyone who thinks that money is the only problem, or that the politicians are the only problem, is similarly deluded. In this country it is very unpopular to talk about any degree of commercialisation of the NHS, and clearly that’s not a silver bullet: one only has to look at the costs of drugs in the USA for an example of how commercialisation can get out of hand.

But so far, nobody seems to have come up with a good way of instilling the disciplines and efficiency and levels of accountability that govern the commercial world into the public sector. And until they do that, it seems to me, we will continue to have some situations where we just have to rely on some people being heroes.

Why I really am awfully lucky…

A gate in Coton

Two and a half years ago, after a couple of decades living happily in the centre of Cambridge, we moved out to the countryside.

Here, that only meant a move of about two and a half miles, but it made a big difference; we basically did a simple exchange: swapping proximity-to-things for space. We got a much bigger detached house in exchange for a small terrace; fields and woods right outside the door; and some real luxuries like a spacious driveway and a garage: things we’d never owned in any size or shape before! The house was almost exactly the same value as the one we sold, so the only major cost involved in the move was a very hefty whack of Stamp Duty.

The current coronavirus lockdown, though, has made me realise just how fortunate a decision that move was. Having more space, both inside and outside the house, makes such a difference in this current climate.

I can’t imagine living in London at the moment. It’s not something I’ve ever particularly wanted to do, but it must be even worse now, though at least a lot quieter and less polluted than usual!

The people who must really be suffering, I imagine, are those working from home, with kids, in a small London flat. I really take my hat off to anyone in that situation who is managing to keep their sanity intact! I’m grateful once again that we decided not to have kids… though I suppose, by now, they would have grown up, moved out and would probably have little viruses of their own.

And finally, since, for many years, I’ve been working half-time from home, we’re well set up for that, so no real changes have been needed on that front. In fact, having my wonderful wife-and-chef working from home too has made most days a gastronomic delight.

All in all, then, we’re amazingly lucky in our version of the Covid-restricted life.

It’s tempting to put some of it down to good judgement. Our past decisions not to live in a big city, not to have kids, not to have high-pressure office-based jobs, to focus on dog-walking more than income-generation, and (recently) to live in the countryside, have all contributed to a good quality of life in general, and a particularly easy transition to the one we’ll be living for the next few months. If only I could claim to have foreseen the inevitability of a global pandemic, I could actually claim some credit for them!

But I do recommend at least some of them, for anyone considering big life-changing decisions in preparation for when the next virus comes along. Because it is a sobering thought, even here in Arcadia, that this almost certainly won’t be the last.

Keeping active during a lockdown

As a result of the virus, and its effect on my consultancy clients, my ‘work’ has fallen to about half its normal level. I hope this doesn’t carry on for too long, because my income has also fallen by about two-thirds. But, just at present, I’m rather enjoying it, and, as people usually say when they retire, “I’m busier than ever”.

The fact that it’s been sunny here at the same time is just icing on the cake. I’ve even been doing some serious lawn maintenance, which perhaps indicates that I’m closer to retirement than I had previously thought. (I used to joke that I knew I was getting old when I voluntarily went to a garden centre as a weekend activity. But in recent times it’s been even worse: I’ve noticed that I’m not even the youngest person in the garden centre! Sigh.)

Anyway, since I have no kids to home-school, the lockdown’s giving me an excuse at least to start catching up with the huge backlog of tasks that I’ve been putting off for months. There are the important ones, which I’m sure we all attend to first: tweaking the configuration scripts in our home automation systems, for example. Making sure our lightbulbs have up-to-date firmware. Redeploying our web services using the container orchestration framework du jour. That kind of thing.

But eventually we get to the more mundane but essential tasks of daily modern life. You’re probably considering some of these too:

  • Is my home and off-site backup system working reliably?
  • Are all my family members using a good password manager? (And can they get access to mine if anything should happen to me?)
  • Do I still have any remaining email accounts with so-called ‘free’ providers, who read it in order to sell me things?
  • Have I merged all the photo and video projects from my laptop onto my main desktop machine?
  • Is my blog properly backed up, and where?
  • Are there any rooms in the house which don’t have proper ethernet cabling yet?
  • What do I still need to scan in my filing cabinet before I can be truly paperless?

Fortunately, I have plenty of other projects to distract me before I can get down to these, which means that we may need to be in lockdown for some months before I actually do old-fashioned things like descaling the coffee machine or looking through the piles of dead trees in my in-tray.

And this is good, because it’s important for people to be able to stay active in their old age.

Especially when the garden centre is closed.

A Network for the Un-networked?

Suppose you’re an older person who has been told you should really stay at home. You have no symptoms, but you decide to go into voluntary total self-isolation.

It’s not easy and you get pretty lonesome, but presumably, after 14 or perhaps 21 days, you have proven yourself to be safe. You could then walk, drive or cycle over to visit any friend who had been through the same purification ceremony, without risking either of you.

There could be a society for those who choose to do this proactively, for those who have sworn an oath to forego all human contact for a short period now in order to have a restricted amount of it thereafter. First of all, though, it needs a name.

I suggest “The Lone Rangers”.

Some more Coronastatistics

In a response to my post yesterday, my friend Jonathan pointed me at this excellent article by Tomas Pueyo. It’s long, and I’m not, of course able to check many of his numbers, and there are some places where he has to make estimates and assumptions, and rely on official Chinese figures more than some would think appropriate. But you should read it none the less; the basic model is very useful. I mention some highlights below.

My question yesterday was about when the virus-based health risk of travelling to an event in the UK would actually become more serious than the risks involved in the road travel to get there. Italy has passed that point (and their road-death statistics are much worse than ours!) My own guess while writing was that it would probably be about two or three weeks here, and it hadn’t escaped me that confirmed cases are a week or two behind the dates when those people actually contracted the virus, so probably the real answer was that coronavirus would be more dangerous than driving in the UK in about a week’s time (using my very crude metric). Others have pointed out that the stats suggest that we’re not that far behind Italy, so coronavirus may already be more dangerous than driving.

What I hadn’t fully appreciated, and this is the thrust of the article, was just how effective a lock-down can be. A key graphic is this one:

(Click for a full-size version)

The orange bars show diagnosed cases. The grey bars show when infection must actually have happened; something you can only deduce with hindsight, because it takes a couple of weeks. At the time Wuhan went into lock-down, they had 444 reported cases. There were probably about 12,000 actual cases at the time waiting to appear. And if we believe the official figures, the growth stopped pretty instantly once they imposed a lock-down; the kind of lock-down that perhaps only an authoritarian regime can effectively implement.

At the time, of course, this wouldn’t have been clear; the number of reported cases would have gone on rising for another 10 days or so.

Pueyo then goes on to demonstrate the effect of delaying this kind of lock-down by one day — the very significant impact it can have on the number of cases that actually appear.

This in turn affects the ability of healthcare systems to cope, which then affects the mortality rate, and so once you pass a certain threshold, the impact of each day’s delay is amplified more than you might expect. He posts this graphic by Alexander Radtke – I’ve seen similar ones online recently:

You’ll note that this graph is purely an illustration of a concept without any real data, but it’s a useful one. What’s good about Pueyo’s analysis in general, though, is that he’s trying hard to use real numbers wherever he can. He may be right, he may be wrong, and in particular his analysis may be more or less relevant to the particular situation in the UK, but it’s worth taking seriously.

So, today’s update:

  • Coronavirus in the UK will very soon — probably in a few days — be more dangerous than driving. Maybe even more dangerous than Italian driving. But still not a cause for panic.

However,

  • We’ll know in a couple of weeks just how dangerous it is today.
  • By then it will be a lot more dangerous.
  • Waiting to find that out is the best possible way to ensure that it will be even worse!
  • We’re at the point where each day is very significant.

Therefore:

  • Actions like panic-buying of loo rolls are not a rational response to something that is currently much less dangerous than the drive to the supermarket.
  • Actions like locking down the entire country to restrict movement as much as possible may actually be a perfectly rational response to the same thing.

Fascinating stuff.

Now, here’s my next question:

You may remember the analysis a few years ago that showed that more people died after the 9/11 attacks than during them. This was because so many people were scared of flying in the following days and weeks that they drove long distances instead. Driving is so much more dangerous than air travel that the resulting death toll was higher than that on the day itself.

Now, one result of coronavirus lock-down, I hope and expect, will be that a lot more people will discover the practicality and benefits of working from home. (I’ve been doing it half-time for many years, using long Skype calls to keep in touch with my colleagues, some of whom are only a few miles away.)

If this continues on any scale after the virus threat has receded, how long will it be before the number of lives saved by the reduction in mileage and air pollution outweighs the lives lost in the epidemic?

Update: please read the comments below as well!

Some Coronastatistics

At the time of writing, the number of deaths in UK as a result of Covid-19 since records began is six. Interestingly, that’s about the same as the number of people who died on UK roads…. yesterday. (The number who sustained serious injuries yesterday is about 11 times as high.)

Now, I don’t want to minimise the virus threat, and I do understand that one of those numbers is likely to increase exponentially while the other isn’t, etc. So I’m also taking appropriate precautions like everyone else. But it also explains why I’m happy to go out to a restaurant for dinner tonight… even a Chinese restaurant! If we manage to survive the journey there and back, any sources of contagion we might encounter in a busy restaurant should be child’s play in comparison.

Ironically, Italy, which is suffering a much more serious viral issue than we are, also has one of the highest rates of road fatalities in Europe. Their death rate from the virus has now reached 631, which is about twice as many as road deaths — even at Italian rates — in the same period. We are still a very long way from that here, for the time being, at least. There’s something to be said for living on an island.

For UK readers, though, I think this is an interesting metric to watch, though, to keep a rational sense of the scale of the problem: How long will it be before letting your kids go to a sporting event at school is actually more dangerous than driving them there and back?

**Update: see the next day’s post. **

Inverse Covid-19 protection?

For the last two or three years, I’ve been getting a ‘flu vaccination in the autumn. In the past, most winters would see me knocked out for at least a few days, maybe a week, at some point by a ‘flu-like bug. But once I discovered how easy it was — for people in the UK who aren’t eligible to get it free on the NHS, you just book an appointment at your local Boots and pay 12 quid — I realised this was a small price and well worth paying! Recommended.

Now, the jab obviously won’t protect you against the current coronavirus. It doesn’t even protect you against all strains of normal ‘flu. But it occurs to me that if everybody had had a recent injection, it would probably stop a lot of false alarms. You’d be much less likely to come down with something ordinary that might cause you unnecessary concern, and when you did start exhibiting ‘flu-like symptoms, you would be able to take them more seriously.

I don’t, however, know anything about the seasonality of this. New vaccinations are usually developed to cover the winter period, and I’m not sure about the value of taking one now that was created that many months ago.

But it seemed to me an idea worth considering. Is it worth doing an updated spring vaccination to help protect you against current bugs that are not Covid-19, just to assist with the detection of the real thing?

Heat Haze Hospital

There are many benefits to living close to Addenbrooke’s Hospital, but, as any Cambridge resident will tell you, its effect on the aesthetics of the region is not one of them. Usually the best way to improve its visual appearance is to go a long way away. And then face in the opposite direction.

Even Addenbrooke’s can have its moments, though. It’s about 4 miles from my house, as the crow flies, so this was taken with a long lens from my kitchen window.

Breaking good

breaktimeI keep hearing about research that shows how your life will be dramatically shorter and more problematic if you spend too much of it sitting in front of a computer.

Some of this, no doubt, is encouraged by the manufacturers of the standing desks, and even treadmill desks, which are to the young entrepreneurs of today what the Aeron chair was to the dot-com startups of yesteryear.

But whether or not you believe the more worrying claims of reduced life expectancy, I think we can agree that it’s not a bad idea to get up and stretch your legs from time to time. Maybe have a bottle of chilled water, if you’re from California, or a nice cup of tea, if you’re British.

So I’ve been rather taken with a little Mac app called BreakTime, which will pop up and nag you when you’ve been working at your computer for too long at a stretch. You can choose the time periods: mine requires me to have a four-minute break after 56 minutes, for example, and you have some control over how persistent it will be: are you allowed to dismiss it before the four minutes are up? It also makes sensible decisions if you leave the machine of your own accord first, and resets the timer when you return.

I find, to my surprise, that I really like it: I’ve put it on all my machines, and what it highlights is just how difficult it is to keep track of time myself. I’m amazed how quickly an hour of sitting still can fly by when I’m deep in concentration. Even if I do little more than stand up and tidy some things off my desk, I’m sure it’s a good discipline.

There are several other similar utilities out there, but BreakTime works well for me. Recommended.

Update: Tim Green, on Facebook, pointed out Workrave, which does something similar for Windows and Linux. I’m linking to it here because, of course, you can’t search Facebook – even your own history (something I still find incomprehensible).

© Copyright Quentin Stafford-Fraser