As Christmas approaches along with the promise of a brand new year – Professor Joe McDonald looks at the best and worst times of 2020.

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair.” – Charles Dickens, A Tale of Two Cities.

Joe Column
Joe’s first grandchild, Joseph Arlo McDonald (left) and his Auntie Pat (right)

Auntie Pat (above right) was a beautiful woman with a beautiful singing voice. Before she retired, she was a dental nurse by day, but by night she was a leading lady in the South Shields Operatic Society for many years.

Quiet and a picture of propriety off-stage, she was transformed into a star when she stepped out into the spotlight. She sang Ave Maria solo at my wedding 30 years ago. After the death of her beloved Jim, she became  a regular visitor to our Christmas dinner.

She was an early victim of the, entirely predicted and avoidable, second wave of Covid-19. She died in hospital in the company of strangers on 29 September. The worst of times. We were unable to attend the funeral that would otherwise have drawn her usual crowd.

Pat’s death was clearly the worst news of our family year but, in contrast, the best news of our lockdown times was the birth of our first grandchild, Joseph Arlo McDonald (above left) – who will be known as Arlo to avoid confusion with other Joe McDonalds of this parish. The best of times.

“You’re on mute”

Last Christmas was an entirely normal and joyful affair in the McDonald household, no empty chairs, 23 people for dinner from 8 different households, illuminated jumpers, inflatable antlers etc.

One of our usual guests, Tom, who organises the after-dinner Boys Vs Girls Christmas Quiz, was working in Australia – but being IT types, we organised to beam him in on a video conference call.

We all marvelled at the quality of the picture live from down under but there was no sound. “You’re on mute” we bellowed. Little did we know this would become the mantra of 2020.

My daughter, a junior doctor, led the girls to victory in the quiz but three months later she would contract Covid-19 while sharing PPE with her nightshift colleagues. She recovered. The best of times, the worst of times.

Rolling out digital strategy in weeks

It has been the best of times for NHS IT teams. In my trust the award winning CIO Darren McKenna, and his team, rolled out a five year digital strategy in five weeks, took mental health services online and enabled clinical staff to work from anywhere with a decent internet connection, including some psychiatrists unable to get back from India.

We had already adopted Microsoft Teams, but its national roll-out has enabled a new level of interorganisational communication.

Graham King, CIO at NUTH NHS Trust and the Great North Care Record team rolled out a Health Information Exchange which is used nearly a quarter of a million times a month, in the middle of a pandemic. The best of times.

It has been the worst of times for other aspects of health IT, largely where it was outsourced rather than delivered by local NHS teams. My back of a fag packet calculations suggest NHS Test and Trace has so far cost £440 per citizen. We could have bought everyone a smartphone.

Bring on Christmas 2021

This Christmas will be weird, limited to three households we now have to pick and choose our members, choose between grandchildren and grandparents.

Next Christmas is the one that matters, forget this one. Next Eid, Next Diwali. Next pandemic.

The vaccine offers a spring of hope after a winter of despair which will likely include lockdown 3.0 because of Christmas.

Post vaccination, which I am confident the NHS will deliver, it would be easy to relax and go back to normal, but instead we need to be ready for the next pandemic.


Just about every country in the world has stood up a Covid contact-tracing app based on the thin gruel of Bluetooth connectivity functionality allowed to us by Apple and Google. The jury is out on whether any of them will make a significant difference but anyone who bought a Bluetooth headset to deal with back to back video conferences this year knows just how flaky that technology can be.

On the other hand, Google and Apple already know where (nearly) everyone is (nearly) all the time if you have location services switched on. So here’s a suggestion, Google and Apple work together to develop a pandemic app to be shipped with every new phone sold next year and pushed to every existing phone as part of operating system updates.

Let’s call it PandemApp. Make it compatible with old phones. Hiding behind a privacy fig leaf can’t excuse the big two telling our democratically elected governments what they can and can’t do. Apple and Google could make it a Christmas present to the world next year.

Regular readers will know I am passionate about preserving patient trust in health IT by making sure that patients record remain “inviolably secret” in the words of Hippocrates. Clearly some people would have concerns about Google and Apple sharing information with the government or the NHS.

Secret of consent is to get consent

So, let people decide whether they turn on PandemApp or not. As ever, the secret of consent is to get consent. As a card-carrying privacy nut I, for one, would be willing to suspend my privacy rights for a while, in order to ensure next Christmas is a full, joyous, inflatable antlers on every head, eight household, 23 for dinner, Christmas.

I suspect most of the public would feel the same. More importantly I would happily give up my right to privacy, for a while, to prevent another 60,000 empty chairs next Christmas.