21 February 2022

Your life expectancy is dropping

 Yes, really.

Whether or not you personally have had COVID-19 in any of its variants.

Whether or not you personally shall ever have COVID-19 in any of its variants.

Of the things we can alter (the past we cannot alter, which is where both what's already happened to you and your genetic inheritance reside), life expectancy sits on public health -- clean water, restaurant kitchen inspections, vaccination programs, and so on -- and the health care system.

Public health is subject to the same mammonite pressures (that is, abolish it as a barrier to profits) as everything else; public health is subject to the same supply chain problems as everything else.  Public health is subject to the same labour shortages as everything else.  It's at the very best not improving.

The health care system's damaged; the health care system's actively ablating as trained personnel are lost faster than they are being replaced.  The people still working in the system have been traumatised and aren't making the decisions they might have made without that trauma.

"Oh, well, the future's pretty terrible, I don't care if I live to get old" is one response to this.  It's mistaken -- lost life expectancy doesn't wait for you to get old, on the one hand, and the current likely outcome for someone in most of the developed world is that the health care system does keep you alive, but it doesn't manage to do anything about restoring quality of life, on the other.  But that is certainly a response.

A politically nihilistic response, that's not going to do anything fortunate for those of us who still don't want to die.

So what can we do?


Thing zero is abolishing mammonism, which means income and asset caps, so no one is all that much richer than their fellow citizens and democracy has the option of functioning.  That's going to take awhile, but it's important to remember that's where things need to go.

Thing one is making the effort and paying the money to build a health care system that can cope; that means things like doubling medical student admissions, something like quintupling nursing student admissions, getting an operations research team or six involved in rooting out the "of course a doctor can work a 12 hour shift and make excellent decisions the whole time" 19th century structural hangovers, and most places in the OECD, building more hospitals; get the (staffed!) beds-per-thousand ratio up to 10 or higher.  Find the logistical bottlenecks -- including in specialist training -- and fix them. That's going to take awhile, too, but not as long.  (Do it by training to excess of requirements; we want this to be a global fix.)

(Yes, this does involved admitting that medical care, most places, is rationed by system cost, not outcomes, and that this was not a sensible policy decision to make; that the structure of the question was wrongly chosen, and not just about this.  Facts are only so patient; eventually one must deal with them.)

Thing two -- which ought to be entirely obvious by now -- is policy that acknowledges that COVID-19 will not go away on its own, and that the presently rich who are trying to insist that it must are doing so out of a self-interest that literally does not care who dies, if society keeps functioning, or if humanity goes extinct. (That one is more fossil carbon, but the indifference has been built in to the response to anything else.)  

COVID-19 will go away if and only if we get our collective act together and kill it.  The sooner we kill it, the more comprehensive and complete an effort we make to kill it, the less it costs.  Costs in money, time, people, anything.  Full mobilisation happens because it works, and you can't afford to lose.  COVID-19 is one of those things and this is one of those times.

(Where I live has a long way to go: https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_REAC and a five-year surgical backlog that only stays that short if there isn't another COVID wave.)

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