There are likely as many pundits as there are opinions on what might be driving the disintegration of our healthcare systems. Whether you live in a country with private or public healthcare, or a blend of the two, it is all really the same. Certainly, in private healthcare systems, many more are financially destroyed by the onset of any kind of illness. In public healthcare systems, folks slide into poverty if they become disabled with any illness, as the inability to work makes them dependent on paltry and inadequate state disability payments.
Flickr.com: Rafael Edwards
Furthermore, public healthcare systems have been picked away at for about forty years or so as various interests seek to undermine them enough to make a private for-profit model seem more attractive to the public (that can afford it). The pandemic has likely been used as leverage to further this agenda, in keeping with the concepts found in The Shock Doctrine: the Rise of Disaster Capitalism by Naomi Klein.
Nursing accounts for 59% of the health professionals in healthcare. In the absence of an annual 8% per year increase in graduating nurses, there will be a shortage of 5.7 million nurses primarily in Africa, South-East Asia and the Eastern Mediterranean by 2030. What that shows us is that wealthy countries are able to attract nurses from these regions and even despite this fact, there are not enough nurses to go around. In 2019, there were 43,000 nursing vacancies in the UK that went unfilled as just one example of many countries in the Americas and Europe facing the same issue.
And of course, we have likely all read the recent coverage in all of our countries of the mass exodus of healthcare professionals because the pandemic pressure is not sustainable. Direct care is awash in exhausted and crushed human beings who cannot keep the pace of compassion and care going through wave after wave of suffering and death.
But as I have already mentioned, the pandemic has not caused these failures and has simply revealed the pre-existing decay. After forty years of consistently eating away at direct care in favour of the plumping up the executive and intermediary ranks, our healthcare systems were already far too brittle to take on any kind of pandemic.
What is most fascinating about the pandemic is that despite the unprecedented ability to actually reveal the nature of the virus (its mutations, spread and impact), we are not differing much from the paths of human responses to plagues for millennia. It is just the usual swirl of special interests and uneven and highly unequal distribution of pain and misery with the elite grabbing more of what they can.
As the public health function has been completely subsumed by political interests that in turn represent big money interests, there is no possibility that any western nation could mount a communal effort at this point to try to support those most vulnerable to the impacts of COVID. But the kicker is we are all vulnerable and yet have somehow absorbed the messaging that some are more vulnerable than others. Our vulnerability is communal because we are social primates and are impacted by the loss of those who are not as hardy as we might be ourselves.
The hardy guy who figures it will be the cold he just shakes off either discovers he is not as hardy as he figured he was, or he discovers that his cherished aunt or son are the ones who succumb to the “nothingfluburger” he passed onto them. The sixty-something couple who tire of all the rules to head off to Hawaii this season discover that their triple-vaccinated mask-wearing status does not help them when the wife has a serious fall down their condo stairs and she subsequently has a four-day wait for surgery and dies of secondary infections that simply could not be caught in time because it was a ward with 1 RN three weeks out of school to cover 40 beds and the ICU was over-full in any case.
This does not even touch on the issues surrounding Post-Acute Sequelae COVID-19 Syndrome (PASCS) or long-COVID. Given that any strain of SARS-CoV2 appears to do long-term damage to assuredly 10% and more likely closes to 50% of all cases (and it also looks as though that is true for those who are vaccinated with infection as well), no matter the severity or mildness of the initial onset, millions of families face profoundly altered futures with significant quality and length of life reductions.
We will not be going back from this nor will we be moving forward from this. But we can move forward with this.
Next week let us look at how anyone with an existing chronic illness is going to move forward with these realities in mind.