In Episode 7 of his new book, author Julian Roup looks at the fear of going anywhere near a hospital thanks to Covid-19.
In case you missed Episode 6, click here.
Life in a Time of Plague
Sussex, 14th April 2020
By Julian Roup
To most of us without medical knowledge or more precisely an understanding of the behavior of epidemics, this has been a confusing time as we grapple to understand our government’s response and its attempt to protect us.
Slowly, however, the picture is becoming clearer. Leading immunologists give us two scenarios. The first is what happens naturally in an epidemic without medical intervention. In this case, the disease sweeps through a population killing many, hardest hit are the sick, elderly or frail – those whose immune systems are already compromised. Younger people with strong immune systems and the resilience of youth survive in greatest numbers and finally a ‘herd immunity’ is established.
It is interesting to be reminded by the phrase ‘herd immunity’ that we are after all just another species of herd animal.
This scenario poses a huge problem, especially for unprepared governments like our own here in the UK, which has over the years run down funding for the NHS which now is desperately short of doctors and nurses and the technical equipment needed – respirators, drugs and the personal protective clothing (PPE) that we hear so much about. Politically, the Government can’t be seen to simply stand by and let nature run its course while grannies and grandpas, mothers and fathers and even children die like flies. And it also needs to ensure that the shaky medical infrastructure is not totally overwhelmed.
So we see the second scenario – an attempt to intercede in some ways to slow down the natural ‘herd immunity’ process. Every effort is put into “flattening the curve” of the disease, spreading out the spike of highest deaths over a longer period to help our hospitals cope, to avoid being simply overwhelmed. So that is why we get the ‘lockdown’ process adopted by almost every country on earth, with one or two exceptions like Sweden. But this lockdown policy brings its own downside: the duration of the epidemic’s impact is lengthened in time and this has all sorts of human and economic costs of its own.
One of the first collateral impacts that we are already seeing signs of are the non-related medical impacts. People who need hospitalisation are not going to hospital because they are scared of getting coronavirus there, a very real possibility. And many thousands who need attention for cancer treatment, heart treatment and other acute medical needs are not getting attention, as all medical effort is now focused on fighting one enemy and one only: Covid-19.
So by the time the dust settles on this debacle, the death toll for this period and the health damage caused to the general populations will be much greater than that caused by coronavirus deaths alone. Epidemiologists tell us that by the end of the pandemic, 80% of us will have had coronavirus – impacted mildly, almost unnoticed, or at its worst, violently and fatally. As a percentage, deaths are predicted to range from 1% to 3% of the population, the greatest toll being among the elderly and the poor who have little chance of self-isolation or social distancing.
Then there is the economic impact of the pandemic to national and private economies to consider. We are about to see a fall in GDP at least as great as the 6-8% drop seen after the 2008 economic collapse and maybe much greater; nobody at this stage has any real idea, except that it is going to be crippling. At a personal level, greater poverty will ensure that on average all of us will live at least three months less than we might otherwise have lived.
Mental health is also being negatively impacted, and that too will have a cost that each of us will have to bear financially as taxpayers, and personally with relatives who suffer. It is a daunting prospect.
As I listen to the news and process the tidal wave of information, the Easter weekend has ended in a cold snap. The warmth of recent days is gone, and the skies overhead are grey.
What would normally have been a very busy week, with millions returning to work after the Easter break, roads and ports and airports jam-packed with bleary eyed travellers and commuters heading back to the nine-to-five routine, is now deathly quiet. A deadly stasis hangs over us all as we cower inside our homes. Only the hospitals are hives of activity as doctors and nurses, ambulance teams, porters, cleaners and myriads of others who make up our medical infrastructure battle on night and day against this enemy.
As someone who has pronounced hermit-like tendencies I cannot say that I have found this enforced purdah a problem. I welcome peace and quiet and am delighted to have fewer people at our front door. In recent years, I have found the increase of Amazon deliveries a growing source of irritation. But now packages are simply left at the door, as drivers keep their distance.
Thinking and writing about my experience of this strange time, I miss having an old schoolmate and family friend, the late Professor Robert Shell, to speak to. Rob, a distinguished historian whose subject was slavery and pandemics, would have been the perfect person to discuss these events with. His personal irreverence for everything was matched by a huge and forensic intelligence that he brought to his work, and his books remain essential reading for those studying his subjects.
I remember fondly his telling me of how, when at Yale, studying for his doctorate, he would make it a rule to stand while reading the Wall Street Journal or the New York Times, to focus on the essentials before his knees gave out. He was awarded his PhD in 1986, with a thesis entitled “Slavery at the Cape of Good Hope: 1680-1731.”
He is so very much missed. His uncompromising directness and honesty led to a falling out with the then South African President Thabo Mbeki who took exception to comments Rob made about his handling of the HIV-Aids epidemic in South Africa. No doubt Rob would have had piercing insights into the current tragedy.
The news today is that both Spain and Italy are slowly, cautiously, getting back to work. In Italy, touchingly, shops selling children’s clothing are among the first to be allowed to open, and in Spain it is construction and manufacturing that are going back to work.
Today I intend going for an hour-long walk in the woods, a circle walk down the back hill to the river bridge and south along the stream to the lake, crossing its retaining wall and then up the hill home. My quarry is bluebells. I will take Gus with me, and he will doubtless keep the squirrels on their toes.
Click here for Episode 8.