Cancelling society to save lives

A wise retired surgeon said on a radio phone-in yesterday that, just a few years ago, we wouldn’t even have known about COVID-19 until the pandemic was past its peak, and we would probably have concluded that it was just a particularly bad winter for elderly deaths from respiratory disease. Maybe ignorance is bliss.

I think he’s right. I don’t even remember the last significant pandemic, Hong Kong flu in 1968-9, except by name, though I lived through it, and I do remember revising for A-levels, looking forward to the moon landings, getting my first guitar and liking Jethro Tull. My parents and elderly grandparents were not affected, and nor were my future wife’s. Although 80,000 excess deaths occurred in the UK that winter, life went on for most as normal.

That figure of 80,000 is to some extent comparable to the possible maximum of 400,000 suggested in the current pandemic:

Professor Neil Ferguson, of the School of Public Health at Imperial College London…insisted he was not predicting 400,000 deaths, but was warning that the figure ‘is possible’. He said he would ‘prefer to be accused of overreacting than under reacting’. (Daily Mail)

But unlike Coronavirus Hong Kong flu also killed many infants, rather than only those approaching the end of life anyway. Individual tragedies all, but it didn’t even make a blip on economic growth or corporate profits.

I’m in the at-risk age group for this one, but have known for years that I might die at any time from a coronary event or some form of cancer: dying’s what you do as you get old. Most octogenarians I know feel they’re on borrowed time anyway. A 1% death rate, and 80% prevalence, means around 3 deaths in my small village. We have that many some winters anyway.

I think, however, that there’s some utopian thinking going on in the present “shut the world” management plan, apparently based on the illusion in our liberal democracies that stable societies exist by default, and economies are just there to provide unnecessary luxuries. Actually economies are there to keep mass-starvation at bay, and without fully-functioning societies there are no functioning humans.

Yet our government, like most others in the world, is determined to reduce, or at least slow down, the deaths by pressing the off-switch not only on the economy, but on society itself. This is an unprecedented global experiment, and I’m not at all sure it can be done successfully, or at least without a far greater cost than simply letting Coronavirus run its natural course. As is so often the case nowadays, Prof Ferguson’s precautionary principle may well be overreacting, at the cost of creating worldwide societal collapse.

For even while most of us know nobody with the disease, already whole industries have been abruptly curtailed, creating financial crises not only in travel, hospitality, entertainment, retail, child-care and many others, but for all the individual employers and employees who will have to put themselves in quarantine. Or who must stay home to look after children ordered to miss school until, perhaps, the end of summer, and forbidden from playing with their friends or stay with granny. After the 2008 crash, many jobs were threatened, but this time all my children’s families, not to mention every working person I’ve met, has been seriously threatened either with redundancy or the folding of their companies.

Government has announced £330bn of mitigation, over and above a generous budget, but this of course simply means borrowing against tomorrow’s burden of taxation. Austerity from the 2008 recession had already created a crisis in social care, particularly for the elderly. It is ironic to consider that the cost of trying to save them now might be far more deaths, over a much longer period, because of the inability to pay for their future social care. Even now, many elderly are wondering whether open-ended solitary confinement may not be far worse than the risk of a quick death after living fruitfully and convivially.

If governments’ responses to this pandemic do, as I fear, bring about a massive recession, then that in itself will bring many deaths, and those among the most indispensible members of society. Look at these quotes:

Financial crisis caused 500,000 extra cancer deaths, according to Lancet study
The global financial crisis may have caused an additional 500,000 cancer deaths from 2008 to 2010, according to a new study, with patients locked out of treatment because of unemployment and healthcare cuts.

The figures were extrapolated from an observed rise in cancer deaths for every percentage increase in unemployment, and every drop in public healthcare spending. (Telegraph)

Suicides associated with the 2008-10 economic recession in England: time trend analysis.
These findings suggest that about two fifths of the recent increase in suicides among men (increase of 329 suicides, 126 to 532) during the 2008-10 recession can be attributed to rising unemployment.(BMJ)

“Economic growth is the single most important factor relating to length of life,” said principal investigator M. Harvey Brenner, visiting professor in the Global Health Division of the Department of Epidemiology and Public Health at Yale School of Medicine. Brenner is also professor of health policy and management at Johns Hopkins University and senior professor of epidemiology at Berlin University of Technology.

“Employment is the essential element of social status and it establishes a person as a contributing member of society and also has very important implications for self-esteem,” said Brenner. “When that is taken away, people become susceptible to depression, cardiovascular disease, AIDS and many other illnesses that increase mortality.” (Yale News 2002)

We should add to that, of course, the effects on families scared of illness and desperately worried about their jobs cooped up with bored children for the next few months. Expect a few “Loving Father Shoots Family and then Himself” headlines down the road.

Magical thinking seems to pervade some of the comment on the prospective societal changes forced by the crisis, too. Twice on the news today, once from a lady bishop talking more about trees than about Jesus, it was suggested that the enforced removal of the evils of the industrial society would return us to the simple and pure pleasures of life, family, community, working fewer hours and having more time to reflect. Earlier my friend had rejoiced that all the nasty carbon-producing planes are on the runway (though oddly enough he flies regularly and I don’t!).

What planet are these people on? If the planes are on the runway, then all the aircrew, ground-crew, baggage handlers, administrators, travel agents, manufacturers, hoteliers and fuel-producers will not be enjoying the simple life and watching the stars – they will be economically desperate, working all hours at any job they can find to pay the rent and eat whilst stress fragments their families. Or else (since all the jobs are going belly-up) they will be lying on the sofa at home feeling increasingly worthless and depressed, and surviving on increasingly stingy welfare payments, since the new simple society will no longer be able to afford complicated benefits systems.

For better or worse, this may be a dry-run for the carbon-free society they were all hustling for before Coronavirus emerged: it will either plunge us all back into mediaeval living a few decades early, or shock us so much that we abandon the renewable caper and count the blessings of a society that is economically prosperous, and socially liberated from the draconian state controls (though, like Egypt after Joseph’s famine, government may find totalitarianism too valuable to give away now they have it).

One more extraneous thought on the British situation. A year ago, all the millennials were cursing the elderly for ruining their future by voting for Brexit. The economy did not collapse, after all. But what if some of them come to the realisation that the boomers are genuinely destroying the prosperity of the world in order to save their wrinkly skins for a year or two more? Our desperate attempts to control the forces of nature and deny our mortality may well be destroying the future for everyone, and no doubt old white males will get the blame.

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About Jon Garvey

Training in medicine (which was my career), social psychology and theology. Interests in most things, but especially the science-faith interface. The rest of my time, though, is spent writing, playing and recording music.
This entry was posted in Medicine, Politics and sociology, Science, Uncategorized. Bookmark the permalink.

6 Responses to Cancelling society to save lives

  1. Robert Byers says:

    Indeed as your chart shows its much ado about nothing as of right now. its not a epedemic but a potential one. indeed they want to slow it down. I think its from the same people who invented global warming humbug. they did poor sampling by looking at china and italy. Its not spreading fast or at all relative to numbers of people. Yet I agree with a shutdown based on a potential threat. yet its still a dumb reaction to a minor flu episode however new. Remember your chart numbers must take into account smaller numbers of people then, plus less movement of people, plus inaccurate tallys. one way or the other. Those were real epidemics and even then consrvative.
    They shut down everything here in ontario too. Wait a few weeks and see what happens. maybe a chance to discredit the establishment.

    • Avatar photo Jon Garvey says:

      To be clear i think the science is probably right, at least as it informs the UK government’s ongoing policies.

      Where my issue lies is that, as always, science answers tonly he questions you ask, and choosing the questions isn’t science. So it’s one thing to ask, “How can we minimise deaths from this pandemic?” But it’s a separate question to ask, “What harm will our measures cause downstream, including deaths?”

      In practice societies balance such issues every day, and not only in such contentious areas as rationing medical care, though all health systems have to (for example) reduce the facilities to treat cancer because millions of people also need their non-life-threatening joint strains treated.

      But although there are many road deaths each year, traffic is not banned because as a society we consider the many benefits are worth that cost (which, of course, we seek to reduce). We even pay people to take lives and put heir own lives on the line in the forces, because sometimes other factors – liberty, economic prosperity, etc – outweigh risk to life.

      So far the cost of UK interventions is, I hear, £1/3trillion. All of that has to be paid back later, together with the interest to the uber-rich lenders, by our 60 million citizens, over and above their other struggles to recover (including meeting carbon targets!).

      • Robert Byers says:

        Good points. I just note the complete decline in cases in china and the slowness of increase as evidence it was wrongly feared it would increase quickly .
        just a minor point about money. Remember if the money is being paid its going somewhere. into peoples pockets who pay taxes on it and spend it. There is only a loss of money if it leaves the country. Even lenders get taxed and spend the rest.

  2. Avatar photo Jon Garvey says:

    Here’s a sort of update: Prof Neil Ferguson (who, like Michael Mann refuses to release the computer code for his models) last week amended his predicted deaths from “up to 500,000” to 20,000.

    When various commentators remarked on such a drastic reduction, he tweeted that he had been misunderstood, that the original estimate still stood, and that the revision was based on the assumption of the effectiveness of the government’s drastic lockdown measures , which have come since I wrote this piece and which really do threaten to bankrupt the economy worldwide.

    But this explanation is surely palpable BS. The government’s strategy, they say, has been intended to flatten the curve of cases in order to manage the serious cases without overloading the NHS. It will not affect the totlal number of infections, containment having failed. It is still recognised to be the case that the virus will overwhelmingly hit the elderly with existing pathology, and they will still eventually get the virus, on current figures long before a vaccine is available.

    The question then is really whether a coping NHS, with sufficient ventilators and ITU care, could save these especially sick patients. The only figure I’ve been able to find on this is that, with artificial ventilation, 65% of all patients survive, but only 50% of the elderly.

    In other words, accepting Ferguson’s 20,000 figure for deaths (why, I wonder, when the models are a black box?), the aim of government policy is to save another 20,000 or so, the fatalities being those on whom the best care was ineffective. There is no way that ventilation will save the deaths of 480,000 patients who would otherwise have died.

    So what is the game here? It sounds very much like preserving his own reputation as a guru to governments, even if that means collapsing the economy. This, perhaps is what Mr Johnson meant by “the best science” – not the science that predicts correctly, but the science that sells itself most confidently.

  3. Avatar photo Jon Garvey says:

    Update 11th April: Today’s Telegraph headline: “Social distancing measures may need to remain in place ‘indefinitely’, government experts believe.” And a few days ago Dr Fauci was saying in the US that handshakes should become a thing of the past, not only because of the COVID-19 time-bomb, but to reduce deaths from other viruses such as influenza.

    It remains the case that all the current measures are designed to reduce deaths now by preventing infections, and therefore preventing the development of immunity against the hope that, at some indeterminate future date, an effective vaccine might be available. Until that time, on the current logic quarantine should remain and society stay shut down.

    My OP (well ahead of the journalistic field, I’m pleased to say) cast doubt on the very possibility of shutting down both the economy and society without worse consequences. But it’s actually a bigger question even than that: ask yourself why it was that nature developed immune systems, despite their incomplete protection, rather than evolving social distancing instead? Is it because it (ie God) had more sense than we have?

  4. Avatar photo Jon Garvey says:

    Just a late comment for posterity. History shows that when I posted this piece on 18th March 2020, infections nationally had already peaked a couple of days earlier, and in London, where the lockdown was being hatched, they peaked around 14th. Nature was already sorting the epidemic out, as it usually does.

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