Any disease from any vector depends for its lethality on the state of the patient's immune system. There's always someone who recovered from a disease that laid waste to the rest of the town. And someone who was unaffected. What made HIV so shocking was that it was the first virus that attacked the immune system: patients did not die from HIV, but from what they caught because HIV had weakened their immune system. At the moment the way SARS-Cov-2 works is not known. Like all diseases it hurts people with compromised immune systems, and it seems to do more damage to people with existing conditions that would have killed them in the next couple of years. Perhaps those conditions rob the body of its ability to fight the virus. Perhaps it weakens the body and the existing condition then finishes the patient.
Whatever the mechanism, the effect is the same. Hospitals are full of people with compromised immune systems and in poor shape. (Also expectant mothers and people who broke something in an accident - both those groups generally have sound immune systems.) So once SARS-Cov-2, or any other virus with similar characteristics, gets stuck into a hospital building, and in the staff, it kills people. Just like MRSA. Or a bad flu. Nothing new, but a lot more effective.
Many of the people with compromised immune systems and multiple conditions are old. There are a lot of old people in Western populations: a far greater proportion than at any time before. That makes SARS-Cov-2, and the ones that follow it, much more visible. When I was born, most men died before 70, and their wives survived not many years more. Now they live to eighty and beyond.
Western economies can afford to build large central multi-disciplinary hospitals. Such super-hospitals make qualified doctors, consultants, surgeons and other specialists highly productive. Because they make a small number of professionals highly productive, all the professionals are in the hospitals. Anyone needing more than simple care has to go to a hospital because that's where the productive professionals are. So all the vulnerable people wind up in hospital.
So a SARS-Cov-2 or similar virus turns a super-hospital into a killing house. Not because the virus is so awful, but because super-hospitals are where the NHS put its potential victims.
We have learned from the SARS-Cov-2 experience that the viability of the NHS depends on the parameters of the next virus. If the asymptomatic incubation time is too long, if the proportion of the population who are asymptomatic is too high, if the lethality (the ratio of death to infection) is too high, if it persists too long on the surfaces of hospitals and workplaces, then the hospitals become killing houses and have to be shut down.
Or the hospitals can be left open, and the rest of us shut down. Which is the choice Governments all over the world made in 2020.
Those governments thought super-hospitals were the solution. And so had to be "saved". Thus creating the insanity whereby to protect the resource that cures people, people have to be denied access to the resource that cures them.
In fact, super-hospitals are the problem.
People should not be turned away from A&E because of a virus that harms the patients two floors up in another annexe.
Put the children, child birth and maternity activity in a separate building. A&E can have its own building as well. Not annexes of a super-hospital, but in separate buildings, preferably in different postcodes. Under different organisations. I don't know enough about medicine to know what else could be hived off to stand on its own. Inevitably there will be a building for the care of people with compromised immune systems and complications: that will be the big one.
The super-hospital is now a liability, not an asset. It needs de-centralising.
Or it won't be there when we next need it. It will be closed.
Or we will be.
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