What does the future look like? Asking that question now is very different from asking it even six months ago. Six months ago, nobody would have thought that the majority of the world's population could be willingly confined to its homes for an indefinite duration, that businesses and shops would be shut down, grandparents denied visits from grandchildren, and that the UK Government would be paying people in the private sector a majority chunk of their salary for doing nothing.
I can no longer make predictions. This is because I am a sensible person. I know, along with most of the world's senior medical people and many of its doctors, that SARS-Cov-2 is an acute respiratory disease with minimal mortality (in the off-camera words of Russia's coronavirus Tsar) that does not justify quarantining us for our own good. I know nobody is at any more risk of anything unpleasant in a world with SARS-Cov-2 than they are in a world without it. The flu has killed more people this year. I have no idea how anyone can know that, and carry on with propaganda based on the idea that SARS-Cov-2 is so uniquely dangerous that it justifies us spending the rest of our lives two metres from each other, until, that is, we are all vaccinated.
I have no idea how the creatives at MullenLowe, who brought us the CoronaPropaganda, can look at themselves in the mirror. They set out to scare and confuse the British public, and they succeeded. In two years' time, they will be denying their participation in it, because they will be those bastards who lied to us. I have no idea how the print media could take its share of the £35m advertising budget, and provide many millions more in propaganda dressed up as news. Nor do I know how dozens of obscure academics could have allowed themselves to be used as instruments of propaganda, making unjustified predictions about the scale and virulence of SARS-Cov-2, and claiming that we might be living with restrictions for the rest of our lives. As if this was something real.
I am dismayed by the way that commentators, from preppers to Remainers, absorbed the quarantine into their views. The same way they are doing with the riots in the USA as I write this. They know the riots are mostly looters and other semi-organised Usual Suspects. Looting is not a political act. The commentators want to make sense of this. They can't.
Mistakes have no interpretation and make no sense, except as a mistake, a sign that someone did not know what they were doing, was short of the facts, listening to the wrong people. Mistakes tell us nothing about the world, except that it has people who are temporarily dumb. Persisting in the mistake has no other explanation but moral failure and practical difficulty. As the Swedes realised, quarantines of the healthy are too easy to get into, and too difficult to get out of. Interpretations of the quarantine, or of the riots, are futile.
There is nothing to understand.
Life does not go back to anything remotely like normal until we can get as close to each other in public as we need to. Because nobody is going to queue outside a supermarket, let alone a high street cafe, in the cold and rain in October and into winter. And nobody is going to open an office if they know only two people can get into the elevators at any given time, and nobody is going to go to the office if they know the queue for those elevators is going to stretch out into the street, in that same cold and rain.
Government propaganda says that SARS-Cov-2 is a uniquely dangerous virus against which we must be defended at all costs. That isn't true, but it's the Government Propaganda, and in politics, Propaganda is Truth, when you want it to be. The Teachers' Unions are going to hang the Government out to dry on that. Unless the creatives at MullenLowe pull off a staggering counter-propaganda coup before mid-August, the teachers will get their 15-pupil classrooms through 2021, and that will change the way parents organise themselves, and a lot will follow from that. I have no feeling for how that plays out, and it does not affect me.
The managers of large office estates will hibernate their buildings until the Government either abandons social distancing or gets it written into the Building Regulations. Nobody is going to spend money adapting to vague guidelines that might be abandoned sometime in 2021. That means laptop-jobbers are staying at home until at least the start of November, and a lot of them, especially in Zone 6 and beyond, won't be coming back to the office no matter what happens. We can do our jobs just fine from home. Less money for the railway companies; less money for the cafes and shops in London. I've lived the suburban working life: it's okay, but it needs visits to Town like bread needs yeast.
I could set out scenarios based on any number of variables, but it would not help. Scenario planning does not work when too many of the variables are on-off and don't have known odds of happening. Will the Government take away all the restrictions when it stops paying furlough? Will it allow 15-pupil classrooms for 2020/21? Will the crowds come back fast enough for the shops to open for the crowds to come back? As I write, shops are opening in central London but no-one is going into work to buy anything. Scenario planning assumes the environment is operating broadly sensibly in pursuit of broadly sensible goals. The Government is the only environment that matters now, and its goals are unknown, except get-out-of-this-mess-so-we-have-a-chance-at-the-next-election.
I do know that whatever happens, the Great British Public will go along with it. For whatever reasons they have, from virtue-signalling, to simple-minded faith, to a cynical go-along-to-get-along, to the despairing what-freaking-choice-do-I-have? That last is my position. My job lets me see where their money is going, and it's going where it would always go, except when the quarantine stops it. As if that makes it business-as-usual. There will be no legal challenges from companies or trade associations, no photogenic women with deep-pocketed backers to mount legal challenges, and no public disobedience. Because all it is at the moment is a bunch of inconveniences. After October, if the redundancies do not hit, we will go on dealing with the nonsense; if the redundancies do hit, everyone will have much bigger problems.
My guess is that the economy in 2021 will be about the size it was in 2005, but it will look and feel like the much smaller economy of 2000. About three to four million jobs will go, especially in tourism, retail, hospitality and catering. So it's a good thing those sectors employ a disproportionate number of non-UK workers. The EU economic migrants will go home, as the Aussies and Kiwis did in the Oughties when the music stopped. The efforts of many businesses to startup in late 2020 will be a dead cat bounce. Half of them will close within six months, suffocated by Covid loans, unchanged high rents and business rates, and reduced turnover from people who, now that they are back at work, have not got the time to queue. More bankrupt stock for the bottom-feeders to sell on Amazon.
All sorts of things might change. But I have no sense of what. I have never looked into the future and not even been able to see the background.
Thursday, 4 June 2020
Monday, 1 June 2020
Photographs I'm Printing (8)
Olympus OM-10 Kodak ASA 100 colour film
Tomatoes, basil leaf and fennel. On the ground in the Cours Selaya at Nice as the market was closing. I used to go there on the first May Bank Holiday back in the Nineties and early Oughties when the girlfriend and I improving our lot in life. I haven't been for an age: it has probably not changed and yet will feel completely different. And I did not arrange a single leaf.
Labels:
photographs
Thursday, 28 May 2020
Starting to Embrace My New Normal
I'm going to be honest. I don't want to go back to the Old Normal.
The Old Normal, at least in the major towns, in February 2020, was over-crowded, nea rammed. From the train, to the tube, to the office, to the streets at lunchtime, and back again, never any space, always someone in your face. People who drove did not stand on packed trains, instead their cars stood in traffic jams. Every day. Both directions.
The Old Normal office was over-crowded, noisy, distracting and un-productive. And it smelled of micro-waved food from midday onwards.
The Old Normal cafes were full of other people all the time. So were the Old Normal restaurants. And shops.
It didn't used to be that bad. Not in the 1980's or even the 1990's. Pubs and clubs on a Saturday night were rammed, but that was the point of Saturday night, while the rest of the week was either quiet or busy. From about 2015 or so, almost every evening in Soho was bustling (one step up from busy), and from Wednesday to Saturday it was rammed. It got so I gave up trying to find somewhere to have supper after my early evening Meeting.
The Old Normal had people from all over the world packed into a handful of cities - Amsterdam, Paris, London, Madrid, Barcelona, Lisbon, Milan, Rome, Florence - every weekend. If Patient Zero showed up on Saturday in Amsterdam, by the next Saturday whatever it was would be all over Europe, America and Russia.
It didn't used to be like that even at the start of the 2000's. Those towns were busy, had a nice buzz, but were not rammed as they were in 2019.
And don't get me started on traffic.
My New Normal will be that I work from home. I am starting to like a lot about it. I can get a walk in the morning, followed by a short weights session, a shower, breakfast and some time reading, before getting back on the laptop, because I do routine stuff on it first thing. Good start to the day.
I'll be making some more changes to what I do as the time goes on, after I can actually get a haircut and a massage. There is no way my employer will even try to get us all back in the office until at least November, and if the Government builds Anti-Social Distancing into the New Normal, there won't be the space to bring us all back. I will be serving Capitalism by staying home, and SouthWest Trains can figure out how to run at a profit without my fares and car parking fees.
If you're smart, you will not go back to the over-crowded Old Normal. You really want those traffic jams? To stand on the train for twenty minutes? To sit between two other people each less than three feet away and both yammering corporate nonsense on their phones? To hang around for other people to get off the machines at the gym?
I could have gone back to the Old Normal if the lockdown had ended after three weeks. It was in the second three-week period I started to mail-order stuff I needed, and switched my shopping around, and started to understand what my New Normal could be. Six weeks is all it takes to get used to new circumstances. Or not, and go back to the old ways. I might have gone back after six weeks. But when it was obvious from the Government's plan that whatever the New Normal was, it was not going to start until November, I gave up.
I'm not going back.
But then I'm single, I'm still employed, and I'm close to retirement. I'm an insignificant old codger with a data-crunching job in an FTSE-100 company. Heh. The lack of responsibility is positively liberating.
Boris and his cabinet got us into this mess, and it's their job to get us out of it. They have, to their eternal credit, taken the responsibility and handed out money the taxpayer doesn't have, to keep people from poverty and bankruptcy. They are not rocket scientists - if they were they would never have trusted that twat from Imperial College - but they are shrewd political operators. I suspect they knew somewhere in their political lizard-brains that the Old Normal of ever-increasing crowding and 'productivity' had stopped working in about 2016 or so, and everyone was just doubling-down on a dumb trade. I suspect they are now in the social change game. They don't know what they want, but they do know what they don't want, which is why they are making a fetish of Anti-Social Distancing. With that, they can destroy the Old Normal. Because just maybe, anything is better than that.
The Old Normal, at least in the major towns, in February 2020, was over-crowded, nea rammed. From the train, to the tube, to the office, to the streets at lunchtime, and back again, never any space, always someone in your face. People who drove did not stand on packed trains, instead their cars stood in traffic jams. Every day. Both directions.
The Old Normal office was over-crowded, noisy, distracting and un-productive. And it smelled of micro-waved food from midday onwards.
The Old Normal cafes were full of other people all the time. So were the Old Normal restaurants. And shops.
It didn't used to be that bad. Not in the 1980's or even the 1990's. Pubs and clubs on a Saturday night were rammed, but that was the point of Saturday night, while the rest of the week was either quiet or busy. From about 2015 or so, almost every evening in Soho was bustling (one step up from busy), and from Wednesday to Saturday it was rammed. It got so I gave up trying to find somewhere to have supper after my early evening Meeting.
The Old Normal had people from all over the world packed into a handful of cities - Amsterdam, Paris, London, Madrid, Barcelona, Lisbon, Milan, Rome, Florence - every weekend. If Patient Zero showed up on Saturday in Amsterdam, by the next Saturday whatever it was would be all over Europe, America and Russia.
It didn't used to be like that even at the start of the 2000's. Those towns were busy, had a nice buzz, but were not rammed as they were in 2019.
And don't get me started on traffic.
My New Normal will be that I work from home. I am starting to like a lot about it. I can get a walk in the morning, followed by a short weights session, a shower, breakfast and some time reading, before getting back on the laptop, because I do routine stuff on it first thing. Good start to the day.
I'll be making some more changes to what I do as the time goes on, after I can actually get a haircut and a massage. There is no way my employer will even try to get us all back in the office until at least November, and if the Government builds Anti-Social Distancing into the New Normal, there won't be the space to bring us all back. I will be serving Capitalism by staying home, and SouthWest Trains can figure out how to run at a profit without my fares and car parking fees.
If you're smart, you will not go back to the over-crowded Old Normal. You really want those traffic jams? To stand on the train for twenty minutes? To sit between two other people each less than three feet away and both yammering corporate nonsense on their phones? To hang around for other people to get off the machines at the gym?
I could have gone back to the Old Normal if the lockdown had ended after three weeks. It was in the second three-week period I started to mail-order stuff I needed, and switched my shopping around, and started to understand what my New Normal could be. Six weeks is all it takes to get used to new circumstances. Or not, and go back to the old ways. I might have gone back after six weeks. But when it was obvious from the Government's plan that whatever the New Normal was, it was not going to start until November, I gave up.
I'm not going back.
But then I'm single, I'm still employed, and I'm close to retirement. I'm an insignificant old codger with a data-crunching job in an FTSE-100 company. Heh. The lack of responsibility is positively liberating.
Boris and his cabinet got us into this mess, and it's their job to get us out of it. They have, to their eternal credit, taken the responsibility and handed out money the taxpayer doesn't have, to keep people from poverty and bankruptcy. They are not rocket scientists - if they were they would never have trusted that twat from Imperial College - but they are shrewd political operators. I suspect they knew somewhere in their political lizard-brains that the Old Normal of ever-increasing crowding and 'productivity' had stopped working in about 2016 or so, and everyone was just doubling-down on a dumb trade. I suspect they are now in the social change game. They don't know what they want, but they do know what they don't want, which is why they are making a fetish of Anti-Social Distancing. With that, they can destroy the Old Normal. Because just maybe, anything is better than that.
Labels:
Lockdown
Monday, 25 May 2020
Thursday, 21 May 2020
How To Tell An Expert From An Activist With A PhD
Expertise is about knowledge. There are two kinds of knowledge: knowing-how and knowing-that. Some knowing-hows require knowing a lot of knowing-that, but nearly all of us know-how to do things without knowing all the thats behind what we do. Do you know how fuel injection works? Doesn't stop you driving a car.
Expertise requires something that someone can be an expert at. There must be a stable body of effective practice, successfully-tested theory and facts. There can be differences of opinion, controversies and changes in this corpus. Too few and we should suspect a professionally-imposed conformity; too many and the subject stops being stable enough for expertise in it to be meaningful. What counts as too many or too few is itself a matter of judgement.
The subject must be manageable. It must be small enough for one person to get their arms round. If an expert is someone who know all the facts, or at least, knows where the facts may be found and absorbed quickly, then there can't be too many facts. Some subjects, like public health policy, or the dynamics of the climate, are just too large to be expert-friendly.
There are no expert witches, because there are no effective spells, and hence the theories have failed all the tests.
There are no experts on (the whole of) the Law of England and Wales. There are simply too many volumes of Halsbury's Laws of England. No one person can get their arms around it. That's why lawyers specialise.
There are experts at medical diagnosis, usually within a specialist field: the facts are few in number, the theories are simple (compared to Quantum Field Theory), while the techniques may be subtle.
What about computer modelling? Three things go into a computer model: the model of whatever it is; the program that embodies that model; and the values of the various coefficients and initial conditions of the model. Those are three different subjects. To model the spread of a virus, one needs to know some immunology, some epidemiology, and perhaps all sorts of things about how close people sit in offices, how many people come within a given distance of others in the course of a day, and so on. Then someone has to take all that and put it in equations and computer code. Then one needs to measure the value of the key parameters for that virus. If those are not known, the whole thing is pointless. The result has to be calibrated against previous epidemics as a test. Journalists never seem to ask modellers about that part of the process.
This needs team-work. Teams cannot be experts. A team might consist of experts at parts of the process, but there is no guarantee that the team members will work well together. The result may well still be a camel. (A phrase that is unfair to camels.)
How do you and I tell if someone is an expert?
First, the subject must sound like a proper specialism. Immunology is a specialism, 'the climate' is not. Epidemiology is, but only when it is being modest.
Second, if they are quoting computer models, not empirical studies, they are not experts. Experts deal in facts and successfully tested theories.
Third, if asked, experts give practical, useable advice that helps the client achieve their goals - or admit that there is nothing they can offer. Pseudo-experts jump to publish research that a) seems to lead directly to policy advice, that b) is in line with their ideology, and c) politicians or managers cannot or will not follow because of economic / social / legal / market / political realities. That last is essential. If what the politicians or managers do works, everyone's happy. If it fails, the experts can say that they advised something different. So they weren't wrong. They weren't right either, because their ideas are never actually put to the test.
Fourth, they do not use whatever it is to advance their social and political beliefs. Experts are not activists. Experts do not see our crisis as their opportunity.
Activists follow an ideology. Ideologies tell their followers what is right and what is wrong. There is no need to worry about facts or the quality of the theories and models: if it helps the cause, it's good, and if it doesn't, it goes in the bin. If the facts are different, that proves the world is corrupt and must be changed or burned down, not that the ideology is wrong. There is no debate, only persuasion; no information, only propaganda.
Activists are attracted to large subjects where there is plenty of ambiguity, complicated statistics, simplified computer modelling of complex systems, few if any opportunities to test any of the theories, and the appearance of relevance for social and political policy.
Once inside these subjects, activists aim to establish their ideology as the purpose of the subject: for example, if you don't buy Climate Change, you're not going to get a job in the UK Met Office. The central tenet of the ideology is binary: you are a believer or not. But in a twist known to everyone, one can't just pronounce the Shahada and go back to one's life: one has to take on all the cultural baggage.
Or perhaps, one should not pronounce the Shahada unless one is prepared to take on the cultural baggage. People who are not prepared to take on the baggage will avoid the institutions which demand adherence to the Thirty-Nine Articles of Religion, or their modern equivalents, and this is the intention. So much as naming the ideology on the website will deter the non-believers. Internal criticism is not so much actively silenced as recruited away. The old guard either stay quiet or leave.
Fifth, experts do not work in ideological institutions. Why not? Because of the risk they run should their research turn out to be contrary to the aims of the organisation. And because of credibility: once we know a man is being paid to follow a party line, we do not know if he is telling us to follow the party line because it is the best thing to do, or because his paycheque depends on it. Experts need their credibility. Activists just need to fill the air with noise.
So the next time you read an article quoting a piece of research about something in the news, that seems to have immediate policy relevance and fits in with a prevailing ideology, the authors are not experts, but a bunch of academics seeking their fifteen minutes of fame.
Because, sixth and most important, experts stopped talking to the media about the same time that journalists stopped reporting the news and started pushing ideology. Nobody who talks to The Guardian, or the BBC, is an expert. They are a propagandist for a dogma the media want to push.
Expertise requires something that someone can be an expert at. There must be a stable body of effective practice, successfully-tested theory and facts. There can be differences of opinion, controversies and changes in this corpus. Too few and we should suspect a professionally-imposed conformity; too many and the subject stops being stable enough for expertise in it to be meaningful. What counts as too many or too few is itself a matter of judgement.
The subject must be manageable. It must be small enough for one person to get their arms round. If an expert is someone who know all the facts, or at least, knows where the facts may be found and absorbed quickly, then there can't be too many facts. Some subjects, like public health policy, or the dynamics of the climate, are just too large to be expert-friendly.
There are no expert witches, because there are no effective spells, and hence the theories have failed all the tests.
There are no experts on (the whole of) the Law of England and Wales. There are simply too many volumes of Halsbury's Laws of England. No one person can get their arms around it. That's why lawyers specialise.
There are experts at medical diagnosis, usually within a specialist field: the facts are few in number, the theories are simple (compared to Quantum Field Theory), while the techniques may be subtle.
What about computer modelling? Three things go into a computer model: the model of whatever it is; the program that embodies that model; and the values of the various coefficients and initial conditions of the model. Those are three different subjects. To model the spread of a virus, one needs to know some immunology, some epidemiology, and perhaps all sorts of things about how close people sit in offices, how many people come within a given distance of others in the course of a day, and so on. Then someone has to take all that and put it in equations and computer code. Then one needs to measure the value of the key parameters for that virus. If those are not known, the whole thing is pointless. The result has to be calibrated against previous epidemics as a test. Journalists never seem to ask modellers about that part of the process.
This needs team-work. Teams cannot be experts. A team might consist of experts at parts of the process, but there is no guarantee that the team members will work well together. The result may well still be a camel. (A phrase that is unfair to camels.)
How do you and I tell if someone is an expert?
First, the subject must sound like a proper specialism. Immunology is a specialism, 'the climate' is not. Epidemiology is, but only when it is being modest.
Second, if they are quoting computer models, not empirical studies, they are not experts. Experts deal in facts and successfully tested theories.
Third, if asked, experts give practical, useable advice that helps the client achieve their goals - or admit that there is nothing they can offer. Pseudo-experts jump to publish research that a) seems to lead directly to policy advice, that b) is in line with their ideology, and c) politicians or managers cannot or will not follow because of economic / social / legal / market / political realities. That last is essential. If what the politicians or managers do works, everyone's happy. If it fails, the experts can say that they advised something different. So they weren't wrong. They weren't right either, because their ideas are never actually put to the test.
Fourth, they do not use whatever it is to advance their social and political beliefs. Experts are not activists. Experts do not see our crisis as their opportunity.
Activists follow an ideology. Ideologies tell their followers what is right and what is wrong. There is no need to worry about facts or the quality of the theories and models: if it helps the cause, it's good, and if it doesn't, it goes in the bin. If the facts are different, that proves the world is corrupt and must be changed or burned down, not that the ideology is wrong. There is no debate, only persuasion; no information, only propaganda.
Activists are attracted to large subjects where there is plenty of ambiguity, complicated statistics, simplified computer modelling of complex systems, few if any opportunities to test any of the theories, and the appearance of relevance for social and political policy.
Once inside these subjects, activists aim to establish their ideology as the purpose of the subject: for example, if you don't buy Climate Change, you're not going to get a job in the UK Met Office. The central tenet of the ideology is binary: you are a believer or not. But in a twist known to everyone, one can't just pronounce the Shahada and go back to one's life: one has to take on all the cultural baggage.
Or perhaps, one should not pronounce the Shahada unless one is prepared to take on the cultural baggage. People who are not prepared to take on the baggage will avoid the institutions which demand adherence to the Thirty-Nine Articles of Religion, or their modern equivalents, and this is the intention. So much as naming the ideology on the website will deter the non-believers. Internal criticism is not so much actively silenced as recruited away. The old guard either stay quiet or leave.
Fifth, experts do not work in ideological institutions. Why not? Because of the risk they run should their research turn out to be contrary to the aims of the organisation. And because of credibility: once we know a man is being paid to follow a party line, we do not know if he is telling us to follow the party line because it is the best thing to do, or because his paycheque depends on it. Experts need their credibility. Activists just need to fill the air with noise.
So the next time you read an article quoting a piece of research about something in the news, that seems to have immediate policy relevance and fits in with a prevailing ideology, the authors are not experts, but a bunch of academics seeking their fifteen minutes of fame.
Because, sixth and most important, experts stopped talking to the media about the same time that journalists stopped reporting the news and started pushing ideology. Nobody who talks to The Guardian, or the BBC, is an expert. They are a propagandist for a dogma the media want to push.
Labels:
Life Rules
Monday, 18 May 2020
Thursday, 14 May 2020
Big NHS Hospitals Are The Problem: Start Thinking About Solutions
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.
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.
Labels:
Society/Media
Subscribe to:
Posts (Atom)