Culture Change in Health Care

In 1957 the world experienced the most severe flu outbreak since the 1918 Spanish Flu pandemic.  This new flu was called the Asian flu, and it was much more virulent than the typical annual flu.  In fact, about 100,000 Americans died of the Asian flu, while the population was roughly half it was today.  That would mean that under the same conditions, for our current population, it would have meant about 200,000 deaths.

Those who suffered from the Asian flu reported it as completely sapping their strength.  Many reported not being able to stand and had to crawl back and forth between their beds and the bathroom.  Even scarier for the population was that the disease was especially deadly for pregnant women.

The contrast between the government response in the 1950’s and the response to the Covid epidemic today couldn’t be more drastic.  During the Asian flu epidemic, people were told to use common sense (stay home if you are sick, cover your mouth when coughing, wash your hands), and that was about it.  Today, as we all know, the government has shut down most of the economy, and quarantines are imposed for weeks if not months at a time.

The contrasting responses are due to a dramatic shift in the culture of the Health Care establishment, which, in turn, is mirroring a change in our national cultures.  The change is in how we deal with death.

In the 1950s, people alive had had plenty of experience with death, and especially death at young ages.  The Spanish Flu pandemic had only been 40 years before, so decision makers and experienced doctors had lived through it.  There had been other similar if less deadly outbreaks of disease thereafter, such as the diphtheria epidemic and frequent outbreaks of polio, measles, and so on.  And of course, there had been the World Wars, the last of which had only been about a decade and a half before.

People then understood that you die, and frequently at an age younger than hoped.  Most, even up to the time of the Asian flu, believed that mortal life was a temporary condition followed by an eternal afterlife.  Medical research and care, while increasingly advanced, was geared toward helping end conditions that terminated life all too early ages.  This was the age of vaccines for polio and a multitude of childhood diseases.

Today, medical care is focused on preventing any death, at any age, regardless of the cost.  Most of us who have had an elderly loved one with a serious medical condition have had the medical establishment recommend procedures that would cost hundreds of thousands of dollars (or more) to extend life, at questionable quality, for only a short amount of time.

The current epidemic is far and away most deadly and dangerous to those past 80 (or with serious life threatening conditions).  Protections should be in place to protect them from what for them is frequently a deadly disease.  But even now, even in states that saw the worst of this almost six months ago, only 2% of their populations have the disease, and only 0.2% have died from it (the vast majority of those over 80).

We have done ourselves immense economic damage, in efforts that now appear to have been ineffective anyway, to try to save 2 people out of a thousand,  mostly those with rather limited expected life spans.

The reason for this previously inconceivable over-reaction is the change to our culture.  Mortal life is now seen as the only thing that matters, because most no longer believe in an afterlife.  The strange thing is that this cultural change will result in much shorter mortal lives for all.  We are impoverishing ourselves out of an over-reaction to unexpected deaths.  It just so happens the greatest reducer of life span is actually Poverty.  And shutting down entire sectors of the economy for months on end will result in a massive increase in poverty.

What to Do

Epidemics, like natural disasters, are normal events in human experience.  It is always sad when people die young or die from unexpected causes.  We should do what we can, within reason, to combat epidemics, and help any who suddenly stand in need.

But we need to do so reasonably, and in a cost effective and targeted fashion.  Not by panicking and embracing universal policies that do as much or more damage than good.

Early on, from the experience of the passengers and crew of the Diamond Princess cruise ship, it was known what could be expected from the Covid epidemic.  As a result, the elderly (and those with serious conditions) should have started to receive assistance for isolating. 

The rest of us should have continued as normal, recognizing that we needed to do minor things, like wear a facemask or wash our hands more often, to slow the spread of the disease.  This is what Sweden decided to do, and they appear to be no worse off medically than places that have gone into complete shutdown.