Health Maintenance in a Pandemic

 

The telephone rang. It was the doctor. I hadn’t been to see her in over a year. I should have, of course. If only for the obligatory annual check-up. It was not that I was being neglectful but, like just about everybody else, I couldn’t just walk into the doctor’s surgery as in the before-times. The times have changed so much in the last few months that hospitals and doctors’ offices have become no-go areas for the relatively healthy. The need must be truly urgent for one to brave the hazards, real or merely perceived, of entering an Emergency Department, a clinic or doctor’s office. So, unless one was practically keeling over, one tries to avoid such establishments in the way that one would try to avoid the... plague. The ultimate version of social distancing.

Our way of being is changing fast for better or worse, the relationship with our doctors being among the first casualties. And of course, not all caring institutions are the same. Some, or even many, are anything but, becoming instead, either by accident, or even design, places of uncaring and frequently, untimely death due to COVID-19 being allowed free range within their premises. In the province of Ontario, Canada, for example, 9,625 care-home residents have been infected by COVID-19. Of this number 2,471 have died. A  25.7%  death rate, nearly ten times greater than that among other COVID-19 infected Ontarians. These staggering figures need their own separate commentary.

The grim statistics have, so far, not affected hospitals or doctors’ offices. We keep away from them and they, reciprocally, hold us at arm’s length. But if access is restricted, how does one consume health care? (We are all consumers now). Does COVID-induced anxiety supercede all other concerns about our health?

But the morning call did come from the doctor, enquiring about my state of health. She wanted to know how I was, and was there any service that I needed? Then, in a flash, I realized that here was yet another Covid-induced shift. ‘Telemedicine’ and ‘telehealth’ had arrived. Although telehealth had been lurking in the fringes of traditional health care for well over a quarter of a century its impact had indeed been no more than marginal. “Telehealth”, we had been told, “is a collection of means or methods for enhancing health care, public health, and health education delivery and support, using telecommunications technologies.” And within this, telemedicine was anticipated to deliver medical service directly to the individual consumer.

Now the public health arm of telehealth has been in full display since the opening stages of the pandemic, when public health officials, and presidents, potentates and prime ministers, and heads of world organizations stepped forward, with long faces, to warn, if not exactly of impending doom - but close enough – to concentrate the mind, leavened albeit with sensible advice on how to mitigate the pandemic’s spread. The one exception need not detain us here.

The new communications platforms that a pandemic demands create opportunities for those who live in well-resourced countries, but the full promise will, for the foreseeable future, remain unfulfilled for people living in poorer parts of the world. However, for the present emergency, there is perhaps a silver lining in that COVID wields a lighter, gentler touch over some of these countries. With this in mind, and with prospects of effective vaccines just about to be realized, we can all have a less stressful Christmas and a normal 2021.

Cheers.

Tell Fren Tru

Black Bodies And Original Sin

2020 has been a year-and-a-half, even though it is barely six months old. Does anyone remember that early January morning when it burst upon us with all the hype and noise about clear vision, and all that?  Some even suppressed, albeit momentarily, the persistent, deep ache induced by the virus-like sickness that had afflicted us for more than four centuries.

    But the year was not even a week old when reports of a new type of viral illness began to emerge from China. And, in no time at all, the new sickness, which was to be named COVID-19, corona virus disease 2019, had spread, and was continuing to do so, so rapidly, that the World Health Organization was forced to call the outbreak a  pandemic. Shortly following that declaration, many world leaders began the task of controlling the epidemic by curtailing economic and social activities within their territories and, subsequently, closing their borders to all but essential traffic.

         Sixteen weeks on, pandemic is front-and-centre in everyone’s mind, recognized around the world as the plague that is unravelling our modern way of life. As I write, nearly12 million  , distributed over 213 countries, have been infected by COVID-19, and more than half a million have died, economies have tumbled, and social orders rattled. We have had to re-define important aspects of our lives, and unexpected revelations about who or what is important have emerged. The term ‘essential’, as in essential worker, for example, has been clarified in sobering ways.  Essential workers, we now learn, are the workers required to be physically present, on location where, if they are not, the wheels that keep our societies turning grind to a halt. And, unsurprisingly, it is at these interfaces that the risk of catching COVID-19 is highest: We now realize that the essential worker is not just among obvious groups like doctors and nurses, ambulance drivers, EMTs or firefighters, policemen, and security guards, garbage collectors, but also includes people who keep our food and other supply lines intact (obvious as that should have been), workers who keep our transport networks rolling; supermarket checkouts, janitors, cleaners and, notably, the hitherto much under-valued personal service worker or PSW who, to our shame, we had accorded little respect. (We, unknowingly, shot ourselves in the foot here, as the number of vulnerable lives lost among care home residents reveals. That is a story that needs its own telling). These workers are the lifeblood of the economy not only in normal times, but as we now see, in times of trouble as well.

         What about those who are not among the category of the essential? The majority, unfortunately, have been laid off or sent on furlough. However, we are told that as many as 40% of the modern economy’s workforce have continued drawing their pay without leaving the house. These work from home (WFH) folks carry on their business, and/or that of their employer, striking keyboards and clicking mice, experiencing little inconvenience apart from having to change from their pyjamas into their day clothes, if that at all. But, however convenient their situation, their exertions have apparently not been enough to prevent the economy diving. Governments did what they had to do and provided emergency cash for the laid-off or furloughed. So, economic disaster has been staved off.

         Of course, viral pandemics come and go. They appear, suddenly, or, creep up upon us and cut their way through countries and regions, killing hundreds of thousands, or millions, until, eventually, they run out of potential victims, and allow survivors to breathe again. This is what pandemics do and have done for hundreds and perhaps, thousands of years. So, COVID-19 will go away too, sooner or, as some fear, later.

         But, this time, there has been a confluence that has resulted in totally predictable consequences. COVID-19 targets, with unerring focus, the group that have been, and continue to be, the victims of that other virus-like disorder, the one that I mentioned at the beginning of this post, and which has been a stain on humanity for centuries; it is the only virus that has remained resolutely out of control and resistant to all forms of therapy, presumably because it is an affliction of mind rather than one of body. And so, the moment arrives, when COVID-19 meets racism, on the bodies of Black people. The results have been devastating but unsurprising. All the factors contributing to this shameful outcome stem directly from anti-Black racism: having to work in essential fields, inconsistent access to health care, chronic health conditions, the societal stress of being Black and its adverse effects on the immune system are laid bare in this analysis and is the result of what is often called America’s original sin. That sin was in public display when the life was squeezed out of Black George Floyd by a White policeman. America must exorcise this sin, or its presumed leadership of the world would slip into the hands of others. That, perhaps, might not be such a bad idea.

Tell Fren Tru