LEARNING LESSONS TO SAVE LIVES TOMORROW – PART 1

by Sherbhert Editor

DEATH COUNT – BLAME AND SETTLING SCORES SAVE NO LIVES

That the lives of over 100,000 people in the UK who have caught Covid-19 (CV) have been lost, and many more will surely follow, is deeply sad. Many commentators (for example in the Financial Times, Guardian and the Times, and also certain broadcasters) say that deaths could have been avoided, laying blame squarely at failures of UK Government, especially Boris Johnson citing poor decisions, slow decisions or no decisions. Boris Johnson accepts responsibility, rightly not for deaths, but for UKGOV actions and decisions during the pandemic. That so many have made up their minds as to what actions caused what consequences, often measured somehow in deaths, creates the risk of established prejudice. That will create in turn a further complication for the expected public enquiry when CV is finally under control, some months or more away, which will assess the problems of the pandemic.

 It would be surprising if errors were not made – Nicola Sturgeon has said more than once that mistakes when dealing with the unknown as with CV are inevitable but observing at the same time that those in government do their best to decide matters in good faith. How anyone will assign particular blame for any number of deaths due to any course of action, when compared to alternatives and hypothetical consequences, is hard to imagine but that is rightly for another day. For example, taking the proposition that UKGOV should have continued the first lockdown through the summer and many lives might, not would, have been saved – how will the mental health and adverse economic effects and damage to children be measured against the theoretical lives saved? Will successes be netted off against errors? Expert evidence will be vital, and the experience of the pandemic is that expert opinion in all areas from economics to epidemiology to sciences generally can vary considerably, especially when forecasting is concerned, and it is now widely understood that science is not about absolute knowledge. Dividing fault between advisers who advised and Ministers who made decisions and those charged with executing Ministers’ decisions will be invidious. Will fairness be possible? If a public enquiry is to be about blame, will it be a useful exercise?

Comparison of statistics is widely recognised as an imprecise exercise: for example, countries record matters differently and with variable accuracy, there being no common standard; some countries have very dense demographics compared to others. Some experts see excess deaths as the right measure and observe this may only be capable of being established sometime after the pandemic is over – a while away. There may be lessons to be learnt from other countries’ methods and structures.

So, absolute judgement must wait some time. A public enquiry will be years in the completing, and so anyone with mileage to be made out of perceived failings will necessarily seek to settle scores now. Those, and there are evidently many of them for reasons CV unrelated, who wish to see Boris Johnson gone will maximise their aggression now rather than wait. But that perhaps is politics and the result of the passion for conflict and fault which prevails in the UK today. And so, attempts to settle scores will have to be tolerated. The important thing is that valuable lessons must be learnt and there are bound to be many in how the health and other services operate, and cooperation between organisations including UKGOV. A public enquiry may reveal such lessons in years to come but the world cannot wait. 

Perhaps the biggest lesson of all has yet to be properly taken on board. Cardiovascular disease and obesity are major causes of death at all times but especially when they meet CV, and they are avoidable.

THE BIGGEST LESSON OF ALL – TO SAVE UP TO 160,000 LIVES EACH YEAR

Over 90% of deaths of people who caught CV are of people with underlying problematic health conditions. A lot of old people have them, such as dementia and cancers. Many have cardiovascular disease issues, which are heart and circulatory diseases (HCD) and so do many people considerably younger than 80. In the UK HCD is on average the biggest cause of death, about 160,000 a year, with 43,000 of these people being under 75 years of age. The healthcare cost alone, apart from economic loss to the UK, is many billions of pounds. And 80% of HCD deaths are said to be avoidable. 

The reason these deaths are avoidable is that HCD is largely self-inflicted by society on itself, and by individuals, through their choices, on themselves. High blood pressure, smoking, air pollution, high cholesterol, all are relevant. But obesity and diabetes (itself fed by obesity) are the biggest factors behind HCD (the source for statistical information in this section is the British Heart Foundation and the British Nutrition Foundation). Obesity, and bad diet, feed cancers and other conditions too. Over half the patients admitted to ICUs during the pandemic in the UK are obese. At any one time some 7.6million people in the UK are living with HCD. Some will die from it prematurely, and a great many will have quality of life seriously damaged by it in the short and longer term, and this will continue to happen year after year unless real and urgent action is taken.

It is to be hoped that vaccine will mean that deaths and severe consequences from CV in large numbers in the UK will not be a regular problem. HCD will, however, kill and harm every year, and could get worse.

To combat CV in just a year: the UK has spent hundreds of billions on health provision and economic subsidy. Millions await operations and other treatments for non-CV problems and the backlog, with a great deal of suffering as a result, will take years to resolve. And as to freedoms, the population has accepted the removal of the most basic freedoms, such as leaving one’s home and socialising with family and friends, in order to fight CV. Saving lives has been the predominant driver for every decision.

But the fight against HCD has been with the UK for years with little spent on it comparatively and with little regulation of damaging foods and drinks to discourage their consumption even though they cause HCD, and so deaths. A major argument against regulation is the freedom of people to choose their foods, even though the choices cause HCD, cost the country a fortune, and kill even young people in great numbers, not just the very old (unlike CV). It surely now will be generally appreciated that in a future pandemic, in addition to the very old, those with HCD diabetes or an obesity issue are very likely to be among the weakest for immunity and lives which could be saved will be lost.

And outside of any pandemic, why are society and the media not as concerned to save lives? Is it because the NHS has been funded sufficiently to deal with the consequences of HCD and so will not be overwhelmed by it? If HCD can be considerably reduced, not only will thousands of lives be saved but also the strain on the NHS will be lessened, and billions of pounds saved could be used for other purposes.

Tackling obesity and HCD does not need a vaccine. The science exists and is understandable to ordinary people. It means adopting major changes to lifestyle, in diet and exercise. Should not this happen and urgently? The remedy is all within the gift and control of communities with self and mutual help and UKGOV providing a framework of incentives and education. Major food and drink businesses, including also fast-food sellers, surely need to be made to help. Softly, softly will be too slow. UKGOV has been very willing to use draconian emergency powers to legislate during the pandemic to save lives.   The biggest lesson of the pandemic is that deaths are mostly caused by the virus attacking the weakest, the poor health of individuals, not by UKGOV or any one person’s decisions. A great many deaths in the pandemic were made inevitable by years of society largely ignoring personal health responsibility, long before CV came along. Has this lesson truly been learnt?

If anyone is serious about protecting the NHS and saving lives, the answer lies in the hands and decisions of each individual about their own well- being, and in the case of parents the well- being of their children, and the media should look no further for who and what to blame. UKGOV promises to wage war on obesity and needs to take the chance to do so once CV is more under control. 

This big lesson is so obvious. Does the UK really need a public enquiry to know how to save lives?

See also :

COVID-19 – FORGET BLAME – TIME TO AVOID A GREAT DEPRESSION

NON-FOOD, OBESITY AND MORTALITY – TIME FOR A NATIONAL DIET STRATEGY?

Balance and Food – People, Planet, Plants and Processed

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