First, do no harm. For millennia that was the sworn ethical resolve made by every healthcare physician. That oath made our doctors responsible to us patients for our health, and legally answerable for any malpractice. In recent history that began to change. The text of medical oaths (traditionally based on the ancient Greek Hippocratic oath) had been supplanted by various watered-down versions of the text. It is no coincidence that it happened following the formation of medical associations and public healthcare organisations. An individual can take a sworn oath, but an organisation can take no oath of intent.
The notion of a public health organisation is relatively new in historical terms. The first national health services (along with the supra-national World Health Organisation) were born in the post world war era. They were established to ensure everyone requiring clinical care could receive it. Since then, we’ve become accustomed to the notion that a public health service should always be there for us, to treat us when we need it, to heal us when we are sick, and to save our lives and those of our loved ones.
Those expectations made us malleable to accept the first lockdown as a strategy for dealing with a WHO-declared Covid-19 pandemic. Our hopes and our fears are what give our public institutions power over us. The more dangerous of the two – fear – was used to empower the public health service this time. We fear death. Based on prophetic warnings of death on an apocalyptic scale not seen in our lifetimes, we duly did what our public health advisors told us would prevent it. Combined that fear with confirmatory images sent around the world of a totalitarian State’s lockdown response to Covid, and our expectations were set. With the notably new enticements of the force of law and criminalising the disobedient, public healthcare advisors for the first time took - and were given - extraordinary authority to interfere in the daily lives and behaviours of every person, not just those seeking treatment within their hospital walls.
As time went on, it was clear that public healthcare institutions and governments were taking advice on a lockdown strategy not just from sworn-in medical physicians, but from favoured civil and academic experts, from professors and scientific modellers in academic institutions who take no oaths against harm on societal health. Their dedication instead is to their field of expertise, their preferred theories and mathematical models du jour. We were no longer patients being treated, but mere components of a model to be tinkered with, and the outputs observed. These viral and epidemiological academic experts who had spent their careers in the back room working only on theory were now thrust into the public eye and given a once in a lifetime opportunity to validate their theories empirically with real-world live experimentation. Recruited into the upper ranks of the public service, they were presumed more infallible than any pontiff, and their reputation protected as much, because we, in fear, needed to trust they had the way out of the hellish scenario they had prophesied. Instead of a way out, they created a hellish new scenario all of their own.
We’ve had experiment after experiment of lockdown measures. A year ago who would have believed that, in the supposed name of public health, these things would be imposed by our public health services? They have unleashed what amounts to a litany of harm: elderly people told to isolate socially and not leave their homes, while elderly in hospital care were packed off to care homes where public visits were still being allowed; nightly reports of deaths on the national airwaves, fixating the public on a number whose value would be used to rule their lives; commissioning marketing researchers to poll the public ‘worry index’; citizens co-opted to force ‘behavioural change’ on other citizens; children denied proper education and social development; hundreds of thousands put out of their jobs; billions added to the national debt; depression, suicides, and domestic violence rising; thousands of patients with other terminal conditions denied urgent access to diagnosis and treatment; and now, the enrolment of the entire population into a trial of experimental drugs (approved only for use in an emergency)
This is healthy? This is our best public health ‘advice’?
Politicians promised us lockdown wouldn’t happen again. Inconsistent WHO officials told countries to stop using them. That particularly bad experiment was supposedly over. Then the second lockdown came. This time a pique of honesty on the part of healthcare mandarins revealed what many suspected lockdowns were about. It wasn’t about two weeks to flatten a curve of transmission anymore. The mask had slipped. The medical mandarins all but admitted that lockdowns are about first protecting the health of the healthcare system. They feared the exposure of a healthcare system that would be seen as unable to treat those in danger of death. So they continued extraordinarily damaging measures to ensure emergency healthcare demand would remain low.
Every winter in Ireland we hear reports about hospitals filled to capacity with sick people, overcrowding, people on trollies waiting for treatment, people being turned away, staff under pressure. (Those working within organisations also look rightly to that organisation to protect them from harm.) This is not what we expect from our healthcare systems, and so in the past we complained. Annually, we hear the health minister of the hour promise more funding for extra capacity, but that it ‘takes time’ to deliver results. Insufficient funding, resourcing, and ineffective management lead year after year to inadequate capacity to meet periodic demand. Earlier in the year, WHO officials told nations only to use lockdowns ‘to buy you time to reorganise, regroup, rebalance your resources’ In Ireland, we had two lockdown chances to prepare for winter. They knew this was coming. The actual preparations for this winter ill health season taken since the first lockdown are twofold. Firstly, hundreds of additional high-dependancy, surge capacity, beds (that were paid for but never used in the first lockdown) were stood down. Secondly, the capacity for daily Covid testing has been multiplied almost threefold, mostly by private test labs, to detect more ‘cases’. Make of those interesting preparations what you will. Now, yet again, a third lockdown is the preferred strategy.
It was an entirely predictable expectation that in this dark winter of a pandemic a rise in respiratory complaints admissions would happen, as in every other winter, only worse. It would probably be considered heretical to our public health doctrine to even suggest that after a year of lockdown measures our immune systems have been weakened for this winter viral onslaught too. It would be heresy too, no doubt, to suggest that a third lockdown mandating exercising, queuing, dining, and socialising outdoors just when the weather reaches its coldest and wettest was probably not a good way to make people less susceptible to infection and getting sick. Heresy too to suggest that a virus prevented from spreading and mutating earlier throughout the year is left to do what a virus does - mutate to infect the most people - during the season when they are now most susceptible to harm from it.
In-spite of our scientific sophistication with PCR testing, mRNA vaccines, mathematical modelling and predictive simulation, it seems to me that my granny had more common sense advice about avoiding respiratory conditions in winter than all our best assembled medical academics have displayed this year.
The organisation has found a new solution to problematic accusations of unpreparedness for foreseeable winter demand –rather than take the blame itself, it blames the public instead. The attitude of our public health advisors on their daily sermons in the media is clear – we are too uncooperative, we are causing too much demand, we are not doing as were told, we are sinning against the doctrine of public health advice, and so we have been sent to our rooms again accordingly. They have adroitly pointed the finger away from themselves and on to us.
By the way, for those who would defend the argument that it is the behaviour of the public that is to blame for this winter’s predicament in the hospitals, consider this: the current predicament is the very proof why lockdowns didn’t, don’t, and won’t work. By blaming the public for not adhering to the restrictions, health advisors admit the public are not adhering as once they did early on. People can not sustain these restrictions. People get tired. After a long difficult year, we craved the simple contact of others, what festive celebration we could have, and warmth and light in the darkness. It is what makes us human.
Our advisors seem to have developed an unhealthy obsessive addiction to inhumane lockdowns, like they are caught in some sort of gamblers dilemma - perhaps just one more lockdown will surely be enough to win, and justify all the other collateral loses?
In the aftermath of Covid, we’ll be left to wonder whether we’d have been better off without their advice. And we can only wonder – they’ve seen to that. The continuing repeated lockdown strategy will ensure that the results of alternative strategies will never be known. This winter too will pass. In a matter of weeks, these exceptional seasonal demands will abate. A naturally receding pandemic, coinciding with a springtime multiple-vaccine rollout, can be used to claim victory for science and for public health advice over common sense, and misused to vindicate the health authorities’ chosen, erroneous, strategy of repeated lockdown restrictions. Organisations develop tendencies and capacities to protect themselves. In protecting the organisation from pressure, the collateral damage being caused by these cyclical lockdowns is now becoming plain to see, and greater than any damage lockdowns could hope to prevent. So why continue to propose them? It’s no longer about protecting public health. It’s about denying and disguising that they have been doing great harm to the public health. It’s about protecting reputation. They will undoubtedly expect to use this technique for next winter too, to shift the blame and the onus on all of us. And why wouldn’t they expect to - we have let them impose upon us three times already, and we haven’t said stop. We let them. We gave them that power over us. It is up to us to make it unacceptable.
A pandemic has revealed that it is folly to expect a public health service to be able to provide care to all in any and every circumstances. The cost of a destroying a healthy economy, and potentially a healthy society, is the price we will pay for maintaining that delusion. Healthcare is always rationed in some way. Our unrealistic expectations enslaved us to our civil institutions, and lead us to be tyrannised by them. Fear was used to drive this situation, our fear of death and of suffering. That is something that ultimately no doctor, no scientist, no politician, no organisation, and no vaccine can provide a solution for. In avoiding our fear of death, we were willing to let such chronic wounds be inflicted on ourselves and our society.
Continue on this path of repeated lockdown, and the problem may resolve itself, but not in the way any of us might hope or want. When the economy is so devastated, and dwindling state revenue soaked up by interest payments on an obscene national debt, then there will be no money for an over-bloated bureaucratic health system anymore. When the many health care workers these lockdowns were intended to protect are out of a job because there will be no money to pay them, when less patients can be treated, who will clap then?
How can an organisation that takes no oath be made accountable for such malpractice as we have seen this year? How does an entire society damaged by its own institution’s disastrous public health advice seek compensation? It can’t be compensated; it can only seek to change it.
Perhaps this year is an opportunity to reset our expectations and our relationship with our public health service, to one based no longer on fear but on hope, that it can once again become what a public health service organisation was meant to be, and no longer just a self-protecting organ at the service of an increasingly authoritarian State body.
It is an abusive relationship when the more powerful party in the relationship coerces their desired behaviour from the other by manipulation based on fears. Abusive, tyrannical relationships are never ended by the oppressor, they only end when the abused resolves to break free. It is time for us to break free of this relationship in favour for a new, healthier one.
This year, power has been taken by a few individuals to seek to effect change in the behaviour of millions. They need our behaviour, because our concerted behaviour has power. We must never fail to realise that our behaviour has greater power over the few at the top of our organisations than those few will ever have over us. Many in those high positions of power wouldn’t want the public to realise that, because the public can use that power to demand a reset of our authorities. People do not exist to protect healthcare institutions; their institutions exist to protect the people’s health, and should – first of all – do them no harm.