“Time, said Heraclitis, is like a river that flows endlessly through the universe; you cannot step into the same river twice.”

Darn good thing too – can’t think of anyone who’d want a repeat of the last few years. Like most people I rather went through the last years in a bit of a daze, but here we are, still standing. Or lurching as the case may be.

Nonetheless I suspect there were those who rather enjoyed themselves (oh, you know, virologists, epidemiologists, biostatisticians, Pfizer…).

OK, maybe on an individual level it was somewhat subconscious but let’s face it, these people are human and it probably was a bit of a treat having their every utterance and half baked hypothesis treated with reverence and quoted on the news. This may explain why there’s plans afoot looking forward to the next great plague. We barely made it past the oh-no-we’re-all-going-to-die stage (not to mention monkeypox looming), masks, social distancing, general gloom and doom, and now here’s Bill Gates with a Cunning Plan for Covid 2.0. He’s written a book, suggesting an international body with the clever acronym GERM (Global Epidemic Response and Mobilization), on stand by, ready to leap in when there’s even a hint of some killer microbe. The cost? A scant $1 billion/year. Here’s a thought, Bill. Why don’t you take a course on basic physiology. I’m sure they’d let you audit and maybe then you’d stop thinking about disease in binary, tech terms. To paraphrase Larry Brilliant, one of the epidemiologists who helped to eradicate smallpox, outbreaks are part of nature and inevitable but the human response, the “pandemic” part, is optional. There are choices to be made in terms of how we react, and, gosh, wouldn’t it have been great if some better decisions had been made..

Perhaps the part that upset me the most was the mental health aspect as all manner of folks who had been skirting on the edge but were able to manage with their normal routines in place were jolted out of that state over the last years and are now slipping into the abyss of behaviourial, cognitive and what we now call neuro, er, diverse problems.

Broken China

Then there’s China, who’s decided on a “zero covid” policy. It would seem head-smackingly obvious that a virus would be, er, less susceptible to a diktat from Mr. Xi than the beleaguered citizens of Shanghai, under house arrest/lockdown for so many months, but I suppose the Chinese Communist Party assumes what they say goes, everywhere in the micro- and macro-universe. The mind boggles.

Unsurprisingly, mental health issues in China, like everywhere, have skyrocketed – even though China doesn’t really acknowledge their existence. Perhaps it’s a holdover from Mao’s day when dissidents were confined for psychiatric “care” (though apparently that still happens). Depression and suicide are on the rise. Well, as they are everywhere. You can only amp up stress and anxiety levels so long before there are consequences.

 

Hypervigilant Hypochondriacs

Meanwhile, our understanding of how bodies work continues to deteriorate, ably aided by corporations pushing the idea that health is really the sum of its (measurable) parts which we can follow, eagle-eyed, with wearable devices. There is, after all, money to be made. So beady little tech eyes are now turned to what has been termed the “quantitative patient”.

And we’re merrily going along with this, loving our Apple watches and FitBits and apps. Improvements in wireless and other technologies are poised to track your every heartbeat and more – so you can obsess not just about the number of steps you took but your sleep, glucose levels, whatever else they can think of to measure. As if Dr. Google weren’t bad enough, now we can be hypervigilant hypochondriacs 24/7.

We used to refer to these measures as “objective” health (versus “subjective”, which is how you actually feel) but this is taking every breath, hiccup and heartbeat to a whole new level. And I would remind you that the algorithms tracking these rely on large banks of energy-devouring servers, adding to climate change as you compare yourself to some mythical standard.

The Minotaur maybe?

Inevitably it will be the young and tech savvy, those least likely to suffer from anything dire, who will be the ones goimg nuts over this medical micromanaging – and they will be the ones most likely to go crazy when their heart skips a beat or their REM sleep doesn’t conform to some average. Given how dynamic physiology is, not to mention self regulating, knowing this minutae will probably only serve to increase anxiety, not health. After all, everything from stress to food to falling in love affects these mechanistic medical benchmarks.

Soooooo … gazing into my crystal ball I see nervous zombies rising through the mist, upset and worried because their watch told them something was abnormal. I observe health care systems overwhelmed by ever younger people panicked by shrill apps. Social skills further eroded as our phones not only remind us there’s an update on Twitter but that our pulse was a touch thready for 4.3 seconds. Then the doctor-du-jour on some telehealth app will try to reassure us we won’t be dead by next Tuesday.

Julie, don’t go

I don’t suppose the Wayne and Shuster skits would do too well these days; they’re awfully clever and literary. But they still make me laugh. One of the best was the Julius Caesar sketch, with Caesar’s wife repeating, mournfully, that she warned him not to go out on the Ides of March. “Julie, I said, Julie don’t go.” But did he listen? Of course not. By the same token I feel like that sometimes, constantly telling people not to check Dr. Google and go down that rabbit hole of medical misinformation. But do they listen? Of course not. There’s always something going on in that Forum.

To illustrate the point, true story. Big-wig American CEO, recently retired, with excellent insurance, feels a twinge in his left arm. Naturally races to the internet and realizes he must be having a heart attack, and must run, not walk, to the ER. Hours or possibly days at the hospital where he’s probed and poked, scanned and tested and then it turns out it wasn’t his heart at all. He had recently taken up gardening (repeat, retirement) and overdid things a bit, straining his left arm and shoulder. Oops.

So you see, Virginia, sometimes there is no sanity clause.

Finally

No matter how bad things got the vast majority of us are still here. Statistically, as always, those who did poorly with covid were the poor, the frail, the elderly, the dispossessed; those without access to clean food and water, health care or care in general. The differences between areas that locked down hard (like California) and those that did not (Florida) in terms of covid cases or deaths were insignificant. So much as I hate to say I told you so (OK, I lie, I love it), much of our general freakout and fighting about masks and proximity was misplaced. Basic care and common sense measures would have sufficed. Protecting the most vulnerable. How things might have played out without the panic of the last few years is not knowable; suffice it to say that the current global economic disruption(s) could have been averted, at least somewhat, had saner heads prevailed. Risk, alas, continues to be misunderstood even as the vast majority of us live longer, healthier lives than any other cohort in history.

So, in closing, I leave you with the mental picture of a graphic I recently saw. It read, what’s important to remember is not whether the glass is half full or half empty but that the glass can be refilled. Next to the glass: a bottle of wine.

Cheers.