That’s Covid Sorted – Now We Are Going To Die

Midway through the first Covid wave the BBC’s Health Editor, Hugh Pym, told viewers of the six-o-clock news that the epidemic had ended a decade long run of below average excess deaths in the UK. What were we to make of that: perhaps before the arrival of covid the NHS been well on the way to curing death? To be fair a TV news program is not the place for lengthy and complicated explanations. Not that demographics in general, and death in particular, are particularly complicated concepts, assuming you have a grasp of basic maths and a knowledge of 20th century history. Most people can add 83 (the average life expectancy in the UK) to 1947 (the year live births in Britain jumped from around 600,000 to almost 1 million) in some cases without the help of a calculator. Don’t want to know the result, then look away now. In 2030 the number of excess deaths above the five-year average will jump by around 300,000 (the equivalent to two covid epidemics in a single year.)

Live births jumped following the first World War: this cohort started dying in the late 1990’s. The low death rate Pym described was the result of a relatively low birth rate in years running up to, and including, the second world war.

A reluctance to face up to our own mortality, which made Covid all the more shocking, is widespread and borderline institutionalised. Even the Office of National Statistics has a blind spot when it comes to predicting when deaths will shrink the UK’s population and what happens when the average age of those still living begins to fall. Part of the problem is the Internet, this virtual world unbounded by time and space and populated by immortal avatars onto which we project ourselves fills the void in a secular Britain left when we lost faith in an afterlife. A social media post at the end of 2016, a year during which a large number of well-known TV and film personalities passed away, was particularly telling. ‘This has been a terrible 12 months – let’s hope 2017 is better.’ Obviously 2030 will come as quite a shock to this person, who failed to appreciate one day you scroll down and the screen goes blue, given by the end of the decade the second half of the Beatles and remaining Rolling Stones – except perhaps for Keith Richards – will probably no longer be with us. Our reluctance to thing about death is hardwired into the human brain which during the 6 million years of evolution never once had to think itself out of a situation in which it did not exist.  Now we have until the end of the decade to work out what 300,000 extra deaths will mean for the NHS.

Death is not a problem for the NHS as hospitals run just as smoothly, some time more so, if patients leave A&E in a box rather head for a bed on a ward. However all those people slated to die at the end of decade are currently in their 70s, a decade during which a person’s health rapidly declines. Typically the first major health issue occurs during our late sixties: it is downhill from then on. The first world war baby boomers reached this stage in their life during the 1990s, the decade the NHS faced near collapse and we first heard the term ‘bed blocking.’

The first Steinkrug Publication’s Wireless Healthcare report, published in 2002, was entitled ‘Healthcare for an Ageing Population’ and addressed what we regarded the healthcare sector’s most pressing problem. The report was aimed at mobile carriers and medical device companies and was presented at various technology and healthcare conferences. It was hard sell as, by then, for the NHS at least, the worse was over and the prevailing attitude amongst delegates from the healthcare sector was ‘problem solved.’ Millions had been poured into the healthcare sector by New Labour, much of which was used to recruit additional staff. Co-ordination between local authorities and hospitals had improved, preventing hospital wards turning into nursing homes for the elderly. As well, billions were being spent improving NHS IT and while the National Program for IT was regarded as a failure it did help bring the NHS kicking and screaming into the digital age. However, bed blocking was also easing because many of the elderly patients causing it had died. Unfortunately, as any engineer will tell you, problems which go away on their own can come back on their own. Which brings us to Covid.

Many of the 150,000 who died during the Covid epidemic were the elderly, caught on the wrong side of Matt Hancock’s firewall; some of these were the strongest first world war baby boomers; others the weakest second world war boomers. Several statisticians explained this at the time but stopped pressing a point too closely aligned with the government narrative that these old people would have been dead within a couple of years so where is the harm. One reason the government is delaying an enquiry into care home deaths is to allow time for these elderly people to fade into history. Relatives of the deceased will no doubt respond to this sleight of hand by digging out photographs of parents and partners taken during the nineteen sixties and seventies. This is not the only history lesson Britain’s health sector needs right now, it has to be reminded the surge of elderly patients, which brought the NHS to its knees twenty years ago, was a mere ripple compared to the tsunami which threatens to overwhelm it now.

Unlike the first cohort of baby boomers the second contains more survivors. Unlike their parents, anyone born after the second war was nursed into adulthood by the NHS and unlike their parents many of them did not smoke – in fact unlike their children they were not brought up on a high sugar diet. As far as longevity is concerned the current baby boomer generation finds itself in the sweet spot between respiratory diseases and complications associated with type II diabetes. Even so, the grim reaper will get them in the end and the scything will start in earnest beginning midway through 2030.

It was clear in 2002 the healthcare sector was in denial and was still refusing to acknowledge the problem ageing would cause in 2008 when we published a second report on care for the elderly. It is difficult to decide what scares people most, planning for death, or basic maths.