Is there a difference between death from Covid and death from other flu viruses ?
Forget the blethering of Jonathan Sumption on Radio 4’s Today programme this morning about the distinction between dying “with” and “of” Covid – the most interesting feature of Amol Rajan’s interview with the former Supreme Court judge was the BBC presenter’s interjection in response: “That’s quite a precious thing to have that year of life taken from you by a respiratory virus.”
I wonder whether Rajan would have used the same form of words pre-pandemic to describe the mortality rates produced by the dozens of respiratory viruses that circulate every year. According to the CDC in America, pneumococcal pneumonia causes 150,000 hospitalisations annually in the States. It has a fatality rate of 5-7%. In elderly and vulnerable populations it may be far higher.
In a vaccinated population, Covid poses similar risks to the other respiratory viruses we have lived with for decades. On the latest data from the UK, Case Fatality Rate has dropped from 2% of all recorded cases leading to deaths to just 0.16% of cases.
Land of Zero Covid New Zealand is experiencing an extreme spike in cases of Respiratory Syncytial Virus (RSV), at least six times more than you would expect in a normal year. RSV is generally more dangerous to children than Covid. Hospitals have put care for heart conditions on hold to deal with a massive influx of new patients. Usually, RSV is kept at manageable proportions via herd immunity – as the population gets exposed to it year after year. It is thought that RSV began circulating at scale after a Covid secure travel corridor was opened up between Australia and New Zealand. When New Zealand genuinely opens up to the world, if it ever does, it will face a very tough reckoning.
New Zealand’s experience with RSV shows that for every ‘precious year’ saved by suppressing Covid, many more years may turn out to have been lost in the fullness of time. Respiratory diseases have always caused high mortality among the very young and very old – they will continue to do so once the Covid emergency has passed. In a vaccinated population, we need to start talking about Covid in the same terms as influenza-type illnesses, pneumonia and other respiratory viruses that infect us all the time.
This is the view of the Chief Medical Officer, Chris Whitty. In April, he described Covid in the same terms as seasonal flu: “Here is a seasonal, very dangerous disease that kills thousands of people every year and society has chosen a particular way around it.” That “particular way,” needless to say, does not involve nationwide lockdowns, mandatory quarantine of the infected and mass diagnostic testing.
More worryingly, Rajan’s view reflects a genuine phenomenon in our culture – the once commonplace belief that “once you’ve your three score years and ten, you’ve had a good innings,” is viewed as a cop-out, a sign of a lack of faith in the powers of science to deliver ever longer life.
And yet, the search for ever-longer life is likely to end in disappointment. The 16th century French philosopher Michel de Montaigne reminds us that “to lament that we shall not be alive a hundred years hence, is the same folly as to be sorry we were not alive a hundred years ago… there is no long, nor short, to things that are no more.” The years we spend in old age are no more intrinsically precious than those spent in youth or middle age – spend today in worrying about what tomorrow will bring and you may find it has been wasted. Montaigne continues: “Life in itself is neither good nor evil: it is the scene of good or evil as you make it.”
Many of you will not share that view – it’s a relic of an older time, you might say, a time when antibiotics did not exist, surgery was crude and medicine was mixed with a great deal of quackery. However, we may rue modelling our post-pandemic life around a mentality that tells itself that death is a kind of moral defeat and must be avoided at any cost.
Like the Roman philosophers and generals who spent so much time composing themselves for death, planning their own suicides, and meticulously recording them for posterity, we pay too much tribute to death and in the process line the grim reaper’s coffers. Far better to admit that if, by some quirk of evolution or divine intervention, we were somehow deprived of death, we would spend all our time writing letters to the great Editor-in-chief in the sky, arguing for its many virtues, damning the eternal span of years yet to come, and demanding death’s immediate restoration to its former place.