Beyond Normal: A New Vision of Healthcare After COVID
COVID-19 should be a wake-up call to embrace a preventative, holistic approach to health.
2020 will go down as a famously terrible year. As the virus spread, the prospect of healthcare workers having to choose who to save and who to let die was so intolerable that the sacrifice of lockdowns became the best of several bad options. Governments around the world had to resort to unprecedented social restrictions at a humongous cost to the global economy and the livelihoods of millions. If we couldn’t control the virus, we’d have to control the population. No more face-to-face business. No more gatherings. No more hugs.
When a person or institution is disconnected from the reality and meaning of something, we describe them as ‘out of touch’. To touch is to feel the reality of the world, to connect with it on a level that proposition alone can’t deliver. Reading about an event on Wikipedia doesn’t come close to the significance of being there. A hug has a very real impact on our physiology. In 2020, we were forced out of touch with each other, and with intimacy and connection. As social animals, the trauma of that runs deep. Depression and anxiety were already on the rise in the developed world and a sudden stop to social interaction, combined with a sharp rise in financial strain, has sent rates soaring further (Rates of depression have likely tripled in the US and doubled in the UK). Some governments made efforts to fend off an overflow of misery but in the stew of terrible options, sacrifices have to be made.
A NATURAL ENEMY
When faced with nothing but terrible options, helplessness fosters blame. In the early days of the pandemic, governments were rightly vilified for failing to react decisively, despite prior warnings from experts about the likelihood of serious global pandemics. Fingers were pointed at wet markets and labs in Wuhan. Governments and institutions in the west blamed their Chinese counterparts for a lack of transparency and communication. And now, many are furious at their governments for stifling fundamental freedoms whilst others blame non compliant super-spreaders or a secret cabal of global elites suspected of an evil conspiracy.
It’s precisely the lack of control that has us so riled. Collectively, we’re adjusted to having a certain level of control over our environment. We overcome natural constraints and kill or capture everything that threatens human dominance. The COVID-19 experience, much like natural disasters like hurricanes or wildfires, flies in the face of the human dominance narrative. With blame flying around but no individual, government, or institution directly responsible, the finger-pointing for many ultimately leads back to the virus itself.
We need a common enemy and the virus, along with the harsh, unforgiving natural world that created it, become just that. A narrative forms around SARS-CoV-2 as an unfortunate manifestation of natural evil, a ruthless pathogen with murderous intent. Officials adopt the language of war — ‘we must defeat this virus’.
What kind of problem succumbs to domination and control? The kind caused by something from the outside, something Other. When the cause of the problem is something intimate to ourselves, like homelessness or inequality, addiction, or obesity, there is nothing to war against. We may try to install an enemy, blaming, for example, the billionaires, Vladimir Putin, or the Devil, but then we miss key information, such as the ground conditions that allow billionaires (or viruses) to replicate in the first place.
Charles Eisenstein, The Coronation
Backed into a corner, we have only one way to regain control and dominance. In record time several working vaccines have been developed and are now being rolled out. With an end in sight, governments look forward to being able to declare victory in the war. We’ll all be grateful to see each other again, to gather and interact. Economies will be revived and livelihoods restored. In the euphoria of ‘victory’, we risk missing the most important lessons of this catastrophe.
AN ALTERNATIVE TAKE
The framing of viruses as evil enemies blinds us to the fact that viruses are essential to life itself. They play a vital role in evolution by performing a kind of balancing function in nature. The good-evil framing is a false dichotomy that ignores a lot of nuance. Some viruses, like smallpox or measles, are incredibly dangerous to human life, some completely benign.
The gravity of the COVID situation isn’t defined by the presence of a novel virus itself but by the mortality rate. This particular virus exposes rampant immune deficiencies. We know that healthy, robust immune systems commonly react well to the SARS-CoV-2 virus whilst diabetes, obesity and other chronic health problems drive up the risk of extreme illness or death.
This should point us toward a close examination of immune stressors and their role in bad outcomes from the virus. We know that many lifestyle and environmental factors harm our health and suppress immune function.
Evidence suggests that air pollution has a negative impact on outcomes from COVID-19. Western diets are increasingly unhealthy and sedentary lifestyles common. Our food is riddled with toxic substances, livestock pumped full of antibiotics and hormones, soil and groundwater saturated with pesticides and herbicides. The sterile air inside our buildings and our overuse of cleaning products degrade the microbiome that we depend on for optimal health and resilience. All of these contribute to degraded immune systems and potentially low resilience.
Yet there is little consideration of those inputs in the public conversation, which focuses solely and exclusively on the virus itself. And as a result, the remedy focuses solely on treatment and vaccination, and overlooks underlying causes of immune dysfunction that contribute to bad outcomes from the disease. In our understandable eagerness to escape this compromised situation, we’re developing a blinkered view of a complex picture. Whilst it might dig us out of this hole, it will do little to guard against future crises.
SAME OLD STORY
It isn’t the first time we’ve taken this approach. Cancer affects more than 1 in 3 people but anywhere between 40% and 70% of cases are avoidable through lifestyle change. Sugar, tobacco smoke, and alcohol consumption all contribute. We have carcinogenic substances in our cosmetics, cleaning products, and foods that are completely unnecessary. Research suggests pesticide exposure may cause certain cancers. Yet the vast majority of resources in the ‘fight against cancer’ go toward treatments and the development of prospective cures. Similarly, autoimmune disorders and allergies are on the rise. In some cases, autoimmune diseases are three times more common now than they were several decades ago.
But little attention is paid to the causes of these diseases, whilst we focus intently on cures. For the majority of these diseases, there is no cure and treatments are expensive. To anyone studying them, the spike in these afflictions over the last half-century has been alarming but to the rest of us, they look like an unfortunate fact of life that we assume our parents and grandparents have known before us. Surely it’s just a result of more effective diagnosis right? Unfortunately not.
There is almost universal agreement among scientists and physicians that the environmental toxins and chemicals to which we are increasingly exposed are interfering with the immune system’s ability to distinguish self from non-self.
Douglas Kerr, M.D., Ph.D.
Despite modest efforts to discourage smoking and encourage healthier lifestyle habits, the governments and institutions that we rely on for authoritative health information have done woefully little to right the ship. And the cultural narrative sets us up for further failure.
BAD INCENTIVES AND BROKEN NARRATIVES
Mainstream medicine is overwhelmingly focused on reactionary approaches. Doctors generally don’t work with patients to prevent illnesses before they arise, they intervene afterward. That’s not to place blame on doctors, they understandably have their hands full treating the sick and there’s little provision within the system for preventative approaches.
Much like the COVID situation, we’re backed into a corner with lives to save here and now. Resources are channeled toward short term patches rather than long-term fixes. The incentives of the market drive us down the same narrowing path. There’s huge profit potential in developing pharmaceutical cures and treatments. Sickness provides a need that the market can satisfy whilst many aspects of healthy lifestyles are completely free. There’s not much profit to be had in telling people to drink more water, sleep more, go outside and move their bodies. And reducing consumption of alcohol, tobacco, ultra-processed and industrially farmed foods, ultimately strips corporations and industries of precious profits.
Yet the dominant cultural narrative, despite rising rates of ‘diseases of affluence’ and falling life expectancies, suggests that mainstream medicine offers efficacy and everything else is quackery. The broken incentives of the market combine with the ingrained human dominance narrative to narrow our collective view of what works and what doesn’t. We assume we’re so much smarter than our ancestors, that we couldn’t possibly learn anything from them. How could ancient health practices possibly be reliable when the people that originated them hadn’t figured out antibiotics? Didn’t they all die in their thirties?
Many are skeptical of anything that sounds alternative or ‘woo-woo’ whilst taking the efficacy and safety of pharmaceutical remedies for granted. The growing politicisation of thought adds to the problem. The prospect of falling into the conspiracy box with the QAnon crowd adds to the temptation to accept every mainstream narrative as unquestionable.
But there’s plenty of evidence to suggest our intellectual arrogance is unfounded. To state the obvious, we don’t know everything. Take meditation as an example — ten years ago it would have been laughed off by a vast majority as an unhelpful hippyish pursuit. Today scientific research has caught up and we know that meditation can reshape our brains for the better. The same goes for time spent outside, in connection with nature. And the list of foods found to have anti-cancer properties is ever-growing.
Earthing is an under-researched practice that may prove to be highly effective in reducing inflammatory disorders at zero cost. But the mainstream narrative suggests it’s far too ‘new-agey’ to be trusted. Doctors can’t support their practices by simply telling patients to take their shoes off and stand on the grass. Big pharma can’t turn it into a product. So although it costs nothing and makes perfect theoretical sense in the context of human evolutionary history, the majority feel a reluctance to engage with the idea. But if we can take an anti-inflammatory pill made by a faceless corporation (with a long list of possible side-effects) we’re comfortable paying the bill and asking very few questions.
Part of the misconception comes down to research. A tremendous amount of research goes into discovering chemical remedies whilst relatively little looks into things like earthing, cold exposure, or meditation. But the vast majority of research funding comes from pharmaceutical companies. Why would they channel resources into researching unprofitable holistic practices? They wouldn’t. No single person, company, or institution is solely to blame though.
It is difficult to get a man to understand something when his salary depends upon his not understanding it.
Everyone does the most rational thing from their position within the system. And the system runs on a narrative of dominance, control, and separation. We don’t see ourselves as part of the natural world, or in harmony with it. We fail to give room to everything we don’t yet know and lean complacently into the relatively few things we do.
So the cycle perpetuates. We develop unhealthy lifestyles, detached from nature, and driven by economic incentives. That leads to sickness, dysfunction, and depression. Desperate for quick relief, we seek effective remedies, which pharmaceutical companies gladly provide in exchange for a fee. We patch over the sickness without addressing the underlying causes and go back to our unhealthy lifestyles. We retreat further and further from natural processes, reducing our resilience and exposing ourselves to new threats.
RIGHTING THE SHIP
Rising rates of cancer and autoimmune disorders were relative slow burns in comparison to COVID-19. A slowly developing knee niggle is harder to spot than a traumatic torn ACL. With this sudden car crash situation, we have an opportunity to learn lessons that have been subtly staring us in the face for decades. But the dominant narrative is robust. Given the struggle of the last year, there will be a strong urge to accept the narrow, triumphant view of man vs nature and hastily rush back to life as we knew it.
We’re hooked on convenient, dopamine tweaking, ‘bliss point’ tickling garbage peddled by corporations. The profits from those sales drive up the GDP metrics that governments use to measure success, despite physical and mental health crises wreaking quiet havoc. With all those twisted influences, it will be easy to put the blinkers on and settle back into what we know.
In the wild self-congratulation of victory, and the relief of being able to see each other again, to work and travel, we’ll fail to address the underlying causes of our declining resilience. We’ll tape up yet another hole in the ship, and happily run the next shallow reef, confident we’ll never sink.
Or, maybe we’ll take another look. After a year of being limited to only seeing friends and family outside, people in my neck of the woods might continue to take long walks in nature. They’ll source organic produce and keep refining the new healthy cooking skills they picked up during lockdown. That new morning meditation routine will stick. They’ll cut back on office hours having felt the benefits of time at home with loved ones, despite the pay cut. They won’t be able to imagine life without regular exercise, even though their previous selves were convinced it wasn’t for them. Combined with a revived social life and the possibility of seeing the world again, the newfound sense of wellbeing will be enlightening.
In touch with a new perspective, we’ll demand a new kind of healthcare that prioritizes prevention. We’ll rediscover how to thrive through symbiosis with nature and come together over a common will to protect it. We’ll find a more holistic way to balance pharmaceutical ingenuity with readily available, natural approaches to health. It’s an optimistic outlook, but we must have hope.
…Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting —
over and over announcing your place
in the family of things.
Mary Oliver, Wild Geese
Indigenous communities throughout history felt their place in the delicate balance of nature. They revered their surroundings and held them as sacred. They celebrated community and intimacy, embraced meaningful, communal work, and accepted discomfort. They didn’t live perfect lives, far from it, but they were likely no less happy than we are.
They didn’t have a scientific understanding of exactly what worked and why, but we do, so we have the opportunity to do better. But we need a framework for using it responsibly and time tested principles to guide us through the many blank spots in scientific knowledge. We can and should continue to lean on governments and institutions to enforce responsible practices but we’ll always be playing catch-up without a cultural shift.
We need a different collective outlook. A revived reverence for nature and our place within it would be a good start.