The Great Resignation in a Collapsing Health System

In an increasing number of countries all over the world chaos and despair is rising. People are more frequently ill and dying at higher rates than the past 50 years. At the same time health systems are deteriorating. We need to rethink humanness of health systems versus cold technological solutions.  

More than a seasonal problem

The pandemic measures have accelerated public health systems to the brink of collapse. In many Western countries these systems are facing severe problems, an inferno of pressures, including staff shortages from pandemic burnout, underpaid salaries, discrimination and a cost-of-living crisis, with many health professionals leaving the workforce while the demand for care from the community is rising. 

The often-used explanation for the current situation in healthcare, a tripledemic after two lockdowns resulting from a surge in winter viruses (RSV, Flu and Covid-19), does not hold. Current data do not represent an outlier season. 

Political ideology and catastrophic leadership costs healthy years of lives 

The health system in the UK is collapsing because of a decade or more of underinvestment in the National Health Service and other public services. The indicators for the health service are all red. Increased ambulance times and people waiting for a hospital bed, stranded outside overflowing hospitals, have spiked since December 2022. The overstretched system, with the longest delays on record for millions of treatments for cancer and operations, has left patients in pain, people enduring unnecessary suffering, and has led to 300-500 people a week dying avoidably because of the unsolved current crisis. The roots lie in political choices made, not cold weather or a seasonal flu.

On January 5, 2023 the British Prime Minister Rishi Sunak brought together the current advisors about the pressure of increasing demands. Yet, the response of top and senior managers in health services and politicians is silence, denial, disengagement, and delay, while health professionals are crying out on social media, mainstream media and the British Medical Journal to be heard. 

Other countries like France, Canada, and the US and The Netherlands are facing similar problems in the collapsing health system with shortness of staff and increased demands. 

A fall in life expectancy

Excess disabilities among those aged 16-64 years, and excess mortality among all age groups is noticed in a way that has never seen before. In the US excess mortality is 40 percent up amongst working age people. Cardiac health problems and sudden deaths increased most. Undercooled and malnourished elderly people are filling hospital beds and keep them filled as they have no place to go. But also, more newborn babies and young children need hospital care. Stillbirths have skyrocketed to levels never seen before and birth rates around the world have dropped dramatically. Concern regarding a long-term increase in demand is widely spread and worrisome. 

A fall in life expectancy is noticed, with the greatest fall in Spain, Italy, Belgium, the US and the UK. This is of a magnitude which has not been seen since World War II. Life expectancy in the US fell by 2.7 years from 2019 to 2021 due to increased mortality and premature deaths. Covid deaths worldwide from 2020-2022 were estimated at 6,653K, which is 3.86 percent of total deaths. The number of people that survived Covid is 99.914 percent, with the highest percentage in developing countries.

UK figures published this week showed that more than 650,000 deaths were registered in 2022 – 9 percent more than in 2020. Roughly 38,000 deaths involved Covid compared with more than 95,000 in 2020. Covid is one of the factors rather than the main explanation. Excess deaths in 2022 is among the worst in 50 years. A call for independent investigations is growing all over the world though they are kept on hold by Public Health ministers.

The real pandemic policy

More and more medical doctors and scientists are speaking out for an immediate halt of the mRNA vaccines until proven otherwise. German pathologists investigated people who died within 14 days after vaccination and observed that in certainly 30 percent of the cases but possibly 70-93 percent there was a relation. The more you vaccinate the worse the immune system gets.

Recently, mandates on Covid-19 vaccines for employees in private sector NYC, healthcare workers in NYCity, and the US military have been lifted. 

As the tipping point of reality of the Covid pandemic policy is near, there are many within and outside Parliament and healthcare for whom questions about the coercive nature of the mandates, lockdowns and the catastrophic situation are now increasingly uncomfortable. Governor Ron DeSantis of Florida has recently called for a statewide grand jury to investigate the alleged crimes and wrongdoing surrounding the Pfizer-BioNTech and Moderna Covid-19 mRNA vaccines and the CDC. 

The policy of the pandemic crisis ruined lives. The immune system in all age groups has been weakened in multiple ways, while the infection fatality rate of the SARS-CoV-2 virus pre-vaccination level is 0.007 percent for people aged 0-69 years, 0.003 percent for 0-59 years of age, and 0.0003 percent for children aged 0-19 years of age. 

The pandemic policy is acknowledged by wrong decisions and wrong investments based on poor studies, manipulated data, assumptions, incomplete or false communications and most of all, censoring voices of medical doctors and scientists questioning the policy. In past years the genuine concern of leading politicians, public health professionals, and journalists about the health and well-being of the population are shown to be very low or at some points even absent. 

Accountability

The health system is turned into a money driven Public Private Partnership, selling sickness, with limited interest in promoting health and well-being, let alone considering the advice of Hippocrates ‘First do not harm.’ 

During the past decade huge investments of tax money have been transferred to technological innovation in healthcare and even increased further over the past three years with the aim to contribute to the UN Sustainable Development Goals of the UN and Future Pandemic Preparedness, the proposed treaty of the WHO. Nevertheless, rising expenses for citizens on healthcare did not add years of a healthy life nor improved life expectancy. Even before the pandemic, the US, often referred to as having the best health system, already had the lowest life expectancy among large wealthy countries while it far outspends its peers on healthcare. 

CEO’s, senior managers and politicians are challenged to tackle glaring failings and accountability for current disasters which were predictable and could have been prevented. 

The Great resignation

A recent Deloitte article reports around 70 percent of high-level executives are seriously considering quitting their jobs; 1 out of 3 executives are constantly struggling with fatigue and poor mental health, which influences firm performance. Women leaders are leaving companies at the highest rate ever. The National Rural Health Association Policy Paper reported a turnover rate of CEOs of 18-20 percent per year. Over 650 CEOs in the US left their jobs in 2022, an increase of 13 percent as compared to 2021. 

The complications of unstable leadership can have a significant short- and long-term impact on hospitals, quality of care and the broader community. Leadership is a vital enabler to address burnout from organizational collapsing. A need for strong and steady leadership has never been greater to prevent hospital closure and continue care, which is especially needed for hospitals in rural health. 

Many doctors and nurses are choosing early retirement or leaving the sector for alternative careers. Unfortunately, for people working in the frontline and supporting staff, increasing problems of burnout have been observed also. The tipping points of self-sacrifice or no longer being willing to deal with a moral conflict have passed. The monthly resignation rates in the US during 2021 were the highest in the 20-year history of the Job Openings and Labor Turnover Survey. 

Preliminary findings of the International Council of Nurses suggest that the Covid-19 effect is highly likely to have a significant long-term impact as it contributes to a wave of post-traumatic stress disorder, depression, and anxiety. Even if only 10-15 percent of the current nursing population quits because of Covid-19, the effect there could be a potential shortfall of 14 million by 2030. which is the equivalent of half the current nursing workforce. Prior to the Covid-19 pandemic severe burnout was typically found in 20-40 percent of the healthcare workers. 

European Junior Doctors (with 300,000 junior doctors) said in a press release: “Healthcare in Europe is at a precipice. The situation is not new, it was predictable and preventable.” Alarming rates of burnout and other mental problems have resulted in many junior doctors leaving and considering leaving the workforce.

Burnout, depression and anxiety are harmful for the healthcare system, healthcare workers, and patients and are characterized by emotional exhaustion, depersonalization and diminished personal achievement. Risk factors have been exacerbated during the pandemic. 

Also symptoms of Long Covid were found to be increased among healthcare workers as compared to people working in other sectors, resulting in an urgent need for intervention. The overall long-term effects of the Covid measures on people working in the healthcare sector are yet unknown. The symptoms that are contributing to Long Covid and burnout, depression and anxiety could be a result of pandemic measures and masking in particular. 

A crisis to speed the transformation to ‘smart’ hospitals

The collapsing health system enables politicians and healthcare leaders to suggest a range of private market solutions to the healthcare crisis by technology and to contribute to the Sustainable Development Goals to be realized in 2030, as quick fixes for healthcare workers and shortage of beds won’t be realistic.

Burned-out doctors and nurses are being replaced by outsourcing at considerable cost. This will speed up the transformation to ‘smart’ hospitals advised by consultancies like McKinsey, KPMG and Philips NV, using AI, robotics, 3D printing, genomics, telemedicine, and precision medicine. 5G technology is introduced to realize Hospital Intelligent Twins for all scenario intelligence healthcare which is already operating in Guangdong, China.  

These policies are focused on more money, technology, digitalization and robotization, preparing a revolution to transhumanism and a digital health passport with all information of each citizen available in a central system. The experience with the Covid pandemic has shown transhumanism is a ‘utopia’ that can only ever materialize in a dystopia embracing the limits of the world as well as those of the human condition. The way out will be the human factor, not Big Data.

Humanity returns in the center of healthcare 

The loss of trust in government and health systems is bone deep for those who have lost loved ones, have become disabled, and lost their income. On Saturday January 7th 6 BBC buildings were covered with posters, stickers and pictures of people who were believed to be injured or killed by the vaccine: “BBC is the virus.”

Heartbreaking situations urgently need support and care. Interventions are needed to prevent similar situations. Unfortunately, most of the interventions often suggested lack evaluation or evidence to support them. 

Experienced leaders in change are urgently needed to restore openness and transparency, resilience, and support the healing of people in sickness leaves and prevent more people leaving healthcare. As recently proposed by DeSantis, mask and vaccine mandates should be permanently banned as well as the controversial Covid-19 Hospital Immunity protocol. 

The highest priority is a focus on the well-being of all employees, and safe and cost-effective treatments including nutrition and lifestyle interventions strengthening the immune system to support all people in choices for a healthy life. Employees with natural immunity fired during the pandemic should be hired back. Processes need to be simplified and focus on human-centered care.

Leaders of change in healthcare live the principles of universal public health coverage funded by taxation, being responsible and committed, and are not afraid to speak out, guiding organizations into empowering environments embedding a relationship of trust in the doctor-patient relation at the core of Medicine. Patients will be given optimal information of what healthcare workers know, so they can make informed choices. This will lead to positive change paving the road to a healthy economy making safe and effective, equitable, and human-centered healthcare affordable for all a reality.

This article originally appeared in the Brownstone Institute.

Featured image by Vladimir Fedotov via Unplash, under the Unplash license.