The Thin End

If health care resources and staff are stretched to the limit, difficult life or death choices must be made.  Who to treat? That will be the question. At ordinary times decisions might be made based on whether treatment will do more harm than good.  It might even be the patient who decides.  End of life decisions are more often like that.  Will further treatment help? But these are not regular times. The British Medical Association guidance on pandemics says "In dangerous pandemics the ethical balance of all doctors and health care workers must shift towards the utilitarian objective of equitable concern for all – while maintaining respect for all as ‘ends in themselves’." If resources are spent on saving the life of one person at the expense of many others, how then is that balance to be made? One thing is sure.  Our actions are also part of this ethical mix.  Our efforts will determine whether or not the anticipated surge in those requiri...

The sad truth is that the UK was strategically poorly prepared for COVID-19. We seem to have learnt very few lessons from previous virus pandemics. South Korea learnt those lessons, and they also followed the WHO advice to "test, test, test." We are not alone in acting too little too late.  Most European countries and also the USA appear equally ill-prepared.  Our strategies are led more by panic than clear thinking.   To fight a virus such as COVID-19 preparedness matters.  To save lives, we have to be ahead of the curve.  Most authorities are behind it. We seem to be at that point in a game, when the enemy is coming so fast that we really can't keep up with it and so we shoot, shoot, and shoot, only to find we have run out of ammunition.  The lesson is that we need the resources if a strategy is to work. A plan without resources just isn't worth the paper it is written on. Logistics matters.  We should not have frontline medical staff c...