February 2, 2022

Let’s run the numbers. The omicron wave appears to have peaked and is on the downward slope. Case loads are down about 40% nationally from where they were a few weeks ago and hospitalizations, after peaking at numbers higher than we saw in the surge last winter just prior to vaccines becoming available, are also starting to trend down. Locally, UAB is down about 20% on the inpatient side from 250 cases to about 200 cases currently in house. There’s only one number that’s still going up, and that’s deaths as the numbers work their inexorable way through cases to hospitalizations to deaths over a four to six week cycle. The mortality numbers, currently somewhere between 2,500 and 3,000 a day won’t peak for another week or so, and they should join the downward trend, but not before cresting 900,000 for the pandemic in toto (a number we’ll hit in a week or so) and it’s pretty inevitable that we’re eventually going to hit a million deaths in the US by this summer. That’s a number that would have seemed inconceivable a couple of years ago but now is just one more dull statistic flapping against the numbness of our daily lives as we all continue to try and make sense of our crazy world and carry on.

We’re all in the midst of pretending just a few more weeks or a few more months and then we can get back to normal. I’m not sure we were ever at normal when the pandemic hit. I always tended to be rather sunnily optimistic about how our society worked and that we had the ability to rise up and meet challenges cooperatively. Tommy was very much a pessimist and saw the disasters lurking in our social, economic, and political institutions much more clearly than I. We had a number of very long complex late-night arguments over such things over the years and, were he still here, I could see him sitting up in his side of the bed with a smug grin saying ‘I told you so’. Steve, on the other hand, tended to ignore politics with the exception of LGBTQ rights issues. When it came to those, he was at the forefront of every protest or activist movement. I suppose when you come out at age 14 in 1962, it positions you for that sort of battle. I would join him in his later years, but not quite so noisily and a little back from the front lines.

As I look around, I see the institutions that are most important in my life are cracking in myriad ways. I’ve discussed the issues with the health care system that the pandemic has laid bare ad nauseam in these entries so I’m not going to go into details on that one other than to opine than to say I can’t see it continuing to operate moving forward without serious reform. We’ve lost too many good and experienced people from clinical roles – burned out, retired, chronically ill or dead. We have a population that’s rapidly changing demographically. The boom will start turning 80 in four short years and health care systems have been all about just trying to survive over the last few years so they have spent no energy or resources figuring out what that’s going to mean or what they are going to have to do to retool to provide the services that aging population is going to need. And in the meantime, the administrative arm of healthcare, determined to justify their importance (and their salaries) keeps drifting off into weird tangents. I shall cite one recent example. A large national hospital chain recently did a big data analysis of in hospital suicides (a very low number and generally confined to psychiatric wards) and determined that successful suicides were more frequently accomplished with hanging/strangulation using fitted sheets rather than flat sheets. The chain then removed every fitted sheet from its hospitals, requiring nurses to use flat sheets on mattresses. This might have made sense in the psychiatric wards, but it was applied to all inpatient units. The administrators who made this decision have obviously never tried to make an adjustable hospital bed using flat sheets and it’s leading to huge issues on already overworked nursing staff. Pressure ulcers to begin increasing in 3… 2… 1…

The public education system is also cracking up under the pressures of Covid, between battles over mask mandates, lack of support of classroom teachers by administration, unreasonable demands of parents who are busy taking their stresses out on a convenient target etc. Perhaps the most essential public employee for society to function is a first grade teacher but the opprobrium and scorn and poor salary scales we’ve foisted on public school teachers for years is coming home to roost. Latest polls suggest that 50% of current public school teachers are considering leaving the profession in the next couple of years. And who will be willing to replace them? Conservative legislators are meddling with public schools with all sorts of draconian bills whose purpose seems to be to drive teachers out the doors faster. I’m assuming the end game is to make the current model of public education non-viable so that it can be privatized and monetized like pretty much every other section of the economy. They’re using parents rights as the rallying cry. The thing of it is is that parents are not the customer/stakeholder in education. The stakeholder is the general public who needs a well educated populace in order for its society to function. People seem to forget that relatively basic fact.

Then there’s the political system. Our winner take all system of power pretty much ensures a two party system with both parties in a position to potentially take all the marbles every election, unlike most European democracies where parliamentary systems lead to more proportional representation. When there was a certain amount of comity and behind the scenes cooperation between both parties as they had similar goals, but different ideas about the best way to achieve them, the system had the ability to work. Now it’s mired in partisanship, obstructionism, and, in the case of at least one party, a seeming desire to turn the clock back to the Victorian Age.

Then there’s the performing arts, which are trying desperately to survive in a time of performers getting sick and being unable to perform, audiences that are leery of gathering in groups, and younger generations who are not being taught to appreciate and support the fine arts, not to mention living lives of quiet economic desperation so that they for the most part can’t even if they wanted to. The theater and music groups I work with are all trying desperately to raise funds, to come up with productions that can be mounted safely, and dealing with only a fraction of the ticket revenue they used to generate. They’re limping along but how many more seasons before it just no longer works?

I think we’re coming to a crossroads. We can either try to patch all of these things up with baling wire, spit, and superglue or we can let some things collapse, clear the land, and build back better. To choose the latter course, however, we have to have some time, energy, leadership, and a forward course charted and I haven’t been seeing a lot of that recently. I’d love to say I have the answers but I don’t. I’m as overwhelmed by all of this as everyone else. I think it’s why I’ve been as fatigued as I’ve been this past week or so. Hopefully the last weekend of 9 to 5 will provide some rejuvenation. We’re back on tomorrow night presuming somebody else irreplaceable doesn’t become sick overnight. We had a brush up rehearsal tonight and I still remember my lines and how to fake the choreography so I’m good.

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