In my last post, I wondered about what the medical bureaucracies within government have been doing in the past many decades to prepare for the next epidemic. Undoubtedly, there are many filed reports on the subject, but the actual policy becomes transparent when an actual pandemic erupts. Now, we can see that the planning took for granted that hospitals will revert to their original function as locations for life support to allow bodies to heal themselves.
The bulk of the active policy making focused on detecting potentially transmissible pathogens and isolating them so that the spread does not reach pandemic levels. This policy apparently provided assurance that we would not need stock piles of life support equipment (such as ventilators). Based on the panic occurring withing the medical bureaucracy, they clearly have no new ideas for how to deal with the pandemic than to transfer sick people to hospitals and leave those hospitals the ugly task of how to ration their inventory of beds and equipment where that inventory was based on the faith that things would not get this bad.
I do not understand why the medical bureaucracy planners did not put more emphasis on the inventory of life-support systems that would benefit large populations during a pandemic. They knew that pandemics are inevitable and that modern life assures that it will spread faster and more extensively than in the past. The could easily and confidently predict that the current situation would occur, and in fact may be at the low end side of spread given the time this has been spreading.
One possible policy decision could have focused on the supply of life support systems. They could take a clue from consumer products that were developed and made affordable and reliable. Consumers currently can easily acquire very sophisticated appliances ranging from very advanced automobiles, highly efficient home HVAC systems, solar power and battery storage systems, highly capable computing and communications systems, and so on. All of these have advanced engineering that not long ago would only be available in large businesses that can own them and that can get return on investment from them. Now, these are in many homes or in the hands of the general population.
To be fair, there has been a similar innovation in medical equipment. We have access to automated blood-pressure measurement devices, pulse oxymeters, diabetic blood-sugar testers, hearing aids, and so on. Internally these are sophisticated devices, but they were allowed to be sold directly to consumers, stocked on shelves next to where they can buy aspirins or multivitamins.
Consumerization of medical technologies has been happening. There just aren’t any consumer versions of moderate life-support devices that would be handy during an epidemic. In the context of pneumonia, a very predictable epidemic outcome that can lead to fatality, there could be consumer appliances for oxygen, and ventilators that may require medical assistance to set up or remove but can be run in ones home instead of a hospital bed. More generally, vital measurements can be collected with a consumer device and transmitted to the medical system, perhaps automatically processed to alert nurses or doctors when conditions deteriorate to the point needed changes in treatment.
Where are these devices? Given the rarity and unpredictability of the pandemic, I can understand that there would not be stockpiles of these waiting to be used. In addition such stockpiles would quickly become obsolete compared to what can be built now.
Instead, there could be designs developed and manufacturing plans prepared for rapid production of consumer life-support products when they are needed. The designs would be tested and approved so that they could be distributed as quickly as possible.
Did our governments even consider this option?
There is a difference between medical devices presently available to consumers and life support devices. The failure or malfunction of the latter can lead to death and that will lead to lawsuits to the manufacturer.
From a public policy making perspective, though, we face statistics of large numbers. We have two choices.
- A very limited number of certified highly-reliable devices with some shielding from lawsuits. During a pandemic, this will lead to a large number of deaths due to rationing of this finite inventory
- A very large number of devices mass produced as consumer devices available to anyone. During a pandemic, a much larger population can have access to these devices, but some fraction may malfunction resulting in deaths.
The question for these two choices is which one will lead to the fewer total deaths for a truly widespread epidemic?
Based on our current system of government based on democratic processes and product liability lawsuits, we deny ourselves an option to responding to this epidemic: availability of consumer life-support systems. This option potentially could save more lives or at least provide comfort to more people than what hospitals can dispense. It is because of our forms of governing that we have made such devices illegal or prohibitively expensive for consumers.
The unfolding epidemic may expose the incompetence of our current form of government to neglect to promote a market for consumer appliances for the most common conditions resulting from epidemics, conditions such as pneumonia.
In contrast, a government by data and urgency could consider the full range of data. In addition to the inevitability of a pandemic, the system could observe the efficiency of consumer products and the rapid increase in sophistication of those products. Based on this data, it might conclude that permitting a consumer market of life support devices would be the optimal approach to reach the largest population.
Such an option would lessen the fear of the epidemic. People will have higher confidence that they will get access to life support devices when they need them. The economy can continue at a less degraded rate because of this confidence.