Aging populations + Annual flu season = Difficult choices going forward?

[user1477391263]

I briefly said something about this on another thread.

Populations are aging rapidly all over the world---not just in the East Asian countries and Eastern Europe, but almost everywhere, from the UK to Brazil to Vietnam. We've long been told that this is going to create challenges going forward. I'm increasingly wondering if the COVID19 debacle is giving us a taste of the kind of difficult dilemmas we may face going forward.

Aging populations are going to massively, massively increase demand for healthcare---we know that. And in many countries, the number of people of working age is already shrinking. It's likely these trends will continue going forward. Fewer taxpayers to pay for healthcare systems. Fewer people to work as nurses, doctors, and other healthcare providers.

I don't know when the pressure of aging populations is really going to start to bite-five years, 10 years, 15 years from now? But as the pinch is felt, some of the dilemmas we've been acutely aware of recentlynot enough beds and staff for all the people needing caremight start making themselves felt during "non-pandemic" years as well-at least, during those years when flu is particularly bad.

We've dramatically decreased flu this year, but it appears to have taken social distancing and school closures (or, in Oz, NZ, Taiwan etc., heavy travel restrictions). We can't start doing this regularly. Apart from anything else, if we started doing these things every time we had a bad year, the misery they cause would be likely to have knock-on effects on the birthrate (further accelerating the aging population issue) and driving women out of the workforce (further accelerating the loss of taxpaying workers), not to mention making it hard to attract immigrants.

Perhaps we need to treat this year as a wakeup call and start thinking about what we are going to do about winter bed pressures, going forward? We need to try and think of low-disruption things (higher vaccination rates, better vaxes, some masking/hygiene stuff, handling as many things as possible through telemedicine) that will help us to cope. And also have those difficult conversations about how we can't live forever either.

I know this sounds like a conversation that can be shelved, but I'm reminded of the years before this pandemic hit. Scientists warned us for years that pandemics had not gone away and that we were almost certainly going to be hit by one---and when one did come, we were all a bit blindsided by it. I'm concerned that the aging population issue is also something that we are sort of "aware of" but not really planning for or thinking about with any sense of urgency.

I suppose we'll keep importing young people from countries with the median age about 25.

I agree with @Roystonv

I don't want too. I think life is precious and should be valued.

However, I've seen elderly relatives with dementia living in a way I wouldn't allow my animals to live.

I do think any sort of assisted dying system is open to horrendous abuse so I don't know what the answer is.

I just know I'd rather have had (and strongly believe so would they) a peaceful dignified end instead of two years of hell for them and everybody involved.

appg-longevity.org/events-publications

DH was involved in this early last year. It is very clear that we need to invest in early health and wealth to ensure better, and most importantly, healthier later years.

I suppose we'll keep importing young people from countries with the median age about 25.

You mean as medical care workers? That's tricky. The big story about global aging is that nowadays, most countries (middle income countries as well as wealthy ones) are struggling with the aging population issue---and there are some serious ethical issues with taking healthcare workers away from places like Eastern Europe which are also suffering severe shortages of doctors and nurses. More and more, it's really only sub Saharan Africa which is going to have surpluses of young people, and I am guessing not enough of these populations will have the right skill sets.

I suspect we are going to have to do a LOT of telemedicine, going forward, to cut costs and free up hospital resources for the cases where telemedicine is not possible.

You mean as medical care workers?

social care workers more like.
agricultural labour
IT
engineers
hospitality
"skilled professions" which could include nurses, yes

The immigrants will pay taxes & beget children who pay taxes to pay for the healthcare of the aging indigenous. Isn't this the modern high income country economic model?

My thoughts exactly.

"Save the NHS" " No life is more important than the other" "protect the elderly"

Every year 10s of thousands of elderly die each year from the flu. If we had done lockdowns every year it would save millions of lives and relieve pressure on the NHS. But why haven't we? Quite simply cos cutting off the freedom of the majority to save a small percentage of the population is mad and not viable. Theyve been sacrifical lambs every year but Covid.....oh no...we must cut the country off and people have their conscience back

I think they need to make nursing much more accessible and affordable particularly for women with children as many do go into it later in life. I would have completed my nursing years ago but I need to wait until my youngest is at secondary school so I can complete the early shift placements. They also need to increase the bursary.

We must all take personal responsibility. How you choose to live, what you eat, drink, how active you are, will impact your health. If people were more responsible it could reduce low level use of the NHS. People have a lot of animosity towards the current older generation but are often doing bugger all to reduce the burden they will become.

Tax unhealthy stuff, junk food, alcohol, sugar, whatever you like, invest it into local, cheap leisure centres and health provisions.

How many choices come down to money?

How many swimming pools gave closed?

How many outdoor spaces are nice, inviting places to be?

I always think, turn us into a giant garden. Trees, plants, fruit, etc etc everywhere. Re green our island with paths and tracks everywhere.

The NHS is geared up to deal with the winter virus season, so I'm not sure that that in itself is the issue.

Lives are valuable, and I would have to see any diminution of that as an absolute bedrock of a health care service. One needs to trust that doctors have only your wellbeing to consider when you are the patient.

That said, we have all seen the awful warnings about obesity and other aspects of unhealthy lifestyle which could lead to people dying at younger ages that their parents. It could be argued that we don't actually have a national health service, rather a national illness service.

Much more could be done about preventative medicine. But when you look at the reaction to the CRUK wholly factual ad campaign telling people that obesity is a massive risk factor in many cancers (and using an image of a fat warning on a cigarette-like pack, no image of people) the response was a round kicking about fat shaming. There are a lot of attitudes which could do with a change

Masks and social distancing might become normalised in the winter to deal with this. At least in bad flu seasons.

I agree we'll see masks more routinely in future among the vulnerable (or paranoid), regardless of how gone covid might be.

@DuchessofHastings1

My thoughts exactly.

"Save the NHS" " No life is more important than the other" "protect the elderly"

Every year 10s of thousands of elderly die each year from the flu. If we had done lockdowns every year it would save millions of lives and relieve pressure on the NHS. But why haven't we? Quite simply cos cutting off the freedom of the majority to save a small percentage of the population is mad and not viable. Theyve been sacrifical lambs every year but Covid.....oh no...we must cut the country off and people have their conscience back

No lockdowns. Easy 500k+ would have died. And a lot of those would have been non-covid related.

@Roystonv

Very much support dignity in dying (the charity and the idea). The money will not be there to care for all the elderly with dementia, illness and those who have just had enough - we have to be sensible and start talking about the implications for the country and the young if we continue to fund such ill elderly people. Of course you can live as long as you like but please stop rushing to save those who would be happy to just go. Death has to be normalised, we can't evade it. How can being bedridden, in pain, confused and lonely be called living it is existing only. Off track, any money I have I do not want to spend on nursing home fees but to say goodbye and help the next generation of my family. And before hospices are mentioned they do a wonderful job but we are talking about patients outside their remit.

Controversial question, but do you think the whole response to Covid will increase a 'live forever' mentality? We have a very unsustainable attitude in some ways, outlined in OP, to living on and on and on.

Advances in medicine will only increase life expectancy rather than reduce it.

@lljkk

I suppose we'll keep importing young people from countries with the median age about 25.

How many people can our island sustain though? 80 million? 90 million?

The more we increase our population the more we need to build the infrastructure in public services (and health care) to account for that. Instead we've had 10 years of austerity and public service cuts. And that's before a pandemic that we'll be paying off for the rest of our lives.

None of this is sustainable.

@DuchessofHastings1

My thoughts exactly.

"Save the NHS" " No life is more important than the other" "protect the elderly"

Every year 10s of thousands of elderly die each year from the flu. If we had done lockdowns every year it would save millions of lives and relieve pressure on the NHS. But why haven't we? Quite simply cos cutting off the freedom of the majority to save a small percentage of the population is mad and not viable. Theyve been sacrifical lambs every year but Covid.....oh no...we must cut the country off and people have their conscience back

I think it was the sheer numbers that forced their hand this year but I do agree that reporting every death as tragic and wanting that number to be zero is unreasonable. As you said, thousands of elderly people die every year from flu but we don’t report on every one of them.

@scaevola

The NHS is geared up to deal with the winter virus season, so I'm not sure that that in itself is the issue.

Lives are valuable, and I would have to see any diminution of that as an absolute bedrock of a health care service. One needs to trust that doctors have only your wellbeing to consider when you are the patient.

That said, we have all seen the awful warnings about obesity and other aspects of unhealthy lifestyle which could lead to people dying at younger ages that their parents. It could be argued that we don't actually have a national health service, rather a national illness service.

Much more could be done about preventative medicine. But when you look at the reaction to the CRUK wholly factual ad campaign telling people that obesity is a massive risk factor in many cancers (and using an image of a fat warning on a cigarette-like pack, no image of people) the response was a round kicking about fat shaming. There are a lot of attitudes which could do with a change

Completely agree.

I really think we should be opening up outdoor sport ASAP. Surely it’s a lot less risky than people mixing in schools. It would provide much needed exercise and a degree of socialisation.

[quote Doomsdayiscoming]@User133847

Live forever until the boomers die out. But once the more realistic, morally aware generations reach their 70/80s, I think euthanasia will kick in.[/quote]
It does feel like society is there to serve the interests of Boomers, who as a generation had it pretty good. The younger generations are just fucked.

@bumbleymummy

I don’t think anyone is expecting 0.

Once death rates fall to

@Doomsdayiscoming I agree.
They would have been a lot more deaths if it wasnt for lockdown. It was a new virus which they didn't know about etc and it was the right thing to do -but not in the long run. Its not viable for the economy, education and mental health.
Once the over 50s are vaccinated by April (99% of Covid deaths) we need to live life as normal and treat this like any other virus and illness out there.

I don't think it's necessary to have 'hard' conversations. By that I presume you mean not trying to treat people who could otherwise have made it.

What an odd message to take from this pandemic.

Focus on what Boris should have done differently, not who should have been prepared to pop off quietly.

Why is Polaris so fucking untouchable given our diminished role in the world ?

@Doomsdayiscoming I meant in relation to reporting every covid death. Lots of ‘every death from this is a tragedy’ type posts on social media. The death of someone over 80 is of course very sad for their family but if they died from flu we wouldn’t be reporting it as tragic.