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Archive for 21 septiembre 2020

Remedial care, meaning actions taken after an ailment has been detected, has been the traditional focus of healthcare. Probably that is the reason why, when politicians decide to invest in healthcare, they put the emphasis on hospitals and fancy machinery. Let us not be cynical and think that it is because a picture taken in front of a multimillion-euro hospital looks better than one taken in front of a non-descript primary care building. Most probably, policy makers are the slaves of some defunct theory (to paraphrase Keynes).

They, or probably all of us, do not follow the advice – Keynes again- that “When my information changes, I alter my conclusions.” We see it on the current so-called second Covid-19 wave. There is a lot of talk about building more wards dedicated to Covid-19 – remedial – and little emphasis on reinforcing primary care – prevention – where the pressure for tests and tracing is mounting.

Contrary to reacting to a situation, preventing it is a lot more efficient and effective. Unfortunately, the Covid-19 pandemic has demonstrated how few preventive measures have been taken by all of us. We cannot say the problem lies solely with policy makers; it has been all of us who have decided not to take the most basic measures to fight the spread of the virus. We are all to blame.

Apart from the tracing app, there has been very little development of ICT based instruments to fight Covid-19. The fact is that we, as a society, tend to focus on the immediate, and not to look at the big picture: too many tactics and very little strategy. Confronting the problem as a Covid-19 problem will not solve the imbalance in favor of remedial care against prevention care.  We need to divert our investments, human and material, to primary care, where healthcare becomes much more than treating illnesses, where healthcare is preventing people from becoming ill. Thinking that way, I can see lots of ICT applications that could help primary care do its job: simple, user-friendly applications to be used by normal people, designed to help practitioners do their job and the population to remain fit and healthy.

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If we have to choose a single factor that came out of Covid-19, it would be teleworking and its corollary: the death of the city (The death of the city – Politico 17/08/2020) as we know it, since supposedly we can now move anywhere and continue working.

But is it true that we can move anywhere? Even if we disregard manufacturer workers, healthcare professionals, service providers, and other professionals that cannot possibly do their job by teleworking, there is a tendency by journalists to focus their assessment of the situation created by Covid-19 on a very narrow sector of the population: those 30-40 year olds that, like themselves, have no kids,  no health problems and who can telework without major problems.

Cities were invented, and they flourish, because they provide care from cradle to grave. They have the facilities to make sure you are born without problems. They provide the network for you to socialize with children of similar age and learn your first skills. They keep up their offer as you grow, so that you can meet your first love. And it goes on, so that when you become an adult, the city will provide you with a partner and a job where  you can interact with your peers and together come up with bright solutions for whatever your concerns may be.

The wheel continues: in the city, you have a hospital nearby for your children’s safe birth. Maybe the same hospital to which you will accompany your parents for a checkup.  And we have not mentioned anything about ample shopping experience, movies in different languages, and restaurants and bars to mingle.

To sum up; I can identify certain red lines that most people are not prepared to give up. Those are: close availability of healthcare services; ample supply of goods and services; and social activities. Do you know of any environment that can provide those three aspects other than a city?

Let us stop talking about the death of the city and start talking about making the city more humane. A place to enjoy even when going to work. With more room for pedestrians and less room for noisy cars. The place in which we have most of the conveniences within walking distance, forgetting about those horrible malls and huge office buildings. A habitable city.

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