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Flu the Coop
Sick people, sick culture

by Bryan Zepp Jamieson
August 25, 2009

Officials are warning people to expect H1N1, the so-called “Swine Flu” to cause a few problems this winter. Oh, they are saying to expect 90,000 deaths, but don't worry about that too much; in a NORMAL winter, the flu usually kills between 100,000 and 150,000. Granted, H1N1 tends to kill teens and young adults, rather than babies and the elderly. Ironically, it's because teens and young adults have the strongest lungs, and are able to inhale larger colonies of the virus. So if you happen to be young and healthy, try and cut back on the breathing a bit. No hot-n-heavy stuff with a date who is feverish and sweaty. Remember, sex kills.

But the more important news is that a lot of people are expected to get the flu this winter: perhaps as much as 30% of the population, or 100,000,000 Americans. That equates to 10,000,000 Canadians, but Canada uses the metric system, so remember to convert.

Now, a typical siege of H1N1 usually puts someone in bed for 4 – 7 days. If they happen to be unlucky and get pneumonia, that can be two weeks or more. Chances that the flu will kill you are about one in a thousand, or about the same as those of the Washington Nationals winning the World Series this year.

Assuming that 30% of the population will miss about 5 work days due to flu, that means a 0.6% drop in productivity, which will make the people who think high productivity is a good thing generally miserable. Given that the people who are temporarily not contributing to higher productivity because of the flu will also be feeling generally miserable, that seems fair.

But chances are that it will hit the American economy harder than it will Canada, or France, or even Britain, even if the rates of infection are identical. It's because of the peculiar and backward health system America has.

Pretend, for a minute, that you are a single New York City mother with two kids, six and nine, in school. You've got a generally crappy job within an hour's commute, and it covers the rent, clothes for the kids, and half-way decent food, which puts you at about the 50^th percentile in terms of socio-economic status.

Schools anywhere in the world are just big petri dishes with kids rather than microorganisms, and the flu will sweep through the schools repeatedly. Since school boards seldom listen to epidemiologists and thus don't know that pandemics, especially respiratory ones, sweep through in a series of gradually diminishing waves (much like tsunamis, yes), they'll close schools when the first wave hits, and, two weeks later, when the level of new infections has tailed off, reopen them, just in time for the next wave to hit.

So the six year old gets hit first, just as the schools have reopened. You've already blown the budget on baby-sitters because you couldn't afford to stay home for the two weeks when the kids were stuck in the house, bored out of their minds and waiting for you to take off so they could try to descramble the porn channel or try mixing up some meth in the kitchen.

So now you do miss a week's work, because you can't trust the older sibling to notice vaguely alarming symptoms in the younger one, such as cessation of breathing or assumption of room temperature. The boss isn't thrilled, because about a quarter of his staff is already out sick, or tending to sick relatives. He can't understand why, on $15 an hour, these slackers can't afford home care or something.

The week passes, and exhausted, you return to work, where a mountain of stuff is in your inbox because you and a bunch of others were out, but that's no excuse for letting productivity drop.

Then the older one gets sick. Another week at home, another weeks' wages lost, more fatigue, greater demands at work.

So is it any surprise that you get hit hard when the flu gets to you? Because you don't have any sick time, you try to keep working for one more day before finally admitting you can't do it.

Now comes a real dilemma. Bad enough that you're in bed and trying to sleep while the kids are in school (assuming the schools haven't closed again because another wave of flu outbreak has arrived), and you can barely make it to the bathroom to throw up, let alone cook dinner for the kids, but now you're starting to get a rattling cough and your short ribs are starting to hurt, and there's a burning sensation in your chest.

You don't have a regular doctor because either you don't have health insurance, or there's a $1,000 deductible on the health insurance you do have. So you try to tough it out.

And, two days later, the kids go to the neighbor and say you're really acting sick, and the neighbor comes and looks at you, and the next thing you know, you're in the ER, about to be admitted with a case of double pneumonia. You're in the hospital for eight days, at which point you've lost your job (laid off for “lack of work,” or maybe fired for “bad attitude” so you don't collect unemployment), and when you get out, not only do you have no job, but you are now $120,000 in debt, there's no food, the child protection people have been sniffing around because nobody's taking proper care of your kids, and, because hospitals discharge patients as soon as they think they can make it off the hospital grounds alive, you still feel like shit.

That's the status quo that the Insurance companies, the Republicans, and the screamers at the townhall meetings want to maintain. Since no reforms are likely to take effect before next summer, good luck this winter. Don't get sick. Real bad idea.

The insurance companies have hired a staggering fifty THOUSAND lobbyists to promote the idea that health care reform is bad, and will hurt the average working American. Lobbyists don't come cheap, so you can easily surmise that the insurance companies are spending billions of dollars on these paid persuaders. They're doing it because they have only your very best interests at heart, you see.

Now, suppose you are a young mother of two working in Toronto. The flu shows up. Schools close, which is a nuisance. But your employer is part of a pool that maintains children's day-care facilities in the neighborhood, so you send the kids there during work hours. The cost of the “extra” child care will be deducted from your pay, but it will be far less of an economic blow than having to get day care in the US would be.

The first child gets sick, and you take him to the clinic, where he gets vitamin shots and palliative care. It won't make the flu go away, but it will make caring for him a bit less stressful. Because family emergency health matters are legitimate grounds for paid leave, you aren't losing money by staying home seeing to the child. There might be more work when you return, because Canadian bosses like high productivity too, but at least you won't be as stressed and exhausted.

Second child gets sick, and it's about the same as the first. Your employer is looking a bit grim, but he knows it could just as easily be him and his kids, and because he doesn't have to shell out a small fortune on inadequate health insurance for employees, he isn't under the immense pressure his American counterpart is.

And finally, the flu reaches you. Being an adult, you already went to the clinic and got a shot of Tamiflu, so your symptoms are mild. When the symptoms first appear, you call in sick. This doesn't make your boss happy, because a tenth of his work force has been out with the flu already, but he knows that it would be far worse if sick employees were showing up to work and spreading the flu because they were desperate, frightened, and felt they had no choice.

Five days later you're feeling better, and you return to work. Your kids are fine, you feel fine, your job is secure, you have money in your bank account, and all your neighbors, being Canadian, have stopped bitching about the flu and have gone back to complaining about the weather.

Your cousin in New York calls up, and relates a horror story about both boys getting sick a few weeks apart, and then she got sick and had to go to the hospital and nearly died, and now she's deep in debt, out of work, and still weak and frazzled from her ordeal.

You suggest she get out of there and move to Toronto. It's prettier, there's a lot less crime, and if you have trouble, the government will try to help you.

Your cousin, shocked, says she could never consider that. “Why, you pay nearly 15% more in taxes than I do! I don't know how you can live like that!”

Meanwhile, fifty thousand well-paid lobbyists are out there, making sure that nobody should ever have to live like a Canadian.

Posted: August 27, 2009

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