Thread by @HZiauddeen

🧵 COVID-19 & human capital: what we have lost and continue to lose

This is elaborating on the last bit of the 🧵below. If the devastating numbers of lives lost and damaged don't move you enough, perhaps the practical and economic arguments might?
(1/25)

https://twitter.com/HZiauddeen/status/1464757120495194116

A pervasive belief in many political and capitalistic systems is that human capital is just something to be slotted into necessary points in the system & that workers are interchangeable, replaceable & in plentiful supply 'we can just get/take more from elsewhere'.
(2/25)

I emphasise that this is a belief as any vaguely sensible model will make clear that this is not a feasible reality in any sustainable way (depends of course on what you are trying to sustain). But it is a belief that pervades a lot of thinking, especially in politics.
(3/25)

I'll illustrate with healthcare as it's the area I know best. Over the last 20 months we have lost a lot of healthcare workers to death, LongCOVID, burnout, and people leaving because they can no longer manage to work in it.
(4/25)

https://twitter.com/HZiauddeen/status/1432697677930762246?s=20

These are just the folk we have lost completely, the workforce mortality, so to speak but there is a lot more workforce morbidity i.e. those not able to function at full capacity because of all the reasons above plus the increasing workload (pandemic + staff shortages)
(5/25)

The longer this goes on, the more people you lose from the workforce, through burnout and illness and through people leaving before they burn out and fall ill. Deaths and LongCOVID will continue as will the huge element of moral injury.
(6/25)

https://twitter.com/HZiauddeen/status/1449009117230768133?s=20

Stresses will multiply within the system, making the workload and the work environment more toxic, making it harder to retain and recruit staff. One cannot emphasise retention enough, healthcare workers take a long time to train and longer to specialise.
(7/25)

You can't just decide to have more nurses, it takes time to train them and in countries like the UK, we had a huge training deficit to start with. Even upskilling existing staff takes a huge amount of time.

You cannot run a healthcare service without trained staff.
(8/25)

So when people fabricate silver linings on obsidian storm clouds 'Our current rates are comparable to other countries', remember that this is the ridiculous practice of keeping the frame of reference to now, 'just look at now, forget the past, worry not about the future'
(9/25)

Countries that controlled their pandemic better have kept more of their human capital, can keep systems (including their economies) running for longer and if we come out on the other side, they will have a lot more human capital left.
(10/25)

All of the above applies equally to education and other frontline occupations but not just to them. Another part of our political and capitalistic systems is what we place value on and how many aspects of human labour are simply not taken into account.
(11/25)

Many so called low-skill or unskilled jobs, are anything but. Caring for children, dependents & the elderly are vitally important labour that we expect people to do unpaid*, 'responsibility starts at home'.

*this is a huge injustice that esp affects women & minorities.
(12/25)

You can of course take narrow ideological views on this (as conservatives often do) but this unpaid labour is critical to economies & systems. Even if you think the govt shouldn't support these people, at least you'd agree it should when it forces unpaid labour on them?
(13/25)

Because remember all those people we're losing from the healthcare and other workforces? We're losing a lot of them to likely chronic illness and the impacts of this and the losses to death will be huge. Some examples to help illustrate this.
(14/25)

Consider the children who have lost one or more parents to COVID.
Consider the children who have one or both parents suffering with chronic illness because of COVID.
Consider the children who are suffering with chronic illness because of COVID.
(15/25)

Think through what the futures of these children and their families will be like. These are groups of children who have already acquired important risk factors for future ill-health, living in systems that can't or won't protect, support or help them recover & catch up.
(16/25)

These children are just one group of those affected, there are so many others.
We often underestimate the impact of major losses in others (death and chronic illness) because it's not happened to us (yet) and because the enormity of loss is overwhelming to contemplate.
(17/25)

Losses don't go away. They persist, individually and collectively. Some people manage to grow around them. Some people are forever changed by losses. We all lose from the losses of those who are unable to be what they had hoped to be.
(18/25)

One final point about this pervasive belief, which is the idea that many jobs can be done by anyone i.e. either the job is so 'simple and requires no special skills' or it can be made so, or anyone can be trained to do the job.
(19/25)

Therefore the problem is about the motivation of people who won't do the available jobs (not that the jobs are inhumane or don't pay a living wage).
The fact that we've all met people in all sorts of jobs who are terrible at their job shows this is patently untrue.
(20/25)

Some of this relates to a fundamental lack of understanding of what people do in their jobs. When politicians & enterpreneurs talk about technology doing uniquely human jobs like teaching and caring, they seem to think that the job just involves completing certain tasks.
(21/25)

Check out @mrrobnewman's chapter on 'What do lifeguards do?' in Neuropolis (highly recommend the audiobook version).
But if you really want to understand the problem with this view, look at the jobs in unpaid labour.
What do parents do?
What do family carers do?
(22/25)

How would you replace them?
Look at social care and the answer is: with great difficulty, incompletely, and with huge costs, human and financial.
(23/25)

So when people want you to look at hospitals getting overwhelmed in Europe, or at New Zealand seeing case rises (so clearly elimination doesn't work), remember they have managed to keep a lot more of their human capital alive and well than we have.
(24/25)

So if the huge tragedy of the loss of human life & health doesn't do it for you, then think:
How many teachers & HCWs have we lost?
How many parents & carers have we lost?
How many more chronically ill children & adults do we have to look after?
What's this going to cost?
(25/25)