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Whenever I’m asked to speak at local health conferences, knowing the audience predictably consists more of insurance and bean counting administrator types than patient’s rights advocates or medical experts, I like to start with the story of a certain father who created a test to see what future career his 8-year-old boy would choose.

Now, I can tell this story with a cynical smirk on my face, because my own father back in the late 1990s was the Deputy Command Surgeon for the U.S. Air Force’s Air Education and Training Command, which is military-ese for a multibillion-dollar health care administrator.

The story goes that a crafty father once hid in his kitchen pantry closet with the door left barely open. When the man’s wife caught him sitting in the closet she demanded to know what he was doing.

“I’m going to test our son,” the father explained. “On the kitchen table are three items – a $100 bill, a copy of the Journal of the American Medical Association, and a bottle of whiskey. If the boy takes the money, he’ll be a banker, and if he takes the JAMA journal, he’ll be a doctor.”

“But, what if he takes the whiskey?” his wife wondered with concern.

“Well, then he’ll be a drunk,” the father concluded, and the two decide to both wait in the pantry together to observe what their son would do. After a short while, their son comes in, and much to their surprise, pockets the cash, throws the JAMA journal in the trash, drinks the entire bottle of whiskey and leaves.

“What does that mean?” the perplexed wife asks. “Oh great,” the father answers, “he’ll be a health care administrator.”

This story is a great way for me to intentionally upset my audience before I’ve even started to speak to them, because it implies that administrators could care less about medicine and they’re just concerned about the mercenary economics of money and the bottom line. 

During the coronavirus pandemic, we got to see precisely how the love of money and the bottom line turned this state upside down. The crisis turned doctors against laypeople, management against workers, teachers against parents, owners against renters, tourists against locals, and politicians against voters as we juggled the economy against public health. 

At the end of the day, the real public anxiety was never about the threat of dying or getting severely ill from Covid, it was about one group being more upset about their finances being jeopardized than another, and so we made Byzantine compromises, concessions and conflicting rules that essentially rendered pandemic response a quixotic waste of time. 

, “But now the holy dollar rules everybody’s lives, gotta make a million, doesn’t matter who dies!”

If you’re lucky, you made it this far without ever getting Covid, or you got a mild case and no serious aftereffects. But if you’re like millions of other people – including myself – you probably caught Covid and are now struggling with some kind of long-term health challenge.

 – “post-Covid condition” – what the Centers for Disease Control and Prevention describes as “a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes Covid-19.”

You might casually call it “long Covid.”

We know that Americans  as a result of either getting Covid or having PCC symptoms. We also know that large numbers of Covid survivors , with as many as 41% presenting antibodies that target healthy cells a year after the initial infection.

This is serious because people who survive Covid may later find themselves, as a result of these imbalances, experiencing unusual symptoms that they are unfamiliar with and that doctors can’t explain. All you know is that you feel awful, your body doesn’t seem right, and you can’t readily do the things you used to be able to do well.

Adjusting Cultural Norms

In September of last year, after turning up positive with “mild” Covid, the real nightmare for me began days after the infection when I found myself constantly experiencing debilitating inflammation, intense tachycardia, dizziness and an inability to do even the smallest personal tasks. Just one week after Covid, a woman called the paramedics for me in Kailua, and I had a heart rate of 147 beats per minute and a blood sugar reading of 436 mg/dL.

The first thing I did when I finally got home was research all the medical journals I could about PCC, reading about similar incidents in California, Iran and other places all around the world. And then, I went about calming my immune system the “hard” way – engaging in 16+ hours of water-only fasting every day to clear any viral wastes; sleeping as early and as much as possible; removing all inflammatory foods from my diet and looking for any areas where I was facing nutritional deficiencies.

I’m feeling a little bit better five months later, but just getting to “functional” and showing up to work every day has been the most painful and challenging experience of my life.

I worry though about people with low education or low socioeconomic status, because not only are they a vulnerable population for coronavirus infection, they’re also at a disadvantage in getting treated for PCC. If you can’t accurately explain to your doctor what’s going on, the managed care pathway will send you home with an obnoxiously written pamphlet and a directive to just rest and take ibuprofen if you feel bad.

I feel like in Hawaii, reporting a new health issue to your provider goes something like this:

“Doctor, it hurts when I wake up in the morning.”

“Oh really? Did you try waking up in the afternoon?” 

Our society still isn’t ready to deal with millions of people who have long Covid symptoms or disabilities. We need to fund more research into treating Covid and reversing PCC. We need to adjust both the government laws and cultural norms so that fewer people get exposed, infected or repeat infected with the virus. And we need to start educating the public on how to care for themselves and others.

Forget about the money and the bottom line. If we keep thinking that way, in the end, mercenary economics will undermine an entire generation’s health and we won’t be able to make or save any money. We already lost the war on Covid. It’s time to start thinking about how we can heal and rehabilitate the survivors.