THE IDEA BEHIND THE WAITING ROOMS

Which brings me onto the premise of the book: no one over seventy is allowed antibiotics, in a last ditch attempt to keep resistance at bay. A little extreme, you may think. But consider this: antibiotic use by age group is a U-shaped graph. The highest number of prescriptions to stave off infections go to the young and the old. In the UK, the over-75’s account for a quarter of all antibiotic prescriptions. The over-65’s account for a third.

The global population is ageing. Virtually every country in the world is experiencing growth in the number and proportion of its elderly, with the over-65’s growing faster than all other age groups. By 2050, one in four people in the US and Europe will be over 65. The global population of the over-80’s is expected to more than triple. But how well is our society coping with this change? 

A recent report by the Royal Society for Public Health claims that ageism is the most commonly experienced form of prejudice and discrimination in the UK and Europe. This report echoes findings of a 2016 global survey which assessed attitudes to older people across all age groups, in which 83,000 people in 57 countries took part. The research showed that ageism was extremely common but that most people were unaware of the subconscious stereotypes they held.

A key concern is that institutionalised ageism may be used to discriminate against older adults when allocating health resources or when collecting data that influence health policies. It also has a significant impact on the mental and physical health of the elderly, putting them at risk of depression and social isolation.

Compounding this, we have social care systems and health services already in crisis, and needs are only going to increase. 
According to Age UK, the ongoing cuts in public spending combined with increasing demand for care services have resulted in over a million over-65’s not receiving the support they need with basic living requirements. Two million UK pensioners live in poverty. That’s happening now, in one country. Put all this together and you have the perfect storm.

In the months after I finished writing The Waiting Rooms, we have seen the concerning spread and impact of COVID-19: a novel coronavirus for which we have no vaccine and no cure. Many of the crisis scenes I wrote in The Waiting Rooms as fiction are being played out now, for real, in countries around the world. The chilling truth is that antibiotic resistance will increase both the frequency and the severity of global pandemics. The Center for Disease Dynamics, Economics and Policy reported last year that, in the event of a significant influenza pandemic, secondary infections caused by prevalent pan-drug resistant bacteria could be catastrophic.

COVID-19 is already illustrating the threats posed by bacterial infections during a pandemic. Most of the people who have died either already had pre-existing conditions, or developed secondary infections, which become much more prevalent and deadly once our immune systems are busy fighting a virus. See my blog for more on this. And consequently, there has been a surge in use of antibiotics globally to such an extent that WHO is now warning of an acceleration in antimicrobial resistance as a result.

As more diseases become resistant to more drugs, the greater the chances are that multiple pandemics will arise, possibly at the same time, and the drugs we have relied on to treat people in intensive care will no longer work. And yet we rarely hear about the probability or scale of such a threat.
Given the crisis response we have seen for just one pandemic, how prepared are we to tackle that potential scenario, in a not-so-distant future?

For those of you who want to go further, I’ve assembled some more facts and a few links.
But a warning. The deeper you delve, the less speculative and more probable the world of
The Waiting Rooms becomes. Enjoy.