A recent piece in the BMJ Opinion on 4 May highlighted the concept of “Covid Fatigue” among both patient facing hospital staff and those behind the scenes using technology to continue working. Where the former are tired, weary, irritable and disoriented, sometimes not knowing what day of the week it is, the latter are suffering from brain overload due to the lack of contextual markers that signpost our working days. Hours spent on zoom calls, emails and other computer based work with no trip to the kitchen to make coffee, no chatter with colleagues about the usual banal but humanising topics of family, holidays and weekends takes its toll. And all the while we are all waiting, with baited breath for some sign of how we may move forward, some indication of a light at the end of this dark tunnel.

I am spending days planning meticulously for a variety of scenarios that might or might not happen, depending on government policy, public compliance, NHS funding and the willingness of anyone to ever engage in education and development again. Days of meetings, planning, re writing course programmes and trying to work out how we can feasibly achieve that we used to achieve without actually ever meeting our students. Intensive, non enjoyable work, all unpaid. Just in case.

And it is taking its toll on me.

Never a fan of technology – I am of an age that missed the advent of computing in school and as a self employed professional I receive no paid-for training or updates on systems, email etiquette or any other useful help in navigating the ever developing technological field. Like with my car, as long as it works, I can cope, but survival is the name of the game. I will never thrive in a two dimensional, de-humanised world. It’s not who I am and it is not what I was prepared for in my younger life.

There must be many people like me, resenting the loss of the human elements of our workplace that take the edge off the stressful demands, ridiculous targets and ever changing change-for-change’s sake. But our tedium is but a drop in the ocean compared to the real threat posed by technology at this time. If we are not careful we will look back on Covid 19 not just as the end of a large number of lives, but also the end of human civilisation as we know it.

The French writer, Michel Houellebecq, described as the modern prophet of a nihilistic age, has warned that the pandemic is a great excuse to push further the “obsolescence of human relationships” and I fear he is right. He suggests that self distancing and home working that has been such a feature of the way we are told to manage the threat of the virus, is accelerating the technological push to isolate and atomise people. I would add to that the anonymisation of people, which has already begun in some areas of healthcare where professionals are referred to as “the band six,” or “the medical registrar.” I recognise Houellebecq’s need to walk outside in the fresh air to process the inner thoughts he has as a writer; after a day on line, on the phone, on email, I too have a head fit to explode with the noises, the texts and the conflicting demands it struggles to contain. When we evolve as a race to work practically and interactively, to work externally, in contexts with other people, as members of different teams, relating to a range of patients, colleagues, learners, public, and we are then forced to just talk about doing, in a vacuum, in front of a flickering screen, in two dimensional a-septic environments, it is no wonder we struggle.

The real crisis of Covid19 will strike after the pandemic has passed. The real threat to those of us left will not be losing our lives, but losing the lives we were bred to live. Losing our loves, losing our contact with others, losing the essence of all it is to be human, organic and alive.

In his 1909 novella, E.M.Forster gave us a terrifying and uncannily true glimpse into what life would be like. Over a hundred years ago his premonition was no doubt categorised as genuine science fiction, too far fetched to be believable. But read today, we can see that we are only a few years away from the dystopia he describes. In the story he presents humans as living underground, with all their needs met by technology – food, work, communication all provided by the Machine, and interaction with others facilitated through video conferencing and instant messaging. How Forster foresaw that at the beginning of the twentieth century is remarkable in itself. But details aside the message of this short story is that we would end up living in a ‘Technopoly’, our religious deity represented by the Machine which is worshipped and seen as all knowing. In Forster’s world people forget that the Machine was created by humans and they treat it as a mystical entity whose needs superseded their own. Those who do not accept the deity of the Machine are viewed as “unmechanical” and threatened with homelessness.

There are some people living on the surface of the earth in this tale but the underground dwellers who wish to and are granted permission to visit the surface need life support apparatus to do so. Eventually this apparatus is destroyed and then when the Machine malfunctions – as indeed all machines do- and the human ability to repair it has been lost, society as it is expires. The only hope is that those living on the surface are able to save themselves and their world. The overriding message is that humanity and our connection to the natural world are what matters. Technology is merely a tool not a controlling force and we would do well to remember that.

Forster is no longer alive but a conversation between him and Houellebecq would be interesting to hear. I wonder what they would have to say about the current need to extend life in the elderly and the corresponding need to provide residential places to contain the millions of people who inhabit the shaded area between life and death. Another form of underground prison, or technological advancement?

In medicine, there is much talk of GPs not returning to surgeries, continuing to work remotely. And yet some reports relate higher levels of medication prescribing from this approach; when you cannot counsel a patient in the same way, or offer emotional support, when you are concerned that the lack of face to face contact may mean you have missed something and want to err on the side of caution, is it any wonder GPs are prescribing more over the airwaves? In hospitals clinics could be facilitated largely through technological means, but what will the error rate be? How will that affect patient satisfaction, and more importantly, the recognised impact of emotional care on physical healing?

Covid 19 is terrifying, but we really need to lift our heads above the panic parapet and look at the unintended consequences of our fire fighting solutions. Our short term coping mechanisms cannot become long term ways of working without thinking through every possible consequence. Just because we can use technology in the short term to maintain a semblance of continuity, does not mean we should use it forevermore. Not until medicine has the solution for every problem, a pill for every ill, can we afford to dismiss the power of people.

We are standing at the edge of the abyss. If we relinquish human contact, physical and metaphysical human interaction, and rely solely on screens, text and interchangeable robots, we will condemn ourselves to a level of morbidity and mortality that overshadows any viral pandemic. The current threat to life is not just the Covid 19 pandemic but a far more insidious and destructive one – the technical pandemic. It will have far more damaging consequences.

We need to fight for more than life; we need to fight for humanity.