In 2019, 151,793 people died in the Netherlands. Of these, about 20,000 are directly affected by cigarette smoking, 10,000 of which are lung cancer (a cancer almost exclusively caused by smoking) and some 6,000 are due to terminal COPD. In addition, approximately 9,000 people died from stroke and 8,500 people from coronary artery disease. Both diseases are caused by atherosclerosis, an inflammatory disease of the endothelium of the arteries, mainly caused by lifestyle-related factors such as excessive consumption of red meat and dairy. Every year in the Netherlands, approximately 5,000 people die of colorectal cancer, a cancer that occurs almost exclusively in affluent countries, again as a result of an unhealthy lifestyle. Some 2700 people died from the consequences of diabetes mellitus, of which type 2 is a lifestyle disease and about 4000 people from a lower respiratory tract infection, but, due to a severe influenza, this can differ per year and can sometimes (more then) be double. Finally, dementia, which is the indirect cause of death in the Netherlands in about 17,000 cases annually. And so I can go on, but I just want to illustrate that tens of thousands of people die each year from a multitude of diseases, many of which would have been preventable through healthy lifestyles. Lifestyle-related diseases are the leading causes of death in the world. However, we find this mortality and the underlying diseases apparently normal. Because the number of patients with these diseases has been increasing worldwide for years. We accept this as society and politics. No parliamentary questions, no teams of experts who update politicians every week about the possible control of the diseases, no daily newspaper headlines about the increase in the number of deaths and little media coverage.
Like many other higher animals, man is a social animal. We like to connect with each other and form groups that do the same and that gives us pleasure, that is to watch 22 people playing football in a stadium or to study the cartel of rare stamps in a club building with like-minded people. Social interaction is important for normal psychosocial development and entering into relationships. The biological goal of establishing a relationship between a young man and a woman is reproduction. Young people come together in the nightlife for social commitment. The elderly gather to go to a theater together, drink coffee or attend a concert. This creates a connection and strengthens existing ties.
We also like to forage with each other. We also like to do this outdoors, in restaurants. Here, too, commitments are made or confirmed. When two people are in love, they often go out for dinner together. Eating together creates commitment.
People also seek security, comfort each other in the vicinity, feel safe together and experience happiness together.
People communicate verbally, non-verbally, sensually and physically. We listen to each other, look at each other and touch each other. We hug babies and children, and we have known since the experiments of controversial American psychologist Harry Harlow (1905-1981) that juvenile rhesus monkeys became totally cut up due to social isolation. (He locked up monkeys with a metal mother monkey, one of which was cloth wrapped and the other one not. The desperate monkeys chose the cloth wrapped mother.) Touch proved to be an important factor for attachment. Also in people. It is a fact that people like to be touched by each other. Embraced, caressed, tenderly held, kissed, one hand on the shoulder, a pat on the hair, sitting close together. Touching is normal. and a real necessity of life. There are people who are reluctant to be touched by others. We find that abnormal and we have given it a name: haphephobia. Something for which treatment is indicated. We have known for a long time that man has a skin hunger and touch hunger, the deep-seated natural need to be touched.
It is normal that people touch and be close to each other and should remain normal
Since December, there is a new virus that can make people sick, the SARS-2 Corona virus that can cause the disease COVID-19. It is mainly the elderly (over 70-80 years) who die of the disease and they are middle-aged men with overweight and chronic diseases among the members who have to be admitted and treated seriously ill in an intensive care unit. About 10% of these die in intensive care in the Netherlands. It is of course very sad that healthy young people die of the disease, but fortunately this is an exception. Infection with a virus is a natural disease that can affect humans and animals. For centuries, people have died from viral diseases, often during epidemics and pandemics. It has also been known for a long time that older people and people with underlying diseases are more susceptible to a virus infection.
The world is now in turmoil with the virus. The indirect, for example economic, consequences of the pandemic will be enormous. An economic recession or depression is unavoidable.
The Prime Minister of the Netherlands, Mark Rutte, said of the week that “The one and a half meter society will become the new normal.” To prevent people from infecting each other with the coronavirus. We must, at least in the public domain, stay a meter and a half apart. The one and a half meter society. I can understand that you want to limit the amount of sick and dead during the top of the pandemic, but to say that after that, when the number of sick and dead has decreased, the ‘new normal’ is very special, if not really absurd. Normal (in Rutte’s line the “old normal”) is daily social and direct close interaction between people. That is normal and yet really more than desirable to keep people mentally, socially and physically healthy, to enter into and maintain lasting relationships. That does not work with a meter and a half spacing. Not really. Keeping a meter and a half apart is really abnormal for many reasons. When that becomes normal, we get totally screwed up society.
Even outside the corona crisis, it is normal, however sad for those directly involved, that people become seriously ill and die as a result. That is inextricably part of life and since people are born on the front every day, it is more than desirable that people die on the back to keep the world somewhat habitable. One of the reasons why the world’s population is so huge is that we can control many diseases and thereby extend lives.
It is a “temporary normal” that we remain a few feet apart during a pandemic to smooth the curve of virus infections. It is really abnormal that we want to create a society in which we find avoiding normal social interaction between people normal after smoothing the curve.
Mark Rutte should have said “the one and a half meter society is a temporary abnormality”, which would really do justice to what people are: thoroughly social animals with a strong need for direct contact.
The incidence of COVID-19 will decrease in the coming months. But if we start to move more socially again, predictably people will get sick again from the coronavirus and people will die from COVID-19. Even after a vaccine is available. The virus, like influenza, will no longer disappear from the world. COVID-19 will be one of the causes of death in the Netherlands with seasonal increase and excess mortality. We will have to find that normal, just like the other causes of death in the Netherlands. Because that people get sick and die is really inevitable, of course and, as strange as this may sound, also desirable and normal.
In the coming years, inevitably, especially older people and people with chronic diseases, will die of a multitude of diseases, including COVID-19, which, as strange as it may sound, is really normal. Man is mortal.
