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The main reason for everything being in a crappy state is almost certainly (>90%) widespread corruption.

Everyone who can is creaming off a little bit, leaving very little for the actual materiél and training.
So shoddy materials, poor to no training, missing equipment, components and spares.

That said, while it is very likely that the Russian nuclear arsenal is in extremely poor state, and I'd possibly go as high as 50/50 that their ICBMs could launch but cannot be aimed (as that takes expensive components that are easy to steal/not deliver and hide that fact), missing the target by a hundred miles or more is basically irrelevant in the "ending the world" stakes.

A 'tactical' device doesn't need much in the way of aiming, and on the assumption that it does in fact contain nuclear material there's not a huge civilian difference between it exploding 'as designed' or "just" fizzling.

If only the initiator went off, the weapon disintegrated during launch/firing, or the weapon/aircraft was shot down, it would still spread radioactive material over a wide area.

While that wouldn't be the "shock and awe" of a mushroom cloud, it's still pretty devastating to normal life.

It is absolutely certain that there will be more "variants of interest".

This is basically the evolutionary modelling that pretty much all Governments have ignored, every time - Delta and Omicron were predicted by all eviolutionary biologists.

The open questions are:

  • Whether there will be a new variant of interest that is notably more infectious, and thus becomes dominant after Omicron.
    In the UK, Delta completely outcompeted all other variants in around 3-4 months (>95% of all sequenced cases were Delta). Omicron is expected to do the same by Feb if not earlier. USA is likely similar, albeit delayed by a few weeks.
  • Whether future variants cause more or less serious disease than Omicron.
  • When this will occur.
    To me, it seems most likely this will be Feb/March 2022 or Fall 2022

If the answer to the first question is Yes, and the second question is "far less serious", then the pandemic is over When it occurs - it has become another 'common cold' and is unlikely to mutate further to produce more serious disease (because it didn't).

However, if it is Yes and The Same Or More Serious, then we will certainly need further booster jabs in Fall/Winter 2022, perhaps tailored more closely.

In many ways COVID19 is irrelevant.

It's already spreading in multiple countries, and is very likely to become endemic.

However: It is not alone, there will be future viruses.

We should be looking to create habits that will protect us from both COVID19 and all future local epidemics and pandemics.

That means habits that can be maintained indefinitely, not short-term changes that are not sustainable.

Things like washing hands and using hand sanitizer and creams are habits you can learn and maintain.

Checking everyone for fever, selling your stocks to buy X is not sustainable, and so these behaviours will be quickly forgotten.

Hand sanitizer is a poor substitute for actually washing your hands with soap and water.

Coronaviruses are "enveloped" viruses, which means they have a fat-based shell that protects the genetic material and (presumably) aids it in infecting a cell.

Destroying this shell "kills" the virus.

While an alcohol sanitizer can of course dissolve the fats in the shell, it is difficult to get enough alcohol all over the skin to do this.

Soap is more effective because it actively attacks fats, and of course washing your hands provides far more volume and time in which to destroy the virus shells.

Some data from the BBC comparing them:

The current overall death rate is estimated at approx. 1%, with a fairly large number of cases.

It has spread much further and faster than SARS or MERS, but is far less dangerous than either.

Which makes sense - a disease which incapacitates or kills in a high percentage of cases is unlikely to spread as fast as one which has mild symptoms in most infected people.

It now appears almost certain to become endemic. The real goal is to slow down the spread sufficiently to develop vaccines before this happens.

That worked for bird flu and swine flu. It remains to be seen for Covid19

Couple of numbers to think about:

A flu shot covering the four or five "most common" viruses (inc. bird flu) in 2019/2020 cost $10 privately in the UK, and $20-$75 in the USA.

In the UK, everyone registered with a GP who is at increased risk of pneumonia is offered the shot for free, regardless of status.

In the USA, the Affordable Care Act made the flu shot free for most people who have health insurance, and for some groups without insurance. Approx. 10% of US citizens have no health insurance at all, these are of course those who either don't work or have low-paid jobs.

If you live in a nation that has universal and free healthcare, then there is in fact very little reason to worry.

Wash your hands and practice good hygiene.

  • As you should anyway, because that reduces the spread of other diseases inc. flu and colds, which are already endemic.

If you live in a nation like the USA, then you should worry, for several reasons:

  1. Many workers cannot afford to take any time off, and cannot afford to go to their doctor for any treatment until it is already life threatening to them. By that time they are likely to have spread it to customers and colleagues.

  2. Many people cannot afford immunizations. Their insurance doesn't cover them, or their co-pay is high.

  3. These workers also work physically closely with colleagues, and are more likely to travel on buses due to the cost.

Full-service restaurants are commonly extremely low pay (below minimum wage) with little to no health coverage. Yes, there are laws/regulations about food service, but they are routinely ignored - staff can't afford time off and managers turn a blind eye.

There is currently no vaccine and no cure - only general support. So no amount of money will save you from death if you are one of the unfortunate few whose immune system cannot destroy the virus before multiple organ failure.

The group with the highest risk of death (~15%) from Covid19 are old men with heart problems, esp. if they have further co-morbidities.

We can thus predict that quite a few old, rich men are going to die because of the US healthcare system.

If Covid19 worries you, then campaign for free healthcare for all because it is the only way to protect yourself from it - and the future viruses that will inevitably follow.

D is based on a serious misunderstanding of how private health insurance works.


The only limiting factor chosen by the NHS (undertaken by the NICE commitee) is to determine which specific investigations and treatments are 'worth' funding.

For treatments, they use a value function called a "Quality Adjusted Life-Year" (QALY), and compare that to the cost of the treatment. At the time of writing, it's automatically approved if the cost is shown to be under £10,000 per QALY gained, more efficacious at the same price than an already-approved equivalent, or cheaper at the same efficacy.

If it's more expensive then it goes through a slower and more in-depth process to allow public and private argument about both the price and efficacy.

Thus an investigation or treatment that is extremely expensive but is proven to offer extraordinary results will be funded, while one that works but not very well or that is cheap but ineffective are denied.

All approved treatments are approved for everyone.

In the NHS, denials are only ever of specific treatments, and never specific individuals.

In the NHS, doctors are legally required to make decisions based on the needs of the patient regardless of monetary cost. If a treatment is 'on the list' and medically indicated, it is provided.

In the NHS, the cost of treating any individual person is considered irrelevant, and in most cases the doctor does not even have any knowledge of the cost.

The systematic pressure on treatment manufacturers is thus to be more effective than existing treatments, to charge less than competitors for similar efficacy, to charge £9,999 per QALY, or to be really efficacious so that NICE will choose their product. Thus the NHS often gets really, really good prices!

The pressure on the doctors and hospitals is to give you the best treatment on the menu, because it reflects badly on them if people die too often.

You could view this as the NHS giving all doctors and patients a menu.

Private Health Insurance:

Private health insurance also decides which investigations and treatments that they will fund and under which circumstances. This part is almost exactly the same - in some cases they even follow the NICE decisions, as it's a convenient way of avoiding appearing to decide.

The difference is that private health insurance also denies health care to individuals, by stating that the insurance will not pay for treatment of specific ailments (eg pre-existing conditions or effects caused by 'dangerous' activities), by refusing to cover those individuals at all, or by setting premiums outside their ability to pay (effectively the same as denial, but easier to square in their own minds).

So you, personally, may not even be permitted all the approved treatments. Or indeed, any treatments at all.

The systematic pressure is for all providers to charge as much as possible and for the insurers themselves to pass the amortised cost onto their customers and eject any customer deemed likely to want expensive payouts.

This is still a menu, except now there's a bouncer on the door who can decide not to let you in, and the waiter can decide to rip out some of the pages of your particular menu.

Pure Private Health:

You can have anything you can pay for, regardless of efficacy.

The systematic pressure on all providers is to charge the entire wealth of all patients - a sane individual is unlikely to refuse to pay if they or their loved one would otherwise die.

This is a personal chef who takes your wallet.

Note that all other schemes automatically have this as the ultimate backstop, unless explicitly prohibited by law. (eg laws regarding claims of efficacy, licencing of practitioners etc.)


Both the NHS and private health insurance systems limit the available treatments, the difference between them is that private health insurance futher limits which of the 'master list' of treatments are available to individual people.

A purely private health system does not limit the treatments, but does apply extreme limits to individual people, and is always available regardless of other systems.

I think the USA antipathy to a general health service likely stems from this irrational argument:

"If I don't do anything bad, I will not become poor, lose my job, or have a chronic illness that causes me to lose my health insurance.
Thus anyone who is poor or has a chronic illness must deserve to be so.
If they deserve it, then I should not have to pay towards their care and so they should lose their health insurance."

This is of course backed up and encouraged by the insurance and private health providers who benefit greatly from the excessive fees they can charge.