It had been a spectacular year for Sarah Peterson, the country’s Chief Medical Officer.

Although clearly having the credentials, having graduated in medicine at the national university and a 25-year career in public health including seminal research and policy work in indigenous health and refugee care, nevertheless she was quickly put into the position at the beginning of the COVID-19 pandemic when the then Chief Medical Officer had been caught breaking isolation and forced to resign after attending his disabled grandson’s birthday party.

The Federal Health Department had believed this was the right course, as they believed leaders need to be impeccable role models during these unprecedented times. The Federal Opposition had done their job: fed the media circus and made sure of the scalp. Sarah herself agreed with these sentiments, telling herself she would always act and make decisions for the good of the health of the country.

Sitting in her office considering her contributions over the last year to end the COVID-19 crisis and start bringing the country back to some sort of normality made her smile. Sure, some major sacrifices had to be made, but they had been for the good of the country. Looking at an old photo on her desk of her parents, who had died in a car crash when she was at medical school, she was confident they would have been very proud of their only child. She was now looking at herself being nominated for one of the country’s major honours and perhaps even a government representative role in WHO. Maybe even a politician. It was time more scientists play a role in government.

It had been a long, intense year for the country since Sarah had been instated as the Chief Medical Officer just before the second wave of the virus. Closure of the nation’s borders, a complete shutdown of businesses and social distancing had been incredibly successful in flattening the curve. Hope was coming back. Time to fill glasses with beer, schools with the liberated laughter of kids locked up too long and awaken the hibernating economy. Time to again take up the protests against the injustices of the world. National pride was at its highest and no one thought we would end up like the countries hit hardest by the carnage we became used to seeing daily in the media.

Suddenly, the virus resurged, overwhelming hospitals and health services. The problem was not a simple lack of intensive care beds and ventilators, as these had been boosted just in case during the isolation of the first wave. Unexpectedly, health staff used to isolating in the first wave and seeing what happened to their overseas colleagues refused to work. They were frustrated by the community’s lack of discipline in continuing social isolation, frightened by the abuse at work from patients and families, and angry from the lack of resources and protective equipment provided by the government to help ensure their safety. From general practise to hospital across the nation, the sick had trouble finding someone to look after them. As a result of the community outrage during the first wave of the lost lives in the very few nursing homes which had been badly affected, it was now necessary to move residents from affected infected nursing homes to hospital facilities. The relatives of nursing home residents demanded care for their loved ones. No one should be allowed to die in a nursing home from COVID-19. In fact, almost any death anywhere in the country from COVID-19 was broadcast by media as negligence and demanded investigation and enquiry. As too was unemployment, closure of businesses, and loss personal of personal freedom and rights. All were unacceptable and were believed to be the result of someone’s negligence.

The hospitals became crowded with the elderly. Health services where once we were world leaders such as cancer, maternity, and paediatrics now had third-world mortality rates. With no vaccine in sight, nor even treatment to reduce the severity, all we could do was a return to strict lockdown and social isolation. Then it was probably the failure of Internet and Wi-Fi capabilities that accelerated the unrest. The young and middle aged demanded action. Life in isolation without social media was not compatible with civilised life in 2020! It wasn’t just anger amongst the young over their perceived loss of a future. Not all responded the same way. Some started testing themselves with unbelievably risky behaviour and actions while in isolation. Some simply became depressed and killed themselves.

Anger and outrage were probably the most common reactions. Protests against the old and direction of healthcare to them began. First simply on social media when Wi-Fi worked, to stories on the never ending COVID-19 news programs on TV, to protests at our closed beaches, parks and pubs.

“If it wasn’t for the old, we would be back to normal.”

Violence against the old started.

“You have had a good life, don’t destroy ours!”

“Good life, not a long life.”

“You destroyed our planet, now you want to destroy us!”

The elderly became targeted by non-isolating gangs when they ventured out for food and supplies. Their homes had “anti-old” graffiti painted on them. Even some businesses began to refuse to serve the old.

The elderly became increasingly scared and isolated, many dying alone or taking their own lives.

It was unsure who started the thought; however, Sarah Peterson took the acclaim and ran with it. It was an option beyond extreme lockdown where no vaccine or treatment was near. The only scientific research allowed to be conducted needed to be COVID-19 related. Sarah’s government research team produced a value-based healthcare paper sponsored by the health insurance companies. The work was quickly accepted for publication and suggested the elderly wanted three things:

  1. Assurance that their money and possessions would be passed onto their families and friends.
  2. A painless, controlled death.
  3. A wish to contribute and dedicate themselves to the good of all.

Advice and suggestions came immediately from all quarters to help the elderly with their wishes. Government-subsidised lawyers were employed to ensure the elderly had their wills and affairs in place. Media groups put together professional online resources for the elderly to promote the need for accepting “not for resuscitation” and “decision not to be taken to hospital” orders. The government, after discussion with business, minority, and youth groups, agreed that “not for resuscitation” would be the default order for those over 60, only to be individually revoked if a person over 60 had decided against this and been advised in person by a lawyer. To help protect the elderly, such “not for resuscitation” orders could not be revoked by family members. The government were applauded for their reforms to help reduce violence against the elderly. The elderly were being listened to and the community applauded themselves for their benevolence.

This quickly led to Dedication Centres, where Dedication Advocates were employed to coordinate care for our elderly. There was a sudden change in society. From one minute where there was anger against the elderly, there was suddenly a desire to help them with their wishes.

The introduction of the centres was believed to be the one initiative that turned the course of the pandemic. Suddenly, in the midst of despair, massive unemployment, and substantial poverty, there was hope. Within months, the percentage of over-60s in hospitals decreased substantially, regular healthcare returned, lockdown eased, travel increased, businesses reopened, and the stock exchange started to recover.

What probably nailed the recovery was the introduction of euthanasia for the elderly on the basis of COVID-19 related illness. Euthanasia had been legal in some jurisdictions for terminal illness. The Youth for the Future Alliance had the definition of terminal illness tested in court, claiming that as there was no vaccine or treatment for COVID-19, it should be classified as a terminal illness. It was passed unanimously by the Federal Court after the regular judges could not sit as they were in lockdown due to their age and were replaced by a younger cohort of up-and-coming judges.

Dedication Advocates now had a new role. They were given the brief to help the elderly with their decisions on euthanasia. Pathology testing for COVID-19 in the elderly became unnecessary and diagnosis was based simply on clinical grounds: a temperature, sore throat, or runny nose. No longer a need to subject the elderly to uncomfortable nasal and throat swabs. No longer health workers would be put at risk carrying out testing. No longer a dependence on supplies of test kits from other countries. Dedication Advocates could diagnose COVID-19 in the elderly quickly and efficiently without formal testing.

The depressed elderly went to it like lemmings. Over 90 percent of over-60s dedicated themselves for society’s good and euthanised on diagnosis. The country was one of the first to turn around and recover economically from the pandemic. The only ongoing financial cost to the country was the need to provide free childcare to cover that which could no longer be provided by the over-60s. An unbelievable recovery!

It had been a spectacular year for Sarah Peterson. She was rewarded with the whole dedication program being named after her: the Peterson Dedication. She was instrumental in saving the country. Although she knew this had led to the end of an age group in our society, it was for the good of all. The elderly lovingly dedicated themselves. The end justified the means. She was content and knew her future looked even greater.

Suddenly, Sarah’s office phone rings, jolting her out of her dreams. It is her only child, Rachel. Ringing to tell her mum that she is pregnant again for the third time, already having a six- and an eight-year-old. Billy, the eight-year-old, has the “flu” and she is hoping Sarah can come over and look after the kids as she has a doctor’s appointment. Although state-provided childcare is free and available, she is keen for her children to spend some time with Grandma. A rare and almost selfish treat now days. Rachel constantly reminds her children not to tell their friends they are visiting Grandma as she does not want to be thought of as not community-minded.

As she talks, Sarah notices an urgent email come across her inbox from the country’s Chief Scientist, Rosemary Gavin, the youngest to ever hold the position. Like Sarah, she was quickly promoted during the pandemic after the previous chief scientist had isolated himself after contracting COVID-19 while working on a vaccine. In her email, Rosemary writes that COVID-19 has mutated and the new strain only targets children less than ten years old. The new strain is highly infective and computer modelling suggests it will quickly overrun the health services and the country will need to be locked down again to contain it.

The chief scientist, reminding Sarah of her past success, asks her if the country should follow a similar strategy.