In this article, I’ll describe how medicine and society will change, and why you should become a fitness nut and not just a prepper.
There’s a stereotype of preppers, and it’s not kind: A middle aged or older man with a BMI that passed 30 before he was 30 and grew by 1% every year, a ton of guns, canned food, and a half-hearted vegetable garden.
I know because I resemble that. As I’ve been struggling to recover my health, I’ve had a few realizations that have kept me on the path to fitness.
Health is something money can’t buy. Ultimately, whether you’re healthy and fit is a question of discipline and commitment. Having children or dependents should serve as inspiration for the average prepper to do more than just go to the range and plink at blue helmet cutouts. However, as someone who has worked as a Registered Nurse in healthcare, I wanted to discuss in depth some things that we don’t really think about.
So to start, we’ll briefly address the thing all preppers immediately think about. That your odds of surviving the collapse improve all around with your fitness. Being able to run longer, fight harder, survive on less, and have strength and muscle reserves higher than those who decide to become raiders and outlaws will be crucial. Obviously, this is where activities like rucking, marksmanship, running, and martial arts become important. A membership at a local BJJ or Muay Thai gym can help ensure that you’re a force to be reckoned with in close quarters, while marksmanship, running and rucking make sure you’re able to engage in skirmishes and avoid being immediately flanked and outmaneuvered. There will be no guarantees, and even the most skilled fighter can be dropped by a lucky shot. You can improve your chances though and it’s irresponsible not to.
While this is important, and a lot of preppers preoccupy themselves with the “bullets” part of the three B’s, let’s address the biggest reason you should become a health nut, and the one I have the most knowledge on. The end of modern medicine.
At present, modern medicine seems magic. You go to the hospital, the healthcare providers order labs and advanced imaging to determine what’s going on inside your body, and then treat you with powerful pharmaceuticals and imaging guided procedures to directly address the problems. The golden hour, for most traumatic injuries, means even if injury is severe you have a shot at survival if we can get you to advanced medical care in less than 60 minutes.
That will no longer be the case. Injuries and illnesses we currently view as “serious enough for the Urgent Care or hospital but they’ll be all right” will suddenly become life-changing or even fatal. Your doctor spent 12 years learning how to practice modern medicine, and suddenly almost all of the things they were trained to use will disappear. That doesn’t mean doctors will be useless, but it does mean that only doctors with natural problem solving ability and creativity will be effective. The capacity to take existing knowledge and use it as part of a problem solving tool kit will be vital, since the algorithms and best practice case studies currently used to direct modern medicine will no longer function.
Not all Doctors will adapt to the new reality well. Paramedics and Nurses jobs will change less, but they will still change. Stabilization until surgery, vasopressors, mass transfusion of blood and fluids will all be off the table. The basics of nursing, what we call supportive care, will be the new (old) benchmark. Stabilize, ensure adequate hydration, nutrition, cleanliness, turn patients who can’t turn themselves to prevent bedsores, and low tech interventions like steam tents for respiratory infections with tenacious secretions, cupping, positioning etc will become the majority of what caring for the sick looks like.
Many diseases that we don’t currently worry about (tetanus, diphtheria, measles, mumps, rubella, TB, whooping cough, etc) will make a sudden resurgence, and worst of all, the unmonitored and careless use of antibiotics in a post-collapse society guarantees that we will see antibiotic resistant versions of those diseases. So even if your community practices good stewardship of antibiotics and husbands their stock of medications, it will not be enough.
We will also have to approach how we live rather differently. George Washington died of pneumonia following a morning horseback ride in the rain. In the modern world, pneumonia is treatable. Post collapse it will claim many lives. So we will have to weigh our decisions regarding what risks we take much more closely. Making sure you have a good stock of quality work gloves, work boots, coveralls, and the ability to make more of these items from basic materials to protect your hands from cuts, puncture wounds and their ensuing infections (tetanus shots are only good for about ten years) is something hardly anyone considers, but it’s just as vital as the traditional beans, bullets, and bandaids that we typically preoccupy ourselves with.
Gastrointestinal disease will also return as a major killer. Historically, many deaths during disasters, wars, and refugee crises were not caused directly by infection itself, but by dehydration and electrolyte loss following prolonged diarrhea or vomiting. Clean water, oral rehydration, electrolyte replacement, and sanitation become far more valuable than people realize. In a collapse environment those can be some of your most important preps. Electrolyte packets are cheap and easy to stockpile, and salt (one of our most important electrolytes) keeps indefinitely when stored correctly and can be used for assisting with rehydration, making saline solution for wound cleansing, as well as a myriad of other uses.
As an aside, it would be highly beneficial for any prepper with a green thumb to have an herbal garden, and have a working knowledge of what traditional herbs and plants can actually be used for real treatments and medications. Some of our most potent medications were originally derived from plants, and a community member with knowledge and a green thumb will be valuable.
The other reason to take up fitness? We’re not going to be able to use medication to compensate for poor health. At present, the majority of America is obese. BMI 30+. For many years now we’ve ignored reality. Most of America is carrying extra body weight that, untreated, gradually causes the premature deterioration of the body. Once you start carrying that much extra weight, it fundamentally changes and damages the body over time. Strain on your heart, kidneys, liver, and blood vessels eventually causes permanent damage.
Modern medicine can band-aid your problems (medications to lower BP, maintain stable heart rate and rhythm, prevent fluid overload, etc) and allow you to live longer than you otherwise would. If you carry all that extra weight long enough the damage it causes is irreversible, and even if you lose the weight you will still be dependent on daily medications to postpone your final accounting with the almighty. When those medications dry up, it won’t matter how well you’ve prepped. This goes for people with unpreventable chronic illnesses as well. Once medications run out, the timer starts. Some conditions decline slowly. Others deteriorate rapidly.
Preparedness requires honest acknowledgment of personal medical limitations rather than denial. If you take a pill or an injection every day to keep your body going, your body is going to stop. Acknowledge that. Prepare your loved ones to be able to carry on without you. Make sure you’re part of a community you trust so that when you’re no longer there, the ones you love aren’t facing an automatic death sentence.
At any rate, I’ve explained what the end of modern healthcare looks like. Now it’s time to talk about what that means for your prepper community and the individual.
Quarantine, Isolation and precautionary measures
If you have a community member who falls ill, it becomes imperative to minimize the spread of illness. Having an established shelter and designated hospital or quarantine area, or ensuring that dwellings are far enough apart to prevent disease transmission is a minimum. Unfortunately many illnesses have lengthy incubation times, so preventing transmission of disease within your community can be quite difficult. So the key is to prevent it from reaching the community in the first place.
Which brings us back to a very traditional and overlooked aspect of life; treating outsiders with extreme caution. People who want to engage in trade or travel outside the community will need to have a period of quarantine. 14 days is a fairly standard period of quarantine. Naturally if someone develops symptoms, a week from their symptoms resolving should prevent them from bringing most immediately communicable diseases, but it will not protect against latent diseases. Not all diseases are obvious. HIV/AIDS takes 8-10 years after infection to transition to AIDS, but carriers will be infectious during that time. TB infections can be latent for decades before activating, and not always with stereotypical bloody coughs until final stages of the disease. Syphilis, similarly, has a lengthy latent phase (years-decades) and can be passed onto children when they’re born.
Which brings us to an uncomfortable but necessary discussion for modern society.
Your private life is no longer private
We’ve labored under the shared liberal consensus that “so long as it doesn’t hurt anyone, do what you want”. Libertarianism treats this more or less as a point of religious dogma. However this viewpoint depends completely on an advanced society built to insulate the individual and society from the consequences of poor decisions. Emergency services, hospital care, sanitation, public health systems that track and treat communicable disease, and advanced pharmaceuticals. Without the systems we currently take for granted, the individual’s health is directly tied to community survival. In a small or resource-limited settlement, one person’s illness is no longer simply their own problem. One untreated infection, one lapse in sanitation, or one reckless decision can compromise an entire group.
Because of this, the communities that survive and thrive will likely return to enforcing strict expectations surrounding hygiene, cleanliness, quarantine, and behavior. Health becomes a shared responsibility and, in many cases, a condition for continued participation in the group. The ability to act without regard for consequences is largely a product of abundance and infrastructure. Once those guardrails disappear, natural selection will have its say.
Both men and women are going to face pressures modern society currently shields them from. A man who wants to sow his wild oats dramatically increases his chances of contracting a permanent STD. A woman faces the same risk, alongside the additional realities of pregnancy and childbirth in an environment where modern obstetric care may no longer exist.
Modern medicine currently compensates for an enormous amount of sexual risk that most people never even notice.
When a child is born today, hospitals routinely apply antibiotic eye ointment immediately after delivery and vaccinate against Hepatitis B shortly afterward. These mandatory interventions exist because modern healthcare cannot simply assume sexual health, exclusivity or complete medical transparency between partners.
Without treatment, common sexually transmitted infections can blind newborns during childbirth.
If a mother has herpes, modern hospitals will often perform a C-section to reduce transmission risk. If she has HIV, extensive medication regimens, controlled delivery procedures, and formula feeding can dramatically reduce the likelihood of infecting the child.
That will no longer be on the table. The health of both parents will once more directly impact their children. Diseases modern society currently prevents or suppresses become lifelong liabilities. Unknown sexual history becomes a legitimate survival concern rather than merely a personal preference. Over time, communities will adapt accordingly.
Families may once again heavily influence or effectively arrange marriages. Stable pair-bonds, trustworthy family history, and visible long-term health will become biologically and socially desirable under harsher conditions. From the perspective of a parent, the logic is straightforward. Would you rather your child marry someone with an unknown sexual and medical history, from a family that just joined your community? Or would you rather they choose someone from a trusted family whose behavior, health, and reputation you’ve personally observed for years?
Likewise, advanced contraception, fertility treatment, abortion, and emergency obstetric intervention will no longer be consistently available. Sexual activity outside stable long-term relationships therefore becomes significantly riskier for everyone involved, especially for women and their families who will be expected to absorb the consequences of failed pairings, disease transmission, or unsupported children.
In the end, the survival of the individual and the community will no longer depend on advanced healthcare. Does your community foster discipline? Expect competence? Enforce standards of hygiene and sexual restraint? Is physical health and fitness a minimum baseline within your community? I heard it said recently that traditions are solutions to problems that we have forgotten; does your community enforce traditions that make for a healthy, resilient, and wise community?
And just maybe, do you listen to your wife when she tells you it’s too cold and wet to go for a morning horseback ride in the rain.