The fight against the Covid-19 pandemic has led to unprecedented social and economic measures in the UK. For now it is right that we prioritise protecting the NHS, ensuring the ventilator capacity and saving lives. But we also must look to the future. A huge amount is at stake for all of us.
We are just over three weeks into lockdown and the discussion has turned to when to lift it to avoid a second peak this year. However, beyond this will be a third peak to be flattened: deaths caused by the economic contraction and the resulting long-term poorer health. This is not about direct financial support to the NHS and our health service, but rather the impact of a stuttering economy on society and living standards.
The health impact of economic contraction and socio-economic deprivation looms large. When working as a mental health doctor before entering parliament, I saw people every day suffering from severe illness and disability. So often economic factors increased the risk and impinged recovery.
Many common diseases are highly associated with socio-economic deprivation. These include diabetes, hypertension, cardiovascular disease — all of which place people in higher risk categories for death from Covid-19.
Public health is the backbone of medicine but is often sidelined. Screening for high blood pressure, alcohol support services, and early interventions in schools will not get people marching in the street the way cancer care waiting times will, but the impact on people’s lives is huge.
The lockdown is essential to save lives today from Covid-19, especially of the most vulnerable. However, every day that it continues, our economy slows and contracts, and we add to the potential burden of disease in the future. The chief medical officer, Chris Whitty, an epidemiologist by background, knows this well. Last week he spoke about the hard decisions that needed to be made in lifting the lockdown, and warned of the potential “indirect effects” of the coronavirus.
Scientific advisers and the government are wrestling with difficult decisions. Their task is ensuring that this fight does not become a zero-sum game of saving lives now at the expense of future health.
In deciding when to lift the lockdown there are considerations aside from health. However, whatever choices are made, we will know the impact on the economy relatively quickly. The impact on health, however, may not be clear for decades to come.
The pandemic has focused minds on the importance of public health like no other event in recent memory. This crisis must put public health at centre stage of our NHS, and a focus of broader social policies.
We know that opportunities such as education, employment and the living environment are key to a healthy society. As we rebuild our economy post Covid-19, let’s seize the opportunity to make things better than they were before, and flatten every curve.
This article was first published in The Times Red Box here on 15 April 2020.