What effect has Covid-19 had on you this year? Perhaps you’ve been unwell, or lost a loved one. Whilst I don’t know if the virus has affected you directly or not, there is one fact I can be certain of: lockdown measures will have – from small matters like cancelled holidays, to more significant ones such as an inability to see family overseas. Perhaps you’ve been unable to visit a relative in a care home, or had a loved one’s funeral or wedding disrupted. So many human connections have been fractured.
It’s important to question whether lockdown, as an instrument to control Covid, may now be causing more damage to our society than the virus itself. The issues outlined above may sound small and inconsequential. Yet, multiplied a million times over across our population, and coupled with the deep recession we’ve plunged the economy into, our country will undoubtedly feel the effects of lockdown measures for many years to come. Our children will bear the brunt of the Government’s expenditure and the financial damage done to businesses.
The public services they use will be diminished. Their job prospects will be hampered. The cost of their education will be greater. They’ll be more heavily taxed. Their pension ages will be pushed back. Increased rates of poverty will reduce life expectancy, from what it would otherwise have been. The lives of the next generation will be made more difficult as a result of the decisions made this year.
We now know that the majority of Covid deaths will occur in the elderly, or otherwise infirm. Many of these deaths would occur in the next year or two, even if they did not occur as a result of the coronavirus. In short, preventing these deaths will save comparatively few quality adjusted life years. As long as the NHS is not overwhelmed, the deaths from Covid are not going to be anywhere near as catastrophic as we first believed.
As GPs, we have a unique window into society. In a poor outcome, where 120,000 patients died this year from Covid, a GP at a 10,000 patient practice would on average lose 18 patients, with a median age of 82. This is sad, and distressing for those families affected. But how many more of our patients will have lost jobs, had businesses destroyed, missed months of education, or felt isolated – even suicidal?
How many new mums have lost access to crucial support at toddler groups? How many of our elderly are no longer able to attend lunch clubs or coffee mornings? Many of my vulnerable patients are locking themselves in their homes, and haven’t been out since March. I speak to teenagers and young people who are anxious and depressed, despairing at what the future holds for them. How much mental illness are we storing up for the future?
We’re urged that Covid must be controlled at all costs. But what depth of despair, financial ruin, and damage to the rest of the NHS (having universally gone remote), are we happy to accept? I’m now far more worried about the health effects of our response to Covid, than about the virus itself. And what about our liberties? Earlier this year, it was technically illegal to sit on a park bench, or to leave the house with the purpose of buying DIY equipment. It’s still illegal for me to drive to my parents-in-law’s house in Wales. If a friend was distressed, it would be against the rules to give them a hug. How much control over every aspect of our lives should the Government have? This feels too much.
Our society and Government need to realise that we cannot save every life (after all, none of us is immortal). Rather, we need to lead the best lives we can in the time we have, while ensuring we do not unduly harm those around us.
Going forward, we will need to reclaim the freedom to hug, to dance at weddings, to cry together at funerals, to kiss behind bike sheds, to attend theatre productions or festivals. These activities provide joy, excitement, and togetherness. We need to prioritise our return to a collective society, where people meet, socialise and support one another again. After all, it’s much easier to close things down, than it will be to reopen them. When can we say that it’s 100% safe for parents and children to attend a toddler group? Never. Indeed, it was never completely safe, as there have always been infectious diseases. Still, such groups remain vital to our society, and national wellbeing.
Health isn’t just the absence of Covid, and life isn’t just the absence of ill-health. If we continue to believe these myths, further lockdowns will make us all sicker and sadder.
Dr Katie Musgrave is a newly-qualified GP in Plymouth and quality improvement fellow for the South West