The Impact of A Second Lockdown on Health & Social Care

With almost 900,000 cases and 45,000 deaths reported in the UK as of the end of October, and transmission and hospital admissions continuing to rise, the British authorities have been discussing the possibility of a second national lockdown.

The UK Government announced 21,331 confirmed new cases on 20th October: a 50% growth on the previous week, and a four-fold increase on the country’s previous highest ever peak in cases. The British Parliament has recently introduced a tiered system to enforce local measures according to Covid-19 prevalence across regions. However, as hospital admissions continue to soar around the country, a second lockdown may still be on the cards.

Here are four ways that a second national lockdown could impact Health & Social Care, the staff working within the sector and the health and wellbeing of the UK population.

How A Second National Lockdown Could Affect UK Health & Wellbeing

  1. Reduction in Hospital Admissions and Patient Fatalities 

As the UK endures a second wave of high coronavirus cases, hospitals across the country are seeing rapid and continuous growth in deaths from the virus. The Office for National Statistics (ONS) revealed that in the second week in October, deaths from Covid-19 in England in Wales climbed by 53% on the previous week. This figure marks the sixth consecutive increase in fatalities, and hospitals have recorded the highest number of daily deaths for four months.

Since September 2020, hospitals have begun to see dramatic increases in admissions. Doncaster Royal Infirmary (DRI) and Hull University Teaching Hospital, which have been placed under Tier 3 restrictions, have seen Covid-19 cases double in one week, and the Health Service Journal (HSJ) reports that the latest NHS data shows a 42% increase in patients admitted or newly diagnosed in North East and Yorkshire hospitals. Cases are also continuing to rise in Tier 1 and Tier 2 districts such as Suffolk and Essex.

Though economic and social consequences would be expected, previous data suggests that a second national shutdown could serve to dramatically reduce hospital admissions and Covid-19 deaths. The UK Government’s ‘Stay Home, Salves Lives, Protect the NHS’ message of the spring was phenomenally effective: the number of patient admissions fell by up to 90% in the first two months of lockdown.

The implementation of severe restrictions on the country for a second time would limit opportunities for social interaction. Limiting possibilities for the transmission of the virus could slow the growth in Covid-19 cases and subsequently reduce rates of death and serious illness. In turn, fewer coronavirus cases would reduce pressure on the currently stretched resources of the British Health & Social Care sector.

  1. Rising Mental Health and Wellbeing Concerns

Whilst at the end of 2019, around 1 in 4 adults experienced significant mental illnesses every year, trends from the UK’s first nationwide shutdown in March suggest a significant rise in problems is ahead.

Recent research from Glasgow University found that suicidal thoughts increased over the first six weeks of the UK’s national lockdown by around 25%. Between March and May 2020, one in four respondents reported at least moderate levels of depressive symptoms. The study found that young people, women and individuals from socially disadvantaged backgrounds reported the worst mental health outcomes.

Mental health in younger generations also worsened during the first round of restrictions. Prior to the coronavirus pandemic, 1 in 8 children had been diagnosed with a mental health condition. The lack of routine, social interaction and learning time has caused distress, confusion and anxiety in children and young people, and has particularly impacted those living in Northern England, who have seen more severe restrictions in recent weeks. A recent report reveals that one in four children in Yorkshire have had mental health issues during the coronavirus pandemic.

Professor Prathiba Chitsabesan, NHS England Associate National Clinical Director for Children and Young People’s Mental Health, comments: ‘As the whole country continues to find ways to live with the pandemic, many children and young people will be experiencing a range of feelings including anxiety, sadness and loneliness which are understandable responses to such an uncertain and stressful situation.’

Following mass unemployment, financial insecurity, illness and grieving for loved ones lost in the pandemic, wellbeing of the general population could dramatically worsen under a second period of severe national restrictions. With the World Health Organisation (WHO) reporting that mental disorders are among the leading causes of ill health and disability worldwide, a second national lockdown could exacerbate existing issues and create new difficulties with mental health, placing further pressure on healthcare systems across the globe.

  1. Greater Loneliness and Less Support for Vulnerable Individuals

A study from Queen’s University Belfast found that 49% of survey respondents felt lonely during the months of March and April this year, when the nation was first placed under Covid-19 restrictions. This is a sharp jump in previous figures: prior to the pandemic, 1 in 5 people reported experiencing regular loneliness. The study reported that those most likely to suffer from loneliness were living alone, meeting clinical criteria for depression, experiencing emotional difficulties or already vulnerable in another way.

Dr Jenny Groarke of Queen’s University Belfast comments, ‘We found that rates of loneliness during the early stages of the UK lockdown were high. We suggest based on our results that supports and interventions to reduce loneliness should prioritise young people, those with mental health symptoms, and people who are socially isolated.’

The above study was conducted ahead of a longer period of economic downturn which saw almost 10million people furloughed and 60,000 contract workers lose their main source of income. Following the news that the UK unemployment is at its highest level in three years, a second national lockdown is likely to have a greater negative impact than the first, due to the additional financial worries and lack of (digital or face-to-face) interaction with colleagues in now-unemployed individuals suffering from loneliness.

Growing loneliness and further reduction in support for vulnerable individuals would worsen pressure on the NHS and social services. Loneliness often leads to mental health issues and physical health problems which require urgent attention, and vulnerable individuals who cannot access care from families and support networks may experience negative impacts from existing disabilities and health issues.

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  1. Collaboration between Education, Health & Social Sectors

The UK’s first national shutdown highlighted the increased challenges of disadvantaged children and young people, those with Special Educational Needs and Disabilities (SEND) and vulnerable people of all ages. The past six months have further and rapidly exacerbated socioeconomic disadvantage: food bank use is now 17 times higher than in 2019, and workers in lower-paying jobs are far more likely to have been made redundant, suffered lost wages whilst on furlough and felt forced into working throughout illness or safety concerns.

In efforts to adapt to dramatic increases in the need for health and social services, many different branches of the sector have stepped in to provide additional help:

  • Local Authorities have generated additional resources to promote health and education for all children during lockdown, with particular support provided to help rehome and assist looked-after children.
  • Teachers have incorporated pastoral care and personal support into their daily responsibilities, including mentoring and providing online intervention and tuition for looked-after children and those with SEND needs.
  • Nurses and doctors are increasingly collaborating with social workers and care homes to protect elderly and vulnerable individuals, before, during and after hospital stays.

A second national lockdown would require another sustained period of support from education, healthcare and social services. Hospitals, schools and care homes could utilise the opportunity to pool resources and build communication across the public sector, providing a more holistic view of end-to-end care and creating a community of support for each other and the UK population.

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