This is not the blog I planned, nor the blog I wanted to write. My original intention was to look at the work the Global Public Health Network has undertaken over the last year and flag up some of the activity and plans we have for 2021. But that just doesn’t seem right given the scale of the acute health crisis we are currently facing.
Friends and colleagues who work within the health sector are concerned and already exhausted, with certain knowledge that the situation is going to worsen over the next few weeks. The second Covid wave is not just upon us but is threatening to overwhelm our health system. The Mayor of London has declared a major incident. The number of people with the virus is skyrocketing. Admissions to hospitals have grown by over 25% in a week, with the number of people needing specialist support increasing by 42%. The situation is worse than at any time in 2020, and the relentless progression of this virus determines that there is worse to come. The UK’s health system has not faced this kind of challenge in living memory. Many other countries are dealing with a similar situation or can see it coming down the tracks towards them. That light we saw at the end of the tunnel only a few weeks ago was in fact the train coming towards us.
The pressures are particularly severe in my local area, with the eastern outskirts of London and neighbouring counties being termed the “Covid triangle” by the media. Great efforts are being made to boost hospital capacity to deal with those seriously ill from Covid, while at the same time seeking to mobilise an unprecedented vaccination programme. It is proving easier to conjure up kit and repurpose wards than it is to find the necessary skilled staff, with many having been taken ill or having to self-isolate. Firefighters are having to help drive ambulances, and the national government has called in the army to assist with logistics.
It is fair to say that the optimism generated by the beginning of the vaccination programme has been overwhelmed by this surge of infection and the resulting restrictions imposed
It is fair to say that the optimism generated by the beginning of the vaccination programme has been overwhelmed by this surge of infection and the resulting restrictions imposed. Significant constraints on how we live, work and study will remain in place till at least March, with any relaxation then likely to be modest. There is now a concerted effort to reduce expectations, and a lot of discussion and political preparation for further ramping up restrictions, including the potential for reintroducing some controls next winter. At the same time, blame is being directed by politicians and the media towards those who aren’t following the rules or guidance.
Now, clearly there are people failing to observe sensible precautions, and still some who question whether Covid is really that serious (and whether it merits the restrictions placed upon our normal lives). While it may be difficult to fully relate to those who promote conspiracy theories, we can acknowledge the validity of concerns about the impact on mental health, and the consequences of people delaying seeking medical attention for that minor problem, lump, or occasional passing of blood, which in some cases will be a serious condition. Nor should those enjoying their monthly salaries, able to comfortably work from home, whose children have access to laptops and good internet connections, be too quick to criticise those who need to leave their home to earn a living, whose accommodation is cramped, or who are desperate for their kids to be in school.
We are seeing the language of enforcement and blame being ratcheted up – and just to be clear, I have no problem with those who are wilfully irresponsible suffering legal consequences. But I worry about the impact of fining people for driving five miles to walk at a local reservoir. On the face of it, and there may be additional circumstances which influenced the police, it is not at all clear that any law, or even guidance, was broken in this case. I am sure there will be a review and appropriate steps taken, but it highlights the need to better work with our communities. There have been so many changes in law and guidance over recent months, that it is totally understandable that people are unclear as to what is permitted, what is advised, what is illegal.
In general, we really haven’t done enough to inform, and recruit, the public in the fight against Covid. Some professional bodies, such as the College of Policing, have produced good quality advice for their specific audiences, but we have not got enough accessible information out to our communities. Given the current concerns we are promised some shock and awe, telling people if they don’t comply, they are directly contributing to deaths. This will no doubt ramp up the fear of many, and may encourage those who are already being careful to be even more stringent, but will it engage those who are sceptical? Or who don’t understand the potential benefits of masks, social distancing or staying at home? Will it help win over those desperately trying to keep their lives and families ticking over?
Appealing to the public works best if there is clear information which sets out the issues in context and provides advice that can be followed […] Letting people see and understand what is happening where they live, understanding the controls and restrictions at different levels, in turn supports engagement
What is needed is candour alongside some good, well targeted, materials. The scale of the problem is now being made clear, and it would be helpful to acknowledge that some previous decisions and assumptions have not helped. Appealing to the public (and we are all members of the public) works best if there is clear information which sets out the issues in context and provides advice that can be followed. Data has a key role to play here. Letting people see and understand what is happening where they live, understanding the controls and restrictions at different levels, in turn supports engagement. Finland deserves praise for its public-facing communications. Others could usefully learn from their example.
Treating people as part of the solution is an approach that can pay dividends with issues beyond Covid
Of course, some will say it’s all too late. But I disagree. Helping people relate to the problem and what they can do about it, in terms of their lives and their local community, will boost engagement and compliance in a way fines and policing never can. I can imagine few things that would motivate the British public more than a clear message that says: ‘When we reach this level of infection it will be ok to visit loved ones, when it decreases to X level, schools, shopping centres and pubs can reopen, and when it gets down to this level major sports and music events can resume’. Give people targets they can get behind. Treating people as part of the solution is an approach that can pay dividends with issues beyond Covid.
I want to end by thanking all those who are working on the health front line or who are directly supporting it. We all owe you a huge debt of gratitude. To those in our wider GPHN community, stay safe and take care.