The parallel health crises of the Covid pandemic

The priority for the medical battle against Covid-19 has necessarily been to tackle the crisis caused by the virus itself. But other aspects of human health face collateral damage on a huge scale from the pandemic, which will require governments to increase health spending even faster than previously planned for several years to come.

One badly affected field is mental health, as isolation, grief and social disruption take their toll; this is on top of the finding that one in three people who have suffered from Covid-19 were diagnosed with a neurological or psychiatric condition within six months. The other is cancer care, where research, screening, diagnosis and treatments have all been disrupted. In both areas firm data about pandemic damage is emerging that highlight the need for action.

While delays in cancer diagnosis and treatment mainly hit people in middle and old age, the young seem particularly susceptible to indirect mental harm from the pandemic. A study published last month by researchers at the University of Surrey assessed 259 students before the pandemic and again during lockdown last year. They found levels of clinical depression had doubled from 15 per cent to 35 per cent.

On a far larger scale the US Centers for Disease Control released a survey of 790,00 Americans, which showed mental health deteriorating further during the pandemic. The proportion of adults with recent symptoms of anxiety or depression rose from 36.4 per cent in August 2020 to 41.5 per cent in February 2021. Increases were largest in the 18-29 age group.

No government or health system has sufficient resources to improve mental wellbeing substantially for everyone but it is clear that services to help children and young adults should be the priority. In the longer run, training for professionals across the spectrum of mental health professions must be expanded to provide more therapists, psychiatrists, nurses and other specialists and satisfy at least some of the growing demand for their services.

In cancer, pandemic damage begins with discovery and development of new diagnostics and treatments. Labs were shut down for months during last year’s lockdowns, most clinical trials had to close for a period, some scientists left oncology to work on Covid-19 — and research has been hit by a downturn in funding.

Cancer Research UK, Britain’s largest funder of oncology research, is predicting a £300m fall in income over three years because the pandemic has hit charitable giving hard. Researchers estimate that 18 months of progress has been lost. The UK government should respond urgently to the plea by medical charities to make up some of their shortfall in donations.

As Lancet Oncology, the field’s leading journal, says in an editorial this month, “Covid-19 has had devastating effects on patients [around the world] with cancer, with huge numbers of missed diagnoses and delayed treatments, due to health systems under pressure and patients’ reluctance to seek medical care.”

In the UK, around 4.4m fewer cancer diagnostic tests took place last year than in 2019 and 44,000 fewer patients started treatment. Experts estimate that, very broadly, a week’s delay in cancer referral reduces a patient’s chances of survival by 1 per cent.

In the long run, the mental health and cancer fields can improve efficiency by learning lessons from the pandemic — for example treating more patients remotely, whether by running more video consultations or prescribing more drugs that can be taken at home. But action is needed now to tackle the immediate crises in both areas.