A tsunami of health issues is coming if the government doesn’t address the long-term effects of coronavirus

The toxic debate of health versus economy is reductive, an onslaught of illnesses is certain without any investment or planning for the future, says Clare Wenham

The long-term effects of coronavirus need to be addressed now (Getty Images/iStockphoto)

Current efforts to respond to Covid-19 do not go far enough to protect our long-term collective health. I welcome the recent move for the four administrations in the UK to eliminate coronavirus, but would also caution governments to think beyond short-termism. Epidemics have both direct and indirect effects on health, both of which can be long-lasting, but are often overshadowed by the tyranny of the urgent.

We can learn a lot from previous epidemics. Zika and Ebola both caused longer-term health impacts. The distortion of the health system in Sierra Leone to focus on Ebola left many women without antenatal care – consequently as many women died from maternal mortality as people died of Ebola in 2014/5. We are seeing similar disruptions now with coronavirus.

In Nepal, the rate of stillbirths has skyrocketed due to lack of provision. Even here in the UK, there have been huge implications on routine maternity services, and it’s yet to be determined what effect this might have on post-natal depression, or future willingness to interact with health services.

The government has recognised the impact of Covid-19 in the long-term, but pandemic preparedness plans still do not offer sustained financing for long-term needs. Emergency response revolves around patients either recovering or dying, with little consideration offered to alternative trajectories.

During Zika, children with lifelong neurological conditions fell through the gap while the government focused on vector control efforts and the “war” on the mosquito, resulting in insufficient care for those children, with significant effects on their development.

The Brazilian government’s failure to invest in health promotion work, such as increasing physiotherapy services, has left many mothers’ associations to organise and fund care for their own children, despite the promise of Brazil’s free universal health service.

We also know that the looming economic crisis will seriously impact health. The 2008 financial crisis in Greece and Spain led to a significant increase in suicides and mental health concerns. Furthermore, reduction of healthcare budgets due to austerity measures led to cutbacks across health services.

Socio-economic determinants can vastly alter health outcomes. Those living in poverty are likely to experience worse health over their lifetime and die 10 years earlier than the richest in the UK. As poverty increases, as a result of restrictions and job-loss due to government efforts to control Covid-19, what does this mean for the long-term health of our population?

I predict increases in obesity, diabetes, cardiovascular disease, tobacco-related deaths and increased delays to those seeking treatments for ongoing health issues, resulting in worse outcomes for a range of conditions, and a number of preventable deaths. Poorer health outcomes associated with economic downturn are not inevitable, the government can do something about it.

We need to move beyond this toxic debate between health versus economy. Both are important. Population health is the bedrock of a functioning economy, and in turn a healthy economy improves health outcomes. Instead, let’s think beyond the short-term, about what measures can be brought in now to mitigate future health challenges, and prioritise these alongside eliminating Covid-19.

One step would be to ensure the long-term consequences of emerging pathogens are built into pandemic responses and financing plans. A second step is to fully invest in health promotion now. Unfortunately, the UK government seems to have forgotten this amid short-termism. It’s scrapped Public Health England and its provision of health promotion activities, with no clear guidance on how these efforts will be delivered or funded in future.

We need to avoid prioritising people’s lives now over people’s lives later. The government must plan for the future now, while addressing the immediate threat.

Clare Wenham is assistant professor of Global Health Policy at the London School of Economics, she has 10+ years of research in outbreaks of infectious disease, including Zika, Ebola and now Covid-19