Back in the far-off days of pre-lockdown the mantra that was repeated to us in order to secure our compliance in one of the biggest voluntary surrenders of civil liberties in history was “flatten the curve”.
The idea behind it was that we need to ensure that the infection spreads more slowly than it would unabated so that we do not overwhelm our health system with Wuflu cases. The concern was that we would end up like Italy where health workers were being roped in from completely unrelated areas to help with pandemic cases and other patients were having their treatment deferred or cancelled.
Flattening the curve seems to be less popular nowadays. In New Zealand at least it has been replaced by “elimination”: we don’t want the Wuflu here at all. One of the reasons that we have changed our nomenclature is that “flattening the curve” now seems so laughable. Instead of overwhelming our health system, we are dangerously underwhelming it.
I know of one surgeon who is only working two days a week, while a theatre nurse has not been needed at all over the last few weeks. General practitioners are being laid off or having their hours reduced and clinics are closing. A similar pattern is happening overseas as well: hospitals are shutting in the USA, and doctors and nurses there are being laid off or furloughed.
This is because people are either choosing to stay away out of fear for their safety, or they are being kept away because their “non-essential” treatment cannot be given during the lockdown.
We are doing this all for public health and safety, but what is the downside of putting the rest of the health system in hiatus for a number of weeks? What will be the downstream health effects of not having diagnostic tests for all manner of diseases? What will be the downstream well-being effects of deferring that “elective” hip replacement? We have had a child with cancer; I can’t imagine what it would be like if we were in the middle of a course of chemotherapy at the moment.
In the UK the Guardian reports that one of the consequences of the lockdown decision there is that 18,000 more people with cancer could die due to suspended treatment and people deferred seeking care or diagnosis. If this research for University College London and Data-Can (a health research hub) is true, this would mean that there would be a 20 percent increase in the number of cancer deaths in the UK this year. As Macmillan Cancer Support notes, cancer is in danger of becoming the “forgotten C” during the coronavirus pandemic.
The NHS is obviously worried: it has launched a campaign urging people with symptoms of any serious illness to seek help in the normal way. But with breathless, panicked reporting of the Wuflu on every channel and in every newspaper, is it surprising that people are staying away?
When it comes to cancer treatment in the UK, the decline since February has been extremely large. Urgent referrals by GPs for cancer tests have fallen by 76 percent, and appointments for chemotherapy have dropped by 60 percent. The NHS hopes to resume cancer operations this week but faces a large backlog. Its insistence that cancer treatment “should continue unaffected” by the pandemic has obviously not been followed through. As a lead author of the study notes, there are serious “unintended consequences” for locking down the country in response to the pandemic.
I just hope that these unintended consequences have been thought through and weighed up in the policy decisions being taken. In New Zealand at least, I doubt it.