Effects of Covid pandemic playing out in North West five years on

BBC News

18-03-2025

Lancashire's Public Health Director says some health inequalities for the North West are now worse than they were before Covid.Poverty, ill health, and crowded living conditions saw much of the region suffer more restrictions, illness and deaths than virtually anywhere else in the country.Dr Sakthi Karunanithi says the pandemic led to a heightened awareness of the issues, but it hasn't necessarily led to action, although he says the current government does appear to be making moves to change that.The Department of Health and Social Care says the government will tackle these issues "head on" and one of its first priorities "is to halve the gap in healthy life expectancy between the richest and poorest regions in England".
It is now five years since the pandemic hit the UK but Dr Karunanithi said the effects of disrupted schooling, financial insecurity and social isolation were still playing out today."We've seen a rise in the impacts of overuse or misuse of substances, certainly with the younger generations we're seeing an impact on mental health and anxiety, depression and loneliness."There has also been a fall in the uptake of childhood and adult vaccinations, partly as a result of conspiracy theories about the Covid vaccines.Dr Karunanithi still vividly remembers the feeling of preparing for the unknown as Covid-19 spread through the country.
'Deprived communities were more affected'
"We were working through the reasonable worst-case scenario and our preparedness for it and it then started to dawn on me – the heaviness of the type of messages we had to communicate," he said"That was one of the very difficult moments in my professional history."The pandemic brought public health issues into the spotlight"Everything we had known about what determines our health, what keeps us healthy, was in play. So where people lived, what types of job they did, how connected they were, all played a role in the spread of the virus," said Dr Karunanithi."More deprived communities, people who probably didn't have a choice to turn up at work, which we have a lot of in some parts of Lancashire, were significantly more affected than other people."
A report in September 2021 by the Northern Health Science Alliance concluded that about half of the increased deaths of people with Covid and two-thirds of the increased mortalities from all causes were explained by higher deprivation and worse pre-pandemic health in the north of England.That inequality also led to stricter restrictions than much of the rest of the country to try to control the high infection rates. Parts of Greater Manchester and East Lancashire were under almost continuous full or partial lockdown from March 2020 to March 2021.So the announcement of a vaccine in December 2020 was greeted with joy and relief by many, who saw it as a chance to get back to normality.GP Dr Helen Wall is the clinical director for Population Health in Greater Manchester. In late 2020 she was in charge of the Covid vaccine roll-out in Bolton.
"People were being carried in, pushed in in wheelchairs, and elderly people were just crying, their relatives were crying because they'd been so scared of what was going on and they suddenly felt like there was hope. We all felt that," she said."Businesses would drop off food and drink and people would be knitting us masks."Dr Wall had spent much of the pandemic working at Covid clinics, and had seen hundreds of patients affected by the disease."I'd put people in ambulances and not been able to tell their relatives that they'd be alive by the time they got to the hospital, and the relatives couldn't go with them," she said.
"I'd seen relatives banging on the ambulance door wanting to go with [the patients] because their oxygen was so low, and they felt they weren't going to make it."But while early adoption of the vaccines is widely credited with turning the tide on the pandemic in the UK, by the spring of 2021 it had become the target of conspiracy theorists – particularly after requirements were brought in for travel and some professions.Dr Wall said they started to get antivaxxers demonstrating outside the clinics."I started getting hate mail as did some of my colleagues. I got death threats… it became very very difficult to get through the hate that was being levelled."In 2018 90% of UK adults said vaccinations were safe and effective; by 2023 it was 70% according to research from the Vaccine Confidence Project, run by the London School of Hygiene and Tropical Medicine (LSHTM).
'Lessons learned haven't led to action'
Dr Wall says she now sees the results in her job as a GP. "We get a lot more challenge back. People will have often seen things on social media, they will often have read things which for me are misinformation and mistruths, and it impacts on how they feel about vaccines."Nevertheless, she says the pandemic also prompted some change for the better. The use of vaccine buses, for example, sparked an increasing push to take treatments closer to communities."Certainly, in Greater Manchester we've used those theories a lot for things like cervical smears and all sorts of health interventions. We've looked at how we can take things to people rather than expect them to come to a health centre," she said.Along with vaccine take up, healthy life expectancy in the north west of England has also gone down - by more than two and a half years since 2019, far more than the national average.
Dr Karunanithi said lessons learned during the pandemic about the importance of public health had not necessarily led to action. But he said he was hopeful that the current government was looking to change that."I do see a lot of rhetoric and commitment from the policy makers on shifting more towards prevention, doing more with our communities… innovation."But in an increasingly difficult financial climate, he stressed the importance of turning rhetoric into deeds."To improve health, we need to improve housing, the education, the economy more than, I would argue, just improving the NHS""When the resources aren't here it will come down to how we prioritise as a nation, how we prioritise as a society."
A Department of Health and Social Care spokesperson said: "The pandemic impacted us all, with many people losing loved ones and people making great sacrifices to serve their community. "It also highlighted the shocking and appalling healthcare inequalities that exist within our systems.""Through our Plan for Change this government will tackle these inequalities head on. As part of this mission, one of our first priorities is to halve the gap in healthy life expectancy between the richest and poorest regions in England.""We are taking forward the lessons learnt from the pandemic and will continue to bolster our defences against global health threats."
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