Are COVID restrictions ignoring mental health issues?

[IanXC]

However the effects of restrictions will not be that severe for most people. Businesses fail all the time, and it does not kill their owners. It is a very sad thing to happen, but it is not lethal. And please don't misrepresent that statement as a lack of sympathy.

The restrictions in and of themselves might not, but the ensuing recession seems likely to reduce average life expectancy by around 10-12 months.

 

[35B]

I'm not sure many people are a really advocating that, the question I ask is whether this fixation on getting R below 1 is helpful. I would suggest allowing R to rise to allow for some kind of normality, but keeping it low enough that the NHS can cope is the way forward. R value of 1.4 is cited frequently in current economic modelling of this, which is probably about where we are, where, as things stand the NHS *can* cope. Admittedly we will need occasional tightening of restrictions to remain within what might be called the 'target band'.

Managing to a target R level might be viable, but the practicalities of this almost certainly are not. If memory serves me right, the underlying Covid R-value is 2.5-3, so holding down to 1.4 is already highly intrusive.

 

[Tetchytyke]

The restrictions in and of themselves might not, but the ensuing recession seems likely to reduce average life expectancy by around 10-12 months.

It's counter-intuitive, but the evidence is that life expectancy goes up in a recession. Life expectancy went up by 6.2 years during the Great Depression.

The Great Depression had a silver lining: During that hard time, U.S. life expectancy actually increased by 6.2 years, according to a University of Michigan study published in the current issue of the Proceedings of the National Academy of Sciences.

Did The Great Depression Have A Silver Lining? Life Expectancy Increased By 6.2 Years

The Great Depression had a silver lining: during that hard time, US life expectancy actually increased by 6.2 years, according to a new study.

www.sciencedaily.com

 

[43066]

The average age of death may be 82.4, but the average life expectancy is 83.6- and that average is dragged down by all the people who die young. Life expectancy is fluid, too: a man who reaches 80 can expect to live another 8 years on average (source: https://www.annuityadvantage.com/resources/life-expectancy-tables/)

So presumably you think we should be locking down every autumn to prevent thousands of flu deaths amongst the elderly and infirm?!

If we want to play the hard-headed pragmatist, someone who dies of cancer also dies at the end of their "natural life". Yes, earlier treatment could have prevented their death. But earlier restrictions could have prevented care home deaths too.

Cancer is often caused by external factors and equating it with dying of old age is utterly peculiar.

Can you honestly not see a difference between someone passing away in their eighties in a care home, having lived a full life, and someone dying of cancer in their thirties, perhaps leaving young children without a parent, and causing their own parents enormous grief?!

If you can’t then perhaps you haven’t experienced losing relatives in either circumstance. The vast majority of the population who have done so would disagree with your approach, and so does your beloved NHS (or at least it did under pre Covid circumstances).

 

[yorkie]

Life expectancy went up by 6.2 years during the Great Depression.

I suspect that was due to other factors.

Also how is this measured in respect of what year(s) were people born in, whose live expectancy increased by 6.2 years? i.e. are you measuring people born during it, people who died during it, or something else?

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==

You comment on deaths, as though those who died of the old mans friend were already ready for their trip over the Styx. I have two problems with this frame of reference.

The first is that there are those, even in poor health and requiring care, who have lives that they value and do not wish to end any time soon - I know one who is frail and with COPD, and another who is on lifelong immuno-suppressants following cancer treatment, but able to lead a full life. The second is the wider impact of Covid on those who recover from it, where "long Covid" is increasingly evident as a problem from what doctors increasingly recognise is not just a respiratory disease, despite the main presentation.

I don't support the proposition that the only measure of medical success is the prevention of death, but I struggle with the discounting of lives such as these. If we are all of equal worth, then an approach to epidemiology that reverses the normal approach to quarantine by sequestering the frail while allowing the ill freedom, is unethical. So, for clarity, is an approach that discounts all other value in our lives.

Do you deny that all of the above can apply to 'flu too? Only that with 'flu, the risks to younger people are greater, while the opposite is true of Sars-Cov-2

 

[IanXC]

It's counter-intuitive, but the evidence is that life expectancy goes up in a recession. Life expectancy went up by 6.2 years during the Great Depression.

Did The Great Depression Have A Silver Lining? Life Expectancy Increased By 6.2 Years

The Great Depression had a silver lining: during that hard time, US life expectancy actually increased by 6.2 years, according to a new study.

www.sciencedaily.com

The key factor there however, is not a key factor now. Air quality is not the killer it was 50 years ago let alone way back then. We need to look at much more recent data to find anything suitable to apply to this situation. As another example from another source:

Using data on the roughly 4m Americans who entered the workforce shortly before, during and after the 1982 recession—when unemployment reached almost 11%—the authors measured how the downturn affected those people’s health and mortality many years later. On joining the labour force, they faced a national unemployment rate 3.9 percentage points higher than that before the onset of recession. That was associated, the authors found, with a cut in their life expectancy of six to nine months.

Starting work in a recession affects people for their whole lives

Downturns are linked to deaths and divorces long after the economy has recovered

www.economist.com

This is frequently modelled by economists, it was a measurable outcome in the Financial Crisis, and this will clearly be worse.

 

[35B]

I suspect that was due to other factors.

Also how is this measured in respect of what year(s) were people born in, whose live expectancy increased by 6.2 years? i.e. are you measuring people born during it, people who died during it, or something else?

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==



Do you deny that all of the above can apply to 'flu too? Only that with 'flu, the risks to younger people are greater, while the opposite is true of Sars-Cov-2

Yet flu has 1/3 the overall mortality, and no equivalent to long Covid.

In any case, reverting to the psychological impact, flu is an accepted risk. Covid, currently, is not and is seen as new and different. That perception is likely to be maintained, if only by countries without Covid imposing quarantine measures on travellers from countries with Covid.

 

[Howardh]

Regarding the great depression and life expectancy, if there were fewer jobs, then less likely that someone would be killed in a job - eg. building worker etc, as back then there was very little in the way of health and safety?

Therefore automatically increasing life expectancy?

 

[Yew]

If the latter, and it's not as though the possibility hasn't been signalled for a while, then herd immunity is, by definition, never going to be attainable. And that would mean that "letting it rip", a policy with a devilishly high price on it, wouldn't deliver the results it's proponents suggest as a trade-off.

These statements are demonstrably untrue.

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==

The answer is that, yes, the fact that lockdowns and their effects are distressing is taken into account. Medical professionals are well aware that lockdown and isolation are hugely distressing for many people. But so is watching loved ones die of Covid. And there is no easy way of juggling these competing demands.

It seems like their solution is to completely ignore one on the face of the other.

== Doublepost prevention - post automatically merged: 13 Oct 2020 ==

Yet flu has 1/3 the overall mortality, and no equivalent to long Covid.

False, studies, and the WHO's own statistics put the IFR within the margin of error for influenza, and long Covid is another post-viral fatigue, which is seen in some influenza strains.

 

[yorkie]

Yet flu has 1/3 the overall mortality

How many Sars-Cov-2 infections do you estimate there have been in the UK?

Bear in mind that we already have more pre-existing immunity to 'flu; we will over time build that up with Sars-Cov-2

and no equivalent to long Covid.

This is false:

Post-Viral Fatigue: Symptoms, Causes, Treatment, and Recovery

Post-viral fatigue is a type of extreme tiredness that sometimes happens after a viral infection. We'll go over its symptoms, how it's diagnosed, and what may help.

www.healthline.com

Fatigue is an overall feeling of tiredness or exhaustion. It’s completely normal to experience it from time to time. But sometimes it can linger for weeks or months after you’ve been sick with a viral infection, such as the flu. This is known as post-viral fatigue.

It's only newsworthy if it's Covid, though

In any case, reverting to the psychological impact, flu is an accepted risk. Covid, currently, is not and is seen as new and different. That perception is likely to be maintained, if only by countries without Covid imposing quarantine measures on travellers from countries with Covid.

Are you saying this should be the case? You are quite right that any other virus is an accepted risk, even to any individual who is at greater risk from it than Sars-Cov-2. But is that logical?

 

[takno]

”Herd immunity” - sufficiently many people within the population with immunity to the disease that an infected individual will not cause spread within the general population. Typically assessed to require a high percentage immune, but numbers by definition not known now.
”Letting it rip” - a policy at current levels of infection of not actively trying to suppress incidence through measures like social distancing or restrictions on human interactions

Yes, one person won't cause spread within the general population, which is to say a drop in the underlying rate of r to 1 or less. We are going to get there in the end one way or the other. The options are:
- slowly passing the disease round most people, while probably failing to shield the vulnerable because it's all far too long, and trashing the economy to boot
- relatively quickly passing the disease round most people, shielding the vulnerable as well as possible, and keeping life intact
- permanently changing our lifestyles to a point where r<1 without any gain in immunity
Or
- go as slowly as possible while we wait for a vaccine to hopefully gain a bit more shielding for the vulnerable, whilst killing the economy, cancer patients and people who can't cope

The vaccine is only going to go to the over 50s, so any notion it's going to help with long Covid is a simple lie. There is no benefit to the non-vulnerable in any of the slower courses of action at all. For the vulnerable it might help, but only if the vaccine arrives fast, works and we get really lucky, otherwise most of them are going to get it before the vaccine offers them a level of shielding anyway.

Contrary to some of the wild claims of locktivists, including those who should know better such as Devi Shridhar, naturally acquired herd immunity has been vital in a range of diseases. That includes measles - a significantly more deadly disease than Covid which used to kill loads of people, but a fraction of those who were vulnerable, simply because it bubbled around without ever becoming an endemic disease.

Herd immunity is basically the end-game of all the strategies, and the fact that it has turned into a term of abuse for the only strategy that will get us there without destroying the country is a real shame

 

[bramling]

Yes, true. It effectively requires "negative" emotions plus a feeling of "no way out".

There’s plenty of negative emotions floating around at the moment - you name it: fear, anger, boredom, frustration, sadness, worry, just to pick a few off the top of my head.

Meanwhile we have a situation which currently seems like it’s not got an end point in sight (and it was highly irresponsible of Boris to have plucked a number of dates out of thin air, giving people false hope), indeed the prospects are getting worse with restrictions surrounding every aspect of life. I can’t even go for a walk in the countryside from my house without the likelihood of some silly encounter in an alley-way where someone presses themselves up against the wall when passing!

To be frank some of the neurotic behaviour we’ve seen over the last few months is bordering on mentally dubious at times, in terms of some of the out-of-proportion reactions we see to certain things. Masks being a case in point, it simply isn’t rational on a number of levels to be parading through a class 700 seeking to have a go at anyone not in a mask, yet I’ve seen this twice now since June.

 

[bb21]

I think the thread has run its course as some of the more recent debate is not very coherent with people seemingly talking at cross purposes.

Some very good points made upthread but also some truly baffling posts. Have a breather guys.