Irfan Ahmed is a GP and Sport and Exercise Medicine Registrar.
As the UK prepares to unlock and enter a ‘new normal’ world living with COVID-19, I can’t help but be struck by how medically siloed our response has become. While I fully commend the initial response to ramp up ICU capacity, increase the medical workforce, and protect the NHS from collapse, I feel rather stranded by the next phase of the response. We as a medical profession were never going to be able to deal with the social and political ramifications of this pandemic alone, we desperately need the help of our social scientist colleagues.
More often than not, our patients express concerns that are as much economic as they are medical. For instance, the decision on whether to return to work in patients who are shielding weighs up the risks of not being able to pay the mortgage versus the immediate risk to their health.
While I can do my best as a medical professional to work on my half of the equation, I fear I can’t do it alone, not without the help of professionals to support the livelihoods of my patients. For what it is worth, I would like to be able to prescribe high speed broadband to my patient, so that they can maintain their seat at the economic table and work from home. This policy however is not within my gift.
Perhaps… we should add a fourth podium to the government’s briefings and invite an economist or social policy expert?
As a medical student I was taught that medicine is an art, not a science. That in order to come to an effective treatment plan I had to weigh up the psychosocial impact of the illness on my patients, but what if the proposed treatment plan (self-isolation) was as hazardous as the illness itself?
To my patients with severe COPD and frailty I could say ‘stay at home — don’t go out and you won’t get the virus!’, but I fear that a complete loss of social contact will cut the very limited lifeline of support that they so desperately need. I didn’t need any extra guidance to ‘stay alert’, managing risk is after all the bread and butter of my job as a GP. What I would like though, is access to more community services to support and enrich the lives of our shielding patient groups.
I can advise my patients on the most suitable course of action based on the best medical guidance available at the time, but as is becoming increasingly apparent; compliance with this advice varies significantly, right from the highest levels of government to the general population. In my observations it is based on many complex factors, least of which is the daily ‘R’ number.
Noble and well-intentioned individuals are subject to social influence, and for this I really would like to seek the opinion of a behavioural scientist. Inequality, the loss of early years development in school children, and the health impact of social isolation, these are just a few issues that we need urgent answers to.
Perhaps, if needed in the future, we should add a fourth podium to government’s briefings and invite an economist or social policy expert? I, for one, would be quite interested to hear what they say as a contrast to the latest scientific advice.