The shadow of Covid

Today is Long Covid Awareness day. It is strange that such a day should be necessary, given how many people’s lives Covid and Long Covid have touched in this country and around the world. Yet it is very necessary as the prevailing public discourse is that Covid is over, and it was never much of a problem to start with. Yet it still kills every week throughout the year, and an estimated 2 million people have Long Covid, affecting their health, and the country’s economy.

The ongoing Covid pandemic is a catastrophic example of the failures of the UK’s public health system. (I refer here primarily to English experience. The devolved administrations have done better than England, but are still affected to a large and tragic extent by the factors discussed below.) Covid requires both treatment and prevention, both medical and public health intervention, and both short and long term strategies with public, professional and political support.

The NHS did immensely well and the government moderately well in the initial phases; the public in general also did well in dealing with the restrictions and exigencies of lockdown. But there were clearly right from the beginning several negatives, which broadly compromised the capacity of public health approaches to be as effective as they could, and have badly compromised government action and professional and public response in the years since the emergency phase:

a) the instinctive reaction of our right wing governments that private provision must be better than public, so wasting billions of taxpayers’ pounds employing immensely expensive private firms to set up a ramshackle test and trace system rather than using existing public health capacity.

b) corruption in government, making sure for instance that funds for the provision of PPE went to their friends rather than to companies with proven track records in such provision.

c) vociferous anti-science and anti-clear thinking conspiracists given far too much air time on both social and traditional media.

d) a kind of neoliberal reductionism in which marginal increases in economic activity like enabling people to go to pubs again are valued far more than keeping people healthy; and school attendance is valued far more highly than reducing transmission – which has resulted in current high rates of absence of both children and teachers through sickness.

e) a refusal from government to take simple steps that might reduce transmission, such as ensuring air filtration in all classrooms and other public spaces which could easily and relatively cheaply have been done in the last four years.

f) short term and blinkered thinking in government and in public debate, in which the most important, and sometimes, the only important metric is death rates, leading us to ignore the creeping epidemic of long term illness and other forms of severe damage which Covid is wreaking on millions of people. We seem to be terrible at assessing long term risk: the fact that we got over a bout of Covid means we ignore the mountain of evidence that it will have done damage to one or more of our organs, which we will regret in ten or fifteen years time.

his is a massive failure on the part of our entire social and political system. All parties, including the LibDems, are complicit in downplaying and denying the damage this disease has done and is still doing to our health. Is it not time for the LibDems to find a bit of non-conformist spirit, and start saying what no other party will say – that Covid is still here, and we need to be taking it seriously?

* Rob Parsons is a Lib Dem member in Lewes. He blogs at http://acomfortableplace.blogspot.co.uk. He curates Liberal Quotes on Facebook

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35 Comments

  • Many thanks for this post, Rob. Long Covid is so debilitating and often not recognised because it presents in many different ways.

    And you are right to point out one major shortcoming as the Government did not draw on the real expertise of Public Health Officers in containing and dealing with threats to public health. https://www.libdemvoice.org/isolation-diary-musings-on-the-salisbury-poisonings-65022.html

    When my husband got Covid a few weeks ago at least one person remarked that they thought it had gone away. In fact he was bluelighted into hospital and on oxygen for five days. It is still with us and still a danger to clinically vulnerable people. https://www.libdemvoice.org/on-a-virtual-ward-74735.html

  • Good article, Rob.

    Thanks for drawing attention again to Long Covid. A very serious condition

    Long-term post-viral illness – whether post-flu, post-Epstein Barr, post-Covid etc – is a debiltating condition. Sufferers’ difficulties are sometimes worsened by the indifference and disbelief of medical professionals and the public.

  • @ Mary Reid I was sorry to read about your husband’s (and your) travails. It is indeed scary and I can empathise with your predicament. Having had a major transplant back in 2011 I am on the so called vulnerable list and was virtually confined to home for the duration of the epidemic.

    Rob Parsons sums it up very well. Every point he makes has resonance, and as an exiled Yorkshireman resident in Scotland, I can confirm his view that, “The devolved administrations have done better than England”.

    My six month post transplant check ups with the Edinburgh transplant team continued by zoom – with bloods and blood pressure done by my local GP. We got regular phone calls and shopping support by local volunteers in the town. The vaccine when it came was administered locally and efficiently by timed appointment (indeed I received an email yesterday for another dose in April). Now back to six monthly check ups with the world class transplant team in Edinburgh – with a bonus of free hospital car parking. So well done, Scotland.

    Anyway, Mary, good luck. I do hope things progress well for you both.

  • @David Raw – thank you. And best wishes to you too.

  • Chris Moore 15th Mar '24 - 1:05pm

    The article and David and Mary’s posts are a good reminder of the justifiable reasons that there were for masks, social distancing and lockdowns to protect the most vulnerable.

    Good luck to all three of you.

  • Long COVID is indeed a serious and overlooked condition we lost a highly skilled and valued member of staff due to having to dismiss her on capability / medical grounds after she contracted COVID and subsequently long COVID;she has COPD ,now on oxygen, her medium term prognosis is not good.
    That said I worked in a healthcare service throughout the pandemic and would question whether England’s approach to the pandemic was uniquely useless, the devolved administrations largely road the back of what England was doing and tweaked it in the direction, of more, longer, harder, in fact some party’s have never actually said whether they think we should still be locked down or not!
    Most people didn’t wear masks properly, or change them often enough, I know many people who would use one mask / week, take them off, place on desks or in pockets and then put back on…pointless.
    Schools should never have been closed, the damage to young people’s mental health, social development and education is beyond repair, the government backed down to unions and opposition parties, the cowards, schools should never be closed again unless young people are one of the primary risk groups in contracting a highly lethal or damaging virus / bacteria.

  • Ultimately the lockdowns will proven to be infinitely worse than the disease. School closures a huge mistake , missed GP appointments – the ramifications will last for years to come . Mask wearing a pointless & futile exercise – along with social distancing . The publics patience wore thin on the 2nd lockdown when much of the advice was starting to be ignored.

  • @Martin Gray; agreed, during the first lock down trains were deserted except for a few key workers, most places looked like a ghost town, subsequent to the first lock down not so much. Pretty much everyone I know broke the rules, if we want someone to blame, then many of us should look in the mirror.

  • Ross O’Kelly 16th Mar '24 - 7:23am

    Point a, While your broader point may be true, it’s hard to see that the NHS had any spare capacity when covid kicked off, so there wasn’t a lot of choice. It should be that we use the public sector but only if they can do it as well AND cheaper.
    Points b and c spot on. Point d is in itself a tad reductionist. The complete closure of society has health implications in itself, especially mental health. The Government tried to balance different kinds of harm, which is fair enough.

  • Ross O’Kelly 16th Mar '24 - 7:35am

    Sorry, should read “we use the PRIVATE sector…” in line 5. It’s early.

  • James Fowler 16th Mar '24 - 8:59am

    I mostly agree with Martin Gray. Rob’s critiques, though fair in a number of places, are essentially the pro-lockdown arguments re-visited which, as events unfolded 2020-2021, led to implicit support for an eternal lockdown because normal life could never be made safe enough. Zero COVID was a position endorsed by many health care professionals, who did not trouble themselves sufficiently about the wider social consequences – basically the flaw with lockdown full stop. This (colossal) problem was dealt with by the pro-lockdown lobby by labelling wider consequences as ‘The economy’ and then strongly implying that anyone worried about ‘The economy’ was putting money before lives. The possibility that ‘The economy’ might underwrite support for wider health outcomes (like paying doctors and nurses properly) was seemingly lost in the panic/enthusiasm. But it goes deeper than that. What is ‘The economy’? Well, it’s a number that represents the sum total of everybody’s home, job, access to clean water, electricity, clothes, food, education, transport and heating – as well as many more besides. In other words, the things that make a decent life possible. Portraying ‘the economy’ as immoral extra that we could without was an essential part of the pro-lockdown narrative. The moral and practical problems with that position are now self evident.

  • “Is it time for the Lib Dems to say… …Covid is still here”

    Oh no please just don’t. I really don’t think people want to be reminded of the time they couldn’t attend the birth of their children or comfort relatives at funerals.

  • Nonconformistradical 16th Mar '24 - 9:45am

    @Marco
    Trouble is – covid IS still here. And fewer people are being immunised against it – jabs are being made available to a smaller cohort, leaving the rest of the population vulnerable.

    I’ve certainly got relatives who had Covid only a few weeks ago – they’re all better now.

    So if a nasty variant evolves out of the woodwork a large section of our people might be susceptible to it. And perhaps it might not just be the elerdly and immunosuppressed people who have bad symptoms, can’t work, get long Covid etc.

    Personally being elderly and decrepit I’ve had every jab which has been offered to me and will continue to do so – I regard it as a duty to do so.

  • Noah March 15th 6.25 pm. I have to say I disagree fundamentally, Noah. There were costs to lockdown, but nothing like the costs of not locking down would have been. That goes for schools as much as anywhere else. The lazy idea that children don’t get covid, therefore it’s OK to carry on as before is being proven wrong every week with enormous numbers of both children and teachers off sick. It is bonkers that some people are still asking why on earth so many children are off sick, and even more bonkers thta they are then answering their own question by suggesting the parents aren’t doing their job properly. Anything other than acknowledge that covid is still around.

    The greater failure is not making long term plans and provisions right from the outset as to how to deal with this ongoing pandemic. And also how to deal with the inequalities which the pandemic, and the lockdowns, brought into very sharp focus. We learned this week that “levelling up” is a damp squib: that’s not surprising – this government will do nothing for ordinary people.

  • Noah, Martin Grey and Marco this is as blatant a red herring as I have ever seen. Nobody is arguing for permanent lockdown; that is only in the minds of people who think covid is a scam. It is real and it is still here. If you read my piece properly, you would have noticed that I was not arguing for more lockdown, but for sensible mitigation. I am not saying, and have never said, and nobody else has ever said that schools should remain closed. What I said, and repeat here, is that it is an utter dereliction of duty on the part of government not to have budgeted for, and taken, sensible steps like ensuring air filtration n all classrooms to minimise the spread of the covid that is still circulating. That is a fact. People are still dying from it every week. That is a fact. To pretend that it is not happening is utterly irresponsible.

  • @Rob Parsons; it was not my intent to suggest you, or anyone else were advocating for a permanent lock down, obviously that would be ludicrous. I do question the efficacy and whole cost / benefit of the lockdown process as implemented in the U.K. and many other countries.
    What do you think would have been the correct action to take if the vaccines (as weak as they are) had not been developed, at what point would we have unlocked?
    Again with the subject of schools it was not my intent to suggest that anyone advocates that they remain closed, but that they should not have been closed in the first place, as I sai the damage done to the education and social development of many of the young people concerned is beyond repair.

  • @Rob Parsons; I completely accept that COVID is still circulating and that for a significant number of people it continues to be significant, potentially fatal risk to their health. However for most of the population current strains represent very little risk to health, most staff at our workplace who test positive are asymptomatic, but still isolate to protect our patients.
    Re children and young people, obviously they can become infected but again the health risk to them is low, vaccinating children was never clinically warranted and arguably should not have been advised, particularly as the current do not wholly prevent infection or transmission, if they have any impact on those criteria at all.
    I’m not aware that the government is pretending COVID is not still in circulation, we get regular public health updates.

  • Martin Gray 16th Mar '24 - 1:54pm

    Rob – what does that sensible mitigation consist of ?
    If it’s mask wearing & limited social distancing then it would be unenforceable. The 2nd lockdown put paid to the publics patience on those , & would be extremely difficult to repeat …The risk to youngsters was/is incredibly small – it did not warrant the closure of the school system . The missed GP appointments will effect the NHS for years to come . Of course if you feel that your vulnerable then it’s a personal choice if you want to take your own precautions, but imposing them on others is unnecessary…

  • Rob Parsons 16th Mar '24 - 3:06pm

    Noah 16th Mar ’24 – 12:48pm – you’re right, you didn’t mention permanent lockdown – my reply was a portmanteau reply to several people, one of whom did mention permanent lockdown.

    What if vaccines had not been developed – interesting question. First of all, lockdown as such was never complete. Lots of people continued their daily work in the health service, retail, all sorts of professions. And they found wys od dealing with them. In the case of schools, at some point students and teachers would have to return, yes. But there could have been mitigations in place – like filtration, which it beggars belief has still not been universally installed. maybe there could have been a hybrid model with some hours spent learnign remotely and some in school. There are all sorts of possibilities, which havenever been explored, largely due to this fetid government’s antipaty to doing anything which actually helps people.

    As for the damage done by locking down schools, I accept that you saw it happening. I dispute however that it was lockdown per se that did that damage. While there are many factors to discuss, let me focus on just two. The first is that it could have been made much less problematic if the government had acted with the interests of the population at heart rather than the interests of private capital eg much more generous funding to schools to provide laptops, connectivity, and tuition, as well as other services – and that would still have been a bagatelle compared to the billions thrown at private companies. Secondly, people are resilient, children are resilient. If the effects of lockdown have proved long lasting, it is because government policy – starving schools and poor people of funds and opportunities – has continued to oppress them since the end of lockdown.

    I accept lockdown did some damage. Inconceivably more damage would have been done by not locking down – the alternative was to trap children and adults in environments where the virus would inevitably spread with exuberance and cause masses of deaths and serious illnesses.

  • Rob Parsons 16th Mar '24 - 3:20pm

    Noah 16th Mar ’24 – 1:07pm this is my point f) above. “current strains represent very little risk to health,” is not true. The problem is that people can apparently recover from a bout of covid but not experience or understand the damage that it has done. There are now mountains of evidence of long term damage that is done to many people’s hearts, lungs, liver, other organs, as well as compromising people’s immune systems. They may be fine now, but in ten or fifteen years’ time, it may be a different story – particularly if people blithely let themselves be reinfected, as each reinfection does more damage.

    One of the first studies to note the long term effects of Covid was on Bundesliga footballers who, six months after having had a bout of covid, were still functioning five per cent less effectively than they were before. These are the fittest, healthiest and best looked after people on the planet. Now most people won’t notice that – they don’t routinely stress their bodies to 100% of their capacity. But everybody in your workforce who has had covid has lost some health. They just haven’t noticed yet.

    I will also challenge the idea that it is very little risk to health as we know that two million people in this country have long covid, which is bad enough to make their lives miserable and keep them out of the workforce. The fact that a bout of covid doesn’t affect any particular person cannot be the only criterion when two million people are suffering badly, and that number would be a lot less if we took mitgation strategies seriously.

    “particularly as the current do not wholly prevent infection or transmission, if they have any impact on those criteria at all.” – it is well esablished that vaccines do diminish rates or transmission and severity of infection.

    “I’m not aware that the government is pretending COVID is not still in circulation, we get regular public health updates.” They’re certainly acting as if it’s not a problem, viz their foot dragging on filtration in schools. An the publication of data has tailed off significantly. You may be getting updates, but the rest of the population is being encouraged to behave as if it is all over.

  • Rob Parsons 16th Mar '24 - 3:34pm

    Martin 16th Mar ’24 – 1:54pm I would say sensible mitigation takes a variety of forms. Mask wearing would certainly be one of them. Social distancing in queues etc would also be one of them. It’s not unenforceable: mask wearing for instance is adopted routinely in other countries; there comes a point here it is culturally rather than legally enforced. And please don’t say but, but, but freedom loving Brits won’t stand for it. We actually started doing that sort of thing well before the government made rules about it. It fell off because overall public health messaging about it, including central government policy, was terrible. Govt policy was actually destructive – help out to eat out, so we can create super spreader events all over the country. With sensible measures sensibly communicated about eg wearing masks on public transport, a lot could be achieved.

    Just anecdotally, at my local baker, which is a very small space, people now crowd into it just like they used to. When I go there, I queue outside until there are only two people left in the shop. When I do that, other people quite patiently queue behind me; nobody has ever caused a probem about it.

    “The 2nd lockdown put paid to the publics patience on those , & would be extremely difficult to repeat” – this confuses mitigations with lockdowns. Part of the purpose of mitigation is to prevent the need for lockdown.

    “The risk to youngsters was/is incredibly small ” – this is simply not true, particularly if you’re going to say “incredibly” small – children died and still die from covid. And with children as with adults, thousands and thousands are suffering from long covid, which my be lifelong. We can all play our part in reducing the number of people affected.

  • @Rob Evans; you know you’re using almost the very same arguments that the vaccine hesitant deploy re vaccine damage, ever increasing mountains of evidence re the long term damage to people’s vital organs, and wait 10 – 15 years, then you’ll see.
    Doubtless for some both the vaccine and the virus can cause serious life changing damage, but most people recover and recover well. Where are journal reports evidencing the high numbers of people who have received serious, but strangely asymptomatic, organ damage, they aren’t there.
    Re the vaccines, they seem to reduce severity of disease, they clearly don’t prevent infection, and so fail in their intended primary function, the impact on transmission is less clear, and data is continuously being created and reviewed, but certainly their efficacy in preventing transmission is, to say the least, not what was hoped for.

    Other than viral filtration systems, what other mitigation do you suggest should be implemented?

  • Rob Parsons 16th Mar '24 - 3:47pm

    Martin 16th Mar ’24 – 1:54pm “Of course if you feel that your vulnerable then it’s a personal choice if you want to take your own precautions, but imposing them on others is unnecessary…”.

    Here we get to the nub of liberalism, don’t we. We are not free to do whatever we want, regardless of the consequences to other people. We are free to do what we want as long as that freedom does not impact on other people’s. You are free to go about your business as you choose; I am – or should be – free to go about my business without fear of being infected by you.

    Yes, I’m vulnerable – *everybody* is vulnerable. But even if I was in a minority, it is reasonable, and liberal, to ask the majority to take minor precautions to enable the minority to exercise reasonable freedom. It really would be no big deal to normalise wearing masks in shops and on public transport, and the spread of the disease – which still infects thousands of people every week, with potentially devastating effects on their health – could be very significantly reduced. It would actually be helpful to the “majority” of “healthy” as well as the “minority” of “vulnerable” people. The reason it is so difficlt now to contemplate that are manifold but they include the dysfunctional approach this government and the right wing media have taken to public health messaging, an approach which fed on the growth since Thatcher of an “I’m all right, Jack” approach to personal freedom which is inimical to liberalism.

  • @Rob Parsons; one last question if you will then I’ll leave you to the rest of your afternoon.🙂

    What do you make of the Swedish experience? Do you think their relatively low infection and death rate is due to population density, different health and age demographics differences in counting, or pure dumb luck?

    Thanks for your responses not all op writers take quite so much time in responding, despite differences in opinion,it is appreciated.

  • Peter Davies 16th Mar '24 - 4:00pm

    One mitigation would be the availability of good advice on how to minimise transmission tailored to specific workspaces. I received a cut-and-paste email based on government advice advising that I should open the windows when in a meeting. This was not good advice because.
    The windows in our meeting rooms do not open.
    They are in the middle of the building so smashing them would have increased transmission
    They have good down-draft air-con which would be disrupted by open windows.
    We were all working from home and meeting on Microsoft Teams.

  • Rob Parsons 16th Mar '24 - 4:06pm

    Noah 16th Mar ’24 – 3:38pm there are not mountains of evidence about vaccine damage. There are mountains of evidence free assertions about widespread vaccine damage. There are mountains of evidence about widespread damage done by covid.

    Re vaccines and transmission, I wouldn’t say that was a primary function. But at a secondary level it works – the vaccine protects you from the virus. If you don’t have covid, you’re not transmitting it. And, as you have noted, there is evidence that a vaccinated person who reacquires covid gets it at a lesser level, and therefore transmits it at a lesser level.

    Mitigations – well, filtration everywhere is an obvious one. Enabling people to take enough time off sick to recover properly and not stay at work or go back to work while still infectious; and enabling ompensation for employers who need to cover for their off sick staff. That would be very effective, but there’s no chance of that from this putrid noxious government. (One of the reasons Sweden’s approach to the pandemic initially worked quite well – though it fell off a cliff later -is that it has a functioning sickness benefit system.)

    Stopping even medical people who should know better from saying “it’s just like the flu”. (That one really gets me.)

    And masking and distancing; I appreciate that would now be difficult given the cack handed way those ideas have been dealt with up to now.

  • I suspect that most of us are incapable of understanding just how cynical the government’s attitude towards its citizens really is, and not just on Covid. It was obvious within the first weeks that they had decided to let it take its course. Lockdowns were late, poorly implemented panic measures, but they did save lives and keep the NHS functioning. Excess deaths are around 170,000 and would have been much higher if not for the exceptional efforts of the NHS and the teams working on vaccines. Although the vaccine’s protection against reinfection fades over a few months, the protection against serious illness is much longer lasting. That is why we are almost back to normal and grandparents are back to collecting their grandchildren from school, which has freed up their parents to return to work. Little children catch and spread Covid, although their symptoms are usually mild. Until the vaccination program had rolled out, it’s hard to see how primary schools could have remained fully open.
    People I know with long Covid do feel abandoned and, by some, victim-blamed.
    Does the party have plans in place to make sure that the response to the next pandemic is much more effective and humane?

  • Nonconformistradical 16th Mar '24 - 4:34pm

    “It was obvious within the first weeks that they had decided to let it take its course. ”

    And the Prime Minister at the height of it was running round shaking hands with everyone in sight and ended up in intensive care himself.

  • I know it’s still around but we’re living with it as we do with other respiratory viruses. There is zero point in trying to stop people catching it. After catching Covid your immune system helps protect you when you are reinfected. It makes sense to vaccinate the clinically vulnerable whilst relying on natural immunity for everyone else.

  • Martin Gray 16th Mar '24 - 5:14pm

    Rob …Echoing Noah’s comments – thanks for taking time out and answering readers comments . Although we disagree , it’s very much appreciated that you’ve comeback and clarified those arguments…

  • Rob Parsons 16th Mar '24 - 5:16pm

    Martin Gray 16th Mar ’24 – 5:14pm and ditto from me. It is refreshing and thought provoking to have a respectful debate.

  • Rob Parsons 16th Mar '24 - 5:42pm

    Noah 16th Mar ’24 – 3:54pm

    The first thing to note is that, though the Swedes managed without lockdown quite well early on, their infection and death rate climbed significantly later on. Acccording to Wikipedia (I haven’t checked their references) https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden they ended up 30th out of 47 European countries for per capita deaths.

    And the second is it wasn’t a free for all; they did introduce restrictions eg working from home where possible, social distancing, limiting travel.

    Why it worked better than our approach did – I suspect there is a variety of factors:

    – government messaging being consistent and sensible, rather than their PM going round making a point of shaking hands with people. (the distinctive thing there is really us rather than them; I don’t think any other country had such a uniquely irresponsible leader. The USA didn;t get Trump till 2021.)

    – a sickness benefit system which enabled people to stay off work as long as necessary to clear the virus; and enabled employers to let them – as opposed to ours, which is designed to hound people back to work while they are still sick; as well as cultural attitudes about the importance of going to work no matter how sick you are, and no matter how many of your fellow workers you infect (I’ve nver understood that one.)

    Those two are pretty clear; the rest are my unevidenced ruminations:

    – combined with the govt messaging I suspect Swedish society is more community oriented than we are; in other words they would voluntarily do more and keep it up for longer, to protect other people.

    – population density as such shouldn’t have made a difference. Although the overall population is much smaller, 87% live in urban areas, compared to UK’s 91%.

    – on the other hand, I suspect building and public space design in Sweden is much better; it has to be because of their climate. So air flow and other things would work much better.

    I’ve seen quite a few studies comparing different countries’ responses at the political and social level. I do hope some are investigating the role of existing design, spatial usage and infrastructure in influencing outcomes. I’m sure there are some; I must have a look around some geography sites.

  • Peter Davies 16th Mar '24 - 7:59pm

    @Rob Parsons. The USA got Trump in 2017. Brazil had Bolsonaro who probably made Trump look responsible.

  • Peter Davies 16th Mar ’24 – 7:59pm got to say I’m not sure about that, but I understand what you mean, especially after today’s revelations that Bolsonaro tried to organise a coup.

  • Peter Davies 16th Mar ’24 – 7:59pm re Trump – of course, how stupid of me. My apologies.

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