Coronavirus 100 days: Disease and suicides risks escalate due to impact of coronavirus

Figures show patients are staying away from hospitals through fear as others face cancelled tests and operations

Italian Foreign Minister Luigi Di Maio (R) and the President of the Italian Red Cross, Francesco Rocca (front, rear), in Rome. EPA/ETTORE FERRARI

A rise in suicides and unrelated coronavirus conditions, such as heart disease, could play out in months and years to come as a result of the international lockdown, officials warn.

Police chiefs in the UK have noted an increase in suicides during the first two weeks of Britain’s lockdown and Italy has launched a specialist programme to help people.

The Red Cross has also called for urgent psychological aid for health workers.

Worldwide cancer tests and treatments have been cancelled along with operations for many other urgent conditions.

On Thursday, a report by London's Institute for Fiscal Studies (IFS) warned the elderly will suffer the most.

Presently emergency hospital admissions in the UK are 10 times higher among those in their 90s than those in their 30s and elective admissions are more than six times higher among those in their 70s and 80s than among those in their 20s.
"Huge amounts of resources have, for good reason, been re-organised and re-deployed to help the NHS treat patients suffering from the coronavirus. This will have consequences for the wider healthcare system, and for the quantity and quality of non-coronavirus care that can be provided," said George Stoye, Associate Director at IFS.

“Wider emergency care will be hit by the need to divert resources to coronavirus patients, and the NHS has already postponed all non-urgent elective operations for at least the next three months.

“This will cause immediate distress to those affected and knock on effects on waiting times that could take years to unwind. The hardest hit will be those most likely to otherwise use hospital care, in particular older people, and those who are the least affluent and the least healthy to begin with.”

Dr Len Lichtenfeld, of the American Cancer Society, says medics may not have a choice in the delays patients will face. “We are going to face ethical dilemmas, not just in cancer care but in medical care in general,” he warned.

“We recognise that any delay is not good but we may not have a choice.”

Stephen Powis, the national medical director for NHS England, on Wednesday said other conditions should not be forgotten.

It comes as A&E attendances at hospitals in England were down nearly a third last month compared with a year ago and were the lowest number since records began.

"The NHS has worked night and day to surge capacity to manage coronavirus but it’s also there for you if you have symptoms of a stroke, symptoms of a heart attack,” he said.

"Indeed if you have any emergency condition whether it’s a sick child, whether it’s a mother in pregnancy who’s worried about movements of the baby, you should be seeking emergency services just as you always have done.”

A similar picture has emerged with heart patients in Switzerland, one hospital began ringing patients after noticing the hospital was quieter than usual.

"Many patients tell us I waited because I am afraid of coming into contact with a COVID patient," said Giovanni Pedrazzini, president of the Swiss Cardiology Society.

"The risk is that a lot of patients will suffer or die at home when they should go to the emergency room."

In the UK charity Cancer Research UK, which funds 50 per cent of the nation’s fight to find a cancer cure, has slashed £44million in research funding.

It says the fallout from coronavirus is expected to see funding dive by a quarter.

Iain Foulkes, executive director of research and innovation at Cancer research UK said cutting research funding was forced on the body.

“The unprecedented measures to control the global Covid-19 pandemic have had a huge impact on both our researchers’ ability to carry on in the lab, and on our ability to fundraise. Faced with a predicted loss of 20-25 per cent of fundraising income, we are forced to look for savings across our current portfolio,” he said.

“Cancer Research UK funds nearly 50 per cent of the cancer research in the UK and making cuts to research funding is the most difficult decision we have had to make. We don’t do so lightly.

“We are hopeful that limiting our spending now will enable us to continue funding life-saving research in the long run. Cancer doesn’t go away during or after Covid-19, but we’re incredibly proud of our community of researchers who have been very quick to respond to the crisis, using their kit, skills and talent to support the NHS and the Covid-19 response.

“Our mission is so important to people all over the UK and by helping the global effort of tackling Covid-19, we hope we can get back to beating cancer as soon as possible.”

The UK Police Federation’s lead for coronavirus, Sergeant Simon Kempton, said on Monday there had already been an increase in suicides.

“It’s going to be vital that we keep an eye on it and there are very early indications of an increase in suicide attempts and suicides,” he warned.

Last week the Italian government started a nationwide psychological support program to provide free emergency help to anyone who needs it during the lockdown.

Jagan Chapagain, the secretary-general of the International Federation of Red Cross and Red Crescent Societies (IFRC), said he understood that providing mental health support “may not be very high on the agenda as we are trying to contain the virus,” but stressed that the issue is important and “impacts millions and millions of people.”

“I think that could be the big silent killer if sufficient attention is not paid to psychosocial needs and mental health needs,” he said.

In a webinar, IFRC president Francesco Rocca and Mr Chapagain acknowledged that there were no statistics available yet to prove mental health issues and suicides are increasing, but said the discussions they are having with health workers and others clearly point in that direction.

“We know that this is the trend,” said Mr Rocca, who was speaking from his home in Italy.

“We are missing... the hug,” he said, describing how he himself felt earlier this week when a volunteer told him her mother had just died.

“I couldn’t hug her. She was crying two metres away from me... And I couldn’t hug,” he said, adding that the pandemic in this respect was worse than other crises.

“Even in the conflict areas we can hug each other when we are afraid. The terrible thing of this (pandemic) is the lack of the human touch, the physical human touch.”

High unemployment as a result of the pandemic is also expected to have a major impact on health, the IFS says.

It says the employment loss associated with the 2008 recession is estimated to have led to an additional 900,000 people of working age suffering from a chronic health condition, including mental health.

"The health impacts of the economic downturn caused by the coronavirus pandemic will be felt long after the social distancing measures come to an end," says Heidi Karjalainen, a Research Economist at IFS.
"Many of those who are most exposed to the economic shutdown – such as low income families, especially those with young children – are also most vulnerable to long-term effects on both physical and mental health.

“By making sure that the groups that are most at risk are also protected from the negative effects of a downturn, the government can help minimise the long-run detrimental health impacts that would otherwise occur.“

It has warned that the policies of governments will have a key role in mitigating these impacts in the future, such as job retention schemes.

In the UK, latest analysis showed on Wednesday that unemployment has risen to 26 per cent.