Lockdown’s lethal toll laid bare: 50,000 children see surgery postponed, treatments for strokes plunge by almost 50%, and one in FIVE people were hit with depression in just one month as devastating effect of coronavirus restrictions are revealed
- 25,000 more people died at home during pandemic as they didn’t go to hospital
- Huge backlog in NHS treatment set to cause 20% rise in cancer patient deaths
- Organ transplant operations fell by two thirds while waiting list deaths doubled
- Daily Mail carried out audit of 130 studies from journals, academics and charities
A devastating picture of the impact of the lockdown on the nation’s health and wellbeing is today revealed in an exclusive analysis that brings together more than 130 studies.
The Daily Mail audit – based on research published by medical journals, leading academics and charities – shows that the damage inflicted by the lockdown extends into every sphere of health, including cancer, heart disease, addiction, the welfare of children, domestic violence and mental illness.
Experts say the analysis suggests that even after the pandemic ends, it will take years for the NHS to catch up with backlogs – and it will be too late for tens of thousands of patients.
Doctors and politicians called on the Government to ensure all health services are protected if the spread of Covid-19 continues. The audit of 132 documents shows:
- Delays in treatment are set to cause a 20 per cent rise in deaths among newly diagnosed cancer patients in England – 6,270 excess deaths this year;
- Treatment for strokes fell by 45 per cent during lockdown and there were more than 2,000 excess deaths in from heart disease;
- More than 50,000 operations for children were cancelled;
- Organ transplants fell by two thirds, with the number of those who died on the transplant waiting list almost doubling;
- Total waiting lists for routine orthopaedic and eye operations are at record levels;
- Calls to child abuse helplines rocketed;
- As rates of depression and anxiety doubled, thousands of recovering alcoholics have relapsed.
A devastating picture of the impact of the lockdown on the nation’s health and wellbeing is today revealed in an exclusive analysis that brings together more than 130 studies
NHS Digital estimates there were 26.7million fewer GP appointments in England between March and August this year than in the same period in 2019 – down from 146.2million to 119.5million
At least 25,000 more people have died at home during the pandemic in England and Wales because they were unable to – or chose not to – go to hospital, a surge of 43.8 per cent on normal levels.
And 85,400 people died in private homes rather than in hospitals or care homes between March 20, when lockdown started, and September 11, an Office for National Statistics report revealed, the equivalent of around 100 extra deaths a day.
Prince William, speaking to Liverpool business owners yesterday, days after the city was forced into Tier Three virus restrictions, revealed his fears of a ‘mental health catastrophe’ if Britain’s entertainment industry goes bust due to Covid-19.
Cancer patients set to suffer for years
The toll of lockdown on cancer patients will be felt for years, researchers say.
If a tumour is spotted early, it can often be dealt with quickly. But if it spreads there is often nothing a doctor can do.
The suspension of cancer screenings during lockdown is likely to lead to a surge of cases caught too late.
GP appointments also plummeted and between April and August urgent cancer referrals fell by 350,000 in England, according to Cancer Research UK.
Treatment was also put on hold – with chemotherapy procedures falling by between 45 per cent and 66 per cent in April alone.
Academics at UCL calculated that within a year 6,270 extra Britons will have died of cancer in England owing to the pandemic. Hospitals are bracing themselves for a leap in cancer referrals which could add to the impact of a second wave.
Boris Johnson is poised to place Greater Manchester into the highest level of lockdown restrictions today, despite opposition from local politicians. Talks on whether the region should enter the ‘very high risk’ Tier Three ended in deadlock again.
Health Secretary Matt Hancock yesterday said talks were continuing with local leaders in South Yorkshire, West Yorkshire, Nottinghamshire, Teesside and the North East. It means another ten million Britons could face the toughest restrictions by the end of this week.
Wales announced it was to re-enter what First Minister Mark Drakeford called a ‘time-limited firebreak’. He described it as ‘a short, sharp, shock to turn back the clock, slow down the virus and buy us more time’.
More than 43,700 Britons have died from coronavirus, and thousands more would have died had there been no lockdown in March. But, as the country faces tighter restrictions, the focus is now turning to the indirect casualties of those measures.
Professor Karol Sikora, a cancer specialist and head of Buckingham Medical School, said the findings of the Mail’s audit were a ‘stunning demonstration of lockdowns’ harmful effects across society’.
He added: ‘If lockdown were a drug, you’d need to consider the side effects, and yet we’re not – even though we seem to be diving headlong into another one.
‘People sometimes claim it’s a question of health versus the economy, but it’s not – it’s health versus health.’ Professor Sikora supports last week’s Great Barrington Declaration, now signed by more than 10,700 scientists and 29,700 doctors worldwide, calling on governments to adopt an approach of ‘focused protection’, shielding the vulnerable while opening up the economy.
Sunetra Gupta, one of the Declaration’s authors and an Oxford University epidemiologist, said: ‘These papers and data are starting to build the evidence to show that the collateral damage has been immense – and will continue with extreme measures such as lockdowns. The time has surely come to take their full costs measures into account.’
Professor Allyson Pollock, a public health expert at Newcastle University, said: ‘I went along with the previous lockdown, but now the question is, did its harms outweigh the benefits, especially for children and young people?
‘I’m very uncertain about the evidence for the benefits of further blanket measures. They have not been evaluated, and may do real harm. Without very significant investment and expanded public service capacity, the damage will never be repaired. Even with it, it’s going to take years.’
Children’s operations dangerously delayed
Huge numbers of child patients were unable to have operations during lockdown, figures show.
A total of 50,000 children had surgery postponed from March to May.
The figures were revealed by the Royal College of Paediatrics and Child Health.
It warned in a report in July: ‘There is an urgent requirement to re-establish elective children’s surgical services.’ It stressed there was an ‘enormous excess of children…waiting far longer than the recommended 16-week limit for a procedure.’
Meanwhile, a British Paediatric Surveillance Unit survey showed that 32 per cent of experts had seen children whose treatment was delayed by the end of April.
In nine cases where the child died ‘delayed presentation was considered a contributing factor’.
The analysis shows that cancer patients have been especially hard hit and the full cost may not become clear for several years.
A British Medical Journal study found that during lockdown, endoscopies for bowel cancer averaged just 12 per cent of normal levels, and at one point were down to 5 per cent. Delays in bowel cancer diagnosis are likely to lead to between 650 and 2,250 excess deaths in England, according to another BMJ paper. A Lancet study found delays for breast, lung and oesophageal cancer patients caused by the lockdown were likely to cause a further 2,000 excess deaths.
A University College London study for the British Medical Journal found that hospital admissions for chemotherapy fell by up to 66 per cent in April, while urgent referrals for early cancer diagnosis were down by up to 89 per cent. It concluded that this would lead to 6,270 extra deaths in the first year.
According to another BMJ study, there were nearly 2,100 excess deaths in England from heart attacks and strokes, an increase of 8 per cent, while the numbers treated for strokes fell by 45 per cent. The Health Foundation said during the lockdown, accident and emergency visits in England fell by more than half, from more than 80,000 a week to just over 40,000.
Another Lancet paper discovered the average number of organ transplants performed every day fell from 11.6 to 3.1. The total who died while waiting for a transplant increased from 47 in the same period last year to 87 during the three months of lockdown.
Waiting lists for elective procedures rocketed. The numbers needing orthopaedic operations such as knee and hip replacements rose by more than a third to some 700,000. More than 600,000 people are now waiting for eye procedures for conditions such as cataracts.
According to the Royal College of Paediatrics and Child Health, 50,000 children in England had scheduled operations cancelled. The impacts on mental health and addiction to drugs and alcohol were also severe.
The Office of National Statistics found that rates of depression across all ages and genders in England roughly doubled, from one in ten to one in five.
Another paper in the British Journal of Psychiatry said 18 per cent of UK adults reported having suicidal thoughts in the first month of the lockdown. Another suggested: ‘There is a high probability that suicide rates will increase.’
How ‘stay at home’ led to fatal heart attacks
Thousands of Britons died of heart attacks and strokes at home in the first months of the pandemic.
Experts believe the Government’s ‘stay-at-home’ message scared the sick into avoiding hospital even when they desperately needed it.
The toll from cardiovascular causes rose by 2,085 in England and Wales from March to June, analysis by the University of Leeds found. Professor Chris Gale, a cardiologist at the university, said the deaths ‘should not have happened’, adding: ‘The message to stay at home was taken literally.
‘The sad irony is that heart attack services remained fully operational… during the peak of the pandemic.’
The British Heart Foundation found that even among under-65s there were 800 more deaths from heart attacks and strokes than average from March to July.
The charity Action on Addiction found that patients recovering from drug or alcohol addiction were likely to suffer a relapse – almost 40 per cent of the total.
There was a surge in calls to the NSPCC emergency helpline, from an average of 5,593 a week before the lockdown to 8,287 in May.
Calls to the domestic abuse charity Refuge were also almost 50 per cent higher in April than the average before the pandemic.
Leading politicians called for the Government to protect health services if restrictions are tightened further.
Jeremy Hunt, chairman of the Commons health committee, told the Mail that the mistakes of the first lockdown must not be repeated.
‘The last lockdown was devastating for cancer sufferers and we now know led to thousands of avoidable deaths,’ the former health secretary said.
‘Whatever course of action ministers opt for now, it is simply unconscionable for the NHS to become a Covid-only service: urgent treatment must continue at all costs.’
Labour MP John Spellar said: ‘The collapse of the economy can kill people, delays in diagnosis and treatment kills people. I don’t think Matt Hancock has got the right balance.’
The analysis was started by a senior doctor at a busy NHS hospital who has worked in both Covid and non-Covid wards.
Concerned that she was seeing many patients who were much more ill than she would have expected when they arrived in hospital, she decided to collate a database to present the studies of lockdowns’ impacts in an easily accessible form.
25,000 extra people die at home… and the majority of the toll did not succumb to coronavirus
BySteve Doughty Social Affairs Correspondent For The Daily Mail
One hundred extra people a day have been dying at home since the start of the pandemic, official analysis revealed yesterday.
It showed the toll was 25,000 above normal this year – or half the number of deaths attributed to Covid-19.
The vast majority succumbed not to the virus but to the most common killers, including heart disease and prostate cancer for men and dementia and Alzheimer’s for women.
Meherban Khan, 49, who died of a heart attack because he was too scared of catching coronavirus to go to A&E when he started suffering chest pains in April
Academics and leading medical figures said home deaths had increased because older and more vulnerable people had been prevented or discouraged from seeking hospital treatment.
Statistician Sir David Spiegelhalter, of Cambridge University, said the number had risen from around 300 a day to around 400 a day. Professor Spiegelhalter added: ‘Non-Covid deaths in hospital have correspondingly declined, suggesting most of these deaths would normally have occurred in hospital, and people have either been reluctant to go, discouraged from attending, or the services have been disrupted.
‘It is unclear how many of these lives could have been extended had they gone to hospital.’
The Office for National Statistics, which produced the report, said ‘the distribution of deaths has shifted’.
The unprecedented rise in numbers dying at home follows the refusal since the spring of many care homes to take in patients discharged from hospital who have either gone untested for the virus or who have tested positive.
The report said the number of deaths in private homes in England between December 28, 2019, and September 11 this year was 108,842. This was 25,472 deaths more than the average for the same period over the previous five years.
Only 2,358 of these involved Covid-19. There were a further 7,440 deaths from all causes in private homes in Wales, 1,624 above average.
Over the same period there were 52,482 deaths in England and Wales in all locations for which symptoms of Covid-19 were mentioned on death certificates.
Deaths in hospitals from all causes have run below the five-year average since early June, and deaths in care homes have been below average since mid-June.
Care homes saw a major increase in deaths during the first weeks of the pandemic. The virus is thought to have killed 20,000 care home residents, but numbers fell below normal once the first phase of the outbreak passed.
At least 25,000 more people have died at home during the pandemic in England and Wales because they were unable to – or chose not to – go to hospital, a surge of 43.8 per cent on normal levels. Pictured: 60-year-old plumber Roger Mayman died after he waited months for an appointment for what he though was an abscess of his jaw that turned out to be cancer
Six in ten of those who died at home were over 70.
Sarah Caul of the ONS said: ‘While deaths in hospitals and care homes have dropped below the five-year average since the initial peak of the coronavirus pandemic, we have consistently seen deaths in private homes remain well above the five-year average.
‘We have seen an overall increase of deaths as well as a redistribution of various causes of death. For instance, while deaths from heart disease are below average in hospital, they have been above average at home.
‘It is a similar picture when looking at prostate cancer for males and dementia and Alzheimer’s disease for females.
‘Unlike the high numbers of deaths involving Covid-19 in hospitals and care homes, the majority of deaths in private homes are unrelated to Covid-19.’ The analysis found that in the week to September 11, deaths in private homes were 772 above the five-year average. Deaths in care homes were 72 above, while deaths in hospitals were 323 below the average.
Professor Spiegelhalter said: ‘Over 25,000 extra home deaths have occurred this year, particularly from heart disease, diabetes and dementia and Alzheimer’s.
‘Usually around 300 people die each day in their homes in England and Wales – the latest ONS analysis confirms that even after the peak of the epidemic this has stayed at around 400 a day and shows no sign of declining – that is one third extra, very few of which are from Covid.
‘Crucially, the ONS data cannot tell us about the quality of these deaths, particularly in terms of the end-of-life care provided to the patients and the support for their families.’
Professor Pat Price of Imperial College London, a leading oncologist with the campaign group Catch Up With Cancer, said: ‘These figures are yet more damning evidence of the Government’s failure to tackle the treatment backlog. While the figures cover multiple health conditions, nowhere is this worse than in cancer.
‘This is the worst cancer crisis I have seen in my 30-year career.’
She added: ‘Frontline staff are amazing and going above and beyond, but patients fear the toxic combination of treatment delays and dying in isolation.
‘It will never be enough to just get service levels back to pre-Covid levels, we need a super-boost to services, like advanced radiotherapy, to clear the huge patient backlog.
‘Otherwise, thousands of patients will die at home without access to the Health Service and the care they need.’
DR RENEE HOENDERKAMP: Lockdown is a deadly scythe because the cruel irony is it costs more lives than it saves
As winter approaches, the catastrophic impact of the coronavirus national lockdown is becoming ever more tragically clear, says north London GP Dr Renee Hoenderkamp
As winter approaches, the catastrophic impact of the coronavirus national lockdown is becoming ever more tragically clear. In a bitter irony, an approach that was supposedly designed to save lives appears to have achieved the exact opposite.
Even today, Health Secretary Matt Hancock talks of the continuing need for tight restrictions, warning that their removal would let the virus ‘rip’ through our society.
But the truth is that the Government’s own heavy-handed policy has acted like a lethal scythe, particularly against the elderly, the vulnerable and people in poor health.
According to a report from the Office for National Statistics, the number of deaths in private homes during the past nine months is more than 25,000 above the average for the same period over the previous five years.
It is a harrowing statistic which indicates that in 2020 so far there have been an extra 100 deaths every single day. And most of these additional deaths were not caused by Covid-19 – which accounts for less than a tenth of the total – but by common killers such as heart disease, cancer and Alzheimer’s.
The disturbing ONS analysis is backed up by a wealth of other recent studies – highlighted by today’s exhaustive investigation by the Mail – that paint a picture of a healthcare system in deepening crisis because of the unbalanced focus on Covid.
Hospital admissions have plummeted, while screenings, consultations and operations have all been delayed or abandoned.
One survey was typical in finding that urgent referrals for early cancer diagnosis were down between 70 and 89 per cent. Equally chilling was the finding that the number of people who died while waiting for an organ transplant has almost doubled.
As a GP, I feared exactly this outcome when the national lockdown was first imposed in March. It was obvious that a disaster on this scale would unfold when the NHS – already over-stretched and constantly operating at peak capacity – would no longer offer a normal service.
Effectively, thanks to the Government’s edict, the system was all but closed to cases that did not involve Covid-19. In practice, the National Health Service had been temporarily replaced by a National Covid Service.
As I found in my own surgery, it was almost impossible to access the most basic facilities. We could not even get essential blood tests, for instance, except in the most urgent, exceptional cases. Simple requirements became unattainable.
Mr Hancock is keen to promote telephone consultations by GPs and they can work well for many patients. These days I see only around 10 per cent of my patients face-to-face, with the rest of my consultations being via Accurx – the GP’s equivalent of video-conferencing services such as Zoom – or over the phone.
But neither of these methods are of any use to someone who cannot hear because their ears need to be syringed, yet such a procedure can no longer be conducted as a result of Covid.
Every day in my work I see the consequences of this worrying trend.
Only this week I had a telephone consultation with a child with a severe, potentially dangerous allergy, who had been unable to get a face-to-face appointment at an allergy clinic. Instead, the parents were directed to YouTube to teach themselves how to use an epipen to give an adrenalin shot in an emergency.
When the coronavirus outbreak began and the Government talked of lockdown, I felt that tens of thousands of people could ultimately die, not from the disease itself, but the misguided response to it. That is exactly what seems to be happening.
Charities are already predicting there will be 35,000 more cancer deaths than usual because of problems with diagnosis and treatment.
Skin cancer diagnoses in April, for instance, were little more than half those seen in the previous year. Again, I have seen the grim consequences for myself. Recently I had to attend the funeral of a patient who had become a friend. He had been on chemotherapy, but his treatment was suspended in the spring because of Covid. When it started again in May, it was too late. The fallout from this healthcare nightmare can be observed everywhere. Government scaremongering has been all too effective, with the result that I see patients who are terrified of going to hospital.
Similarly the toll on mental health is appalling because of the fear, loneliness, isolation and poverty caused by lockdown. NHS staff are suffering too. I have known colleagues to be traumatised because one of their patients has to go through the final stage of life alone, only allowed to connect with their family through an iPad. That is not cautious. It is inhumane.
We could be living with the ramifications of this policy for years in terms of backlogs, waiting lists and worsening conditions – for ill health always breeds ill health.
I have patients who literally cannot walk because they need a knee replacement, yet they have been told that may have to wait 18 months for such an operation.
The picture of decay and delay is not a universal one. I have GP colleagues in other areas who have been able to access a more comprehensive service from the NHS, albeit never the full one. But that postcode lottery just compounds the injustice. The whole point of having a national service is that it is meant to offer a universal standard of healthcare.
It is certainly not failing in that goal because of the staff. I have certainly worked harder than normal since the onset of Covid, as have my colleagues. But we have all been battling against a flawed approach. Instead of endless crackdowns, which cannot eradicate the disease, the Government should adopt a twin-track policy of, on one hand, shielding the elderly and vulnerable, and, on the other, allowing the healthy to return to normal.
This would be backed up by a comprehensive, efficient testing regime, something the Government has so far miserably failed to deliver. In that way, our society can start to rebuild the economy and return the NHS to its true mission of providing proper healthcare for all.
Dr Hoenderkamp is an NHS GP based in north London
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