Many people in Britain are likely to suffer from physical and mental problems for several years after the Covid-19 epidemic has subsided. That is the grim message from doctors and psychologists who last week warned that even after lockdown measures had been lifted thousands of individuals would still be suffering.
Some of these problems will be due directly to the impact that the virus has had on those it has infected, especially those who went through life-saving interventions in intensive care units (ICUs) in hospital. In addition there will be a considerable impact on vulnerable people affected by the lockdown and isolation.
As a result, there is a danger our society could become more anxious and risk-averse, say scientists who have called for a range of research programmes to be launched to understand the issues and to allow society to prepare itself for the physiological and psychological problems that lie ahead.
“This has been a national trauma like no other that we have experienced,” said psychologist Professor Dame Til Wykes, of King’s College London. “Consider the terrible flooding we had earlier this year. People watched river levels rise and listened to weather forecasts to find out if they might be inundated the next day or the day after. That was stressful.
“But it was nothing compared to this threat which has hung over us for weeks already and is likely to go on for much longer. Spending months looking over your shoulder all the time is going to cause considerable, lasting anxiety for many people. In addition, if you look at other natural disasters, you can usually find help or comfort from people around you. However, it is the people around you that are the threat in this case. So there is no consolation there.”
This point was backed by Rory O’Connor, professor of health psychology at Glasgow University. “Increased social isolation, loneliness, health anxiety, stress and an economic downturn are a perfect storm to harm people’s mental health,” he said.
“If we do nothing, we risk seeing an increase in mental health conditions such as anxiety and depression, and a rise in problem behaviours such as alcohol and drug addiction, gambling, cyberbullying or social consequences such as homelessness and relationship breakdown.”
These are problems that face society in general. For those struck down by Covid-19 and who have been treated in ICUs, there are likely to be further issues, researchers have warned. These problems have been revealed in studies of those who contracted two other diseases caused by coronaviruses – severe acute respiratory syndrome (Sars) and Middle East respiratory syndrome (Mers) – and who also required intensive care in hospitals.
“Being in an ICU can be a horrible experience,” said Wykes. “Studies from those who were treated in ICUs for Sars and Mers reveal that many had post-traumatic stress disorders months, sometimes years, after the event, especially if they were put on ventilators. That can induce panic on its own. Later you get flashbacks, extreme anxiety – particularly about your family and your partner.”
In one study by Hong Kong University researchers of people who had contracted Sars, it was found that those who survived the disease still had, a year later, elevated stress levels and “worrying levels of psychological distress”. They also showed alarming levels of depression, anxiety and post-traumatic symptoms. “There is every reason to expect to see the same sorts of symptoms appearing in those directly affected by Covid-19,” added Wykes.
In addition to the psychological impact of the disease, it is also clear that lingering physiological problems are likely to be associated with Covid-19. “No one knows exactly what the disease will do in the long term to patients but we do know what impacts other forms of viral pneumonia – which Covid-19 can trigger – can have on patients,” said Professor Ian Hall of Nottingham University.
With these conditions, many patients suffer from significant lung scarring and are affected by a condition known as advanced respiratory distress syndrome which can require months of recovery. “There is some initial evidence to suggest that for Covid-19 patients, it may take even longer,” he said.
Hall added that there was likely to be impacts on other parts of the body. “For example, Covid-19 can cause serious inflammation that affects patients in the early stages of dementia and can leave them increasingly confused and stressed.”
Cardiologist Professor Tim Chico at Sheffield University also pointed to studies indicating that people hospitalised with Covid-19 were also at risk from blood clots in multiple locations, including their lungs, veins and brain. “Crucially, the risk of blood clots with Covid-19 appears to be even greater than the increased risk of blood clots seen in other severe illnesses,” he said. Such an effect would leave patients vulnerable to pulmonary embolisms, strokes and deep vein thrombosis.