Intro
As the fifth anniversary of the first lockdown is upon us, it is fair to say that the pandemic changed the world and our everyday lives in more ways than one with the ripple effects having a lasting impact on public health. It’s also clear that society and everyday life have changed for the foreseeable future. For example, working from home has become the norm across various occupations meaning an increased reliance on technology, and people have become more conscious of their hygiene and overall well-being. Before getting into the details of these topics, it’s important to set the context for which the consequent effects followed.
Slow to act
Covid-19 was first discovered in late 2019 in Wuhan, China whereby we have been led to believe the cause was through animal-to-human transmission as opposed to an accidental laboratory leak. On March 11, 2020, the World Health Organisation declared a global pandemic after data showed that there were over 118,000 cases in 114 countries, with the global death toll surpassing 4,000.
Meanwhile, over in the UK, a decade of austerity and reforms to the health system had left the Government severely underprepared for what was about to transpire. This period of austerity had left the Government without the appropriate resources, workforce or capacity necessary to respond adequately to the outbreak. Furthermore, there was a lack of strategy and urgency to act by the Government who decided to abandon contact tracing on 12 March 2020, just 11 days before the UK went into full lockdown. This meant that despite a global pandemic being in full swing, the UK had no measure in place to control transmissions, which likely contributed to more deaths and infections than there otherwise would have been.
There was also a significant delay of two to three months between the UK implementing the recommended (by global health agencies) face coverings for public use, and when the measure was enforced. The measure was made mandatory in public spaces such as shops and supermarkets from July 2020 by the then Health Secretary Matt Handcock after over 100,000 people had already been told to isolate after being found by the test and trace system to have been infected by the virus.
As the UK headed into the summer months, the upturn in weather didn’t correspond to a more positive outlook concerning COVID-19 as the public had to brace themselves for a second wave of the infections coming upon them in the autumn months. At the beginning of September, the R rate (how many people one person infects on average) was above 1 for the first time since May 2020. Rather than trying to prepare for the expected autumn increase, the Government focused on ways to start relaxing the rules as the hospitality sector began taking a turn for the worse. The Former Chancellor, Rishi Sunak, introduced the Eat Out to Help Out Scheme as a response to this which aimed to support businesses in reopening their doors to the public by offering discounted meals of up to 50 percent off the cost of food and or non-alcoholic drinks. Despite the Government raising £840m from the scheme, government scientists say they were not consulted about it, and it was highly likely that the scheme spiked infections and deaths. Consequently, a second and third lockdown proceeded to occur, the former from 5-24 November, and the latter coming into force on 5 January 2021, until the process of easing restrictions began at the end of April.
Following the second wave, the UK rolled out a vaccination programme resulting in 90 percent of the population being vaccinated with two doses by the end of May 2022, beating the initial plan of 75 percent. Unlike the initial stages of the pandemic, the Government acted fast when the vaccine became available, being one of the first countries to approve and distribute it. The UK was home to the first individual to be vaccinated in the world showing how quickly they acted when the vaccine became available. The most vulnerable in society were speedily prioritised with more than half of those aged 80 and over and over half of the care residents receiving their first dose by the end of January 2021. Moreover, all parts of the health sector from primary to secondary care settings were utilised during the rollout. This included GPs, local pharmacies, mobile units and vaccination centers, showing a well-coordinated distribution. This resulted in a drop in COVID-19 deaths and severe cases allowing for the reopening of society.
However, underneath this success story, lay a bleaker picture of how the pandemic had affected individuals in society and the NHS as a health system. The World Health Organisation reported a 25 percent rise in anxiety and depression worldwide and the demand for psychological services increased as NHS workers and individuals found it difficult to navigate the long-term effects of isolation, uncertainty and loss. These effects are still being felt five years later as psychological services such as Strong Foundation Psychological Associates have cited the need to expand their clinicians from just five to 25 since the start of the pandemic until now. Owner Elizabeth Reitz revealed that the sudden state of worry caused by the pandemic has caused lasting anxiety until now as people suddenly had to focus on protecting themselves from a serious threat to their well-being, and this anxiety for some people still lingers.
The prominence of Long COVID in individuals is further evidence of the long-lasting effects still being felt today. In April 2024, data indicated that the number of people with Long COVID in England and Scotland had increased by 9.9 percent reaching 2 million. Of these, 1.5 million reported that their daily activities were adversely limited due to the condition. It has also been cited that getting treatment for the condition can be difficult as healthcare professionals and employers often dismiss it, making dealing with the condition increasingly difficult.
Additionally, the lasting effects on the health service are evident through the mass backlogs of individuals waiting for elective treatments or appointments. As of January 2025, approximately 6.25 million individuals were awaiting elective treatments or appointments and it has been reported that Starmer is unlikely to fulfil the pledge of restoring waiting times for hospital care back to a minimum of 18 weeks. Even though high waiting times for treatment were evident pre-covid, the pandemic exacerbated it as data shows that the total number of people who waited for consultant-led elective care rose from 4 million in April 2020, to 6 million by the end of the following year. This issue would carry over into Keir Starmer’s government who were elected four years after the start of the pandemic, causing him to set out a plan for supplying 2 million more elective care appointments, which he would achieve by January 2025.
Lessons learnt?
An independent public inquiry was set up to analyse the UK’s response to the pandemic, with the aim of ascertaining lessons from the pandemic and establishing actions that could be implemented during the next one. The inquiry produced a report that recommended a major overhaul of how the UK Government and devolved administrations prepared for pandemics and similar emergencies. Some of the recommendations they made included: creating a single statutory body responsible for preparedness and response, simplification of civil emergency preparedness and resilience systems, and holding UK-wide pandemic response exercises every three years with the subsequent outcome being published.
In response to these recommendations, the Government agreed that clear governance was needed to build pandemic resilience across the UK. From this, the National Security Council was established which now oversees action in this area. The Government also agreed that regular pandemic exercises should be held to test preparedness with the Cabinet Office being responsible for the delivery of it. They also agreed that findings from these exercises should be published and with the Department of Health and Social leading on a Tier 1 exercise this year, which is likely to take place in the autumn. Overall, the Government accepted that independent strategic advice and assessment was needed for a more effective UK-wide emergency response system. However, they claimed that they would always remain responsible and accountable for policy and resource allocation decisions.
Additionally, the UK have been supporting the Pandemic Accord alongside other World Health Organisation states since March 2021, which seeks to strengthen global coordination and ensure equitable access to vaccines, treatments, and tests during future pandemics. Negotiations to join the Accord have been ongoing since 2022, to finalise an agreement by May 2025. Ashley Dalton, Parliamentary Under Secretary for Public Health and Prevention, recently updated Parliament saying that 75 percent of the text had been provisionally agreed but issues such as technology transfer are yet to be resolved.
There were also lessons learnt from a public health perspective such as the need to invest in the NHS workforce and increase critical care capacity so that hospitals would be better equipped to weather the increased pressure that comes with a pandemic. Furthermore, it was realised that protecting NHS staff should be paramount, meaning PPE needed to be kept in reserve in the event of future pandemics to prevent the shortage experienced during covid. In 2021 the Public Accounts Committee published a report looking into this and it revealed that the supply of PPE from the Government was inadequate, forcing staff to reuse equipment due to low stock. Within this, there were also ethnic inequalities in the experiences of frontline staff as a third of ethnic workers reported to have experienced shortages, compared to 14 percent of white doctors.
In conclusion, the Covid-19 pandemic exposed many things about the critical state of the NHS that needed addressing which hopefully we will see happen under the Labour government through policies such as the NHS 10-year plan. Labour has already started making strides to clear the backlog caused by the pandemic by already meeting their target of delivering 2 million more NHS appointments within its first year, however, they will be scrutinised on their ability to further reform the system, to ensure it is not stretched to the extent that it was during the pandemic. On top of that, the Government must continue to work at restoring credibility to UK democracy and public trust, which was severely damaged during the pandemic by scandals such as Partygate.