[453qtgreq]

I think it was such a bad move to tie the driving purpose of Covid Restrictions in the UK to "Saving the NHS". One obvious flaw is that people will retrospectively tie the success of lockdowns with the post-Covid state of healthcare. Given that the NHS was already barely functional pre-Covid, denying healthcare for several years and simultaneously making it harder to give healthcare was a recipe for disaster.

[benjaminwootton]

Many of us predicted that the Covid restrictions would kill more people than they would save.

Excess deaths have been high all year and this is likely to remain the case for the next decade. We’ve obliterated the health service and also damaged the economic engine to pay to fix the problem.

(And I’m still downvoted. Open your eyes people, it’s basically Stockholm syndrome at this point!)

[andyjohnson0]

You're blaming the wrong things. Its a system problem.

Waiting lists for elective treatment are high because hospitals are full of mostly elderly people who can't be safely discharged because the social care system is broken - largely due to lack of capacity due to underfunding. And the government recently cancelled the national insurance rate rise that was supposed to fund improvements in social care.

Accident and emergency departments, as well as intensive care, can't move patients into regular and high dependency hospital areas because of the problem above. Which is why ambulances have to wait for so long outside hospitals. Which is why ambulance waiting times are seriously dangerously high.

The NHS generally has a lot of burnt-out people who are quitting or retiring faster than they can be replaced. Part of the problem is low pay (arguably partly due to under-funding of the service) and perception of that NHS roles are high-stress. The same is true for GPs (who generally aren't NHS employees) although the shortage of people wanting to become GPs is less about pay and more about the stressful nature of the job. The stress of dealing with the pandemic also substantially contributed to burn-out.

Ultimately, the UK isn't willing to fund public services properly. Health, education, social care, police, military - they're all grinding to a halt after running hot for too long with not enough people or funding.

If you want to take the argument further - we're looking at the economic damage caused by 14 years of austerity topped-off by brexit. The UK economy can no longer fund the expected activities of the state at the level that people expect.

[543g43g43]

It is - like everything else, our response to Covid has just accelerated anything that was already in decline. The best we can hope for is a well-managed transition to a hybrid healthcare system that all of the other sensible countries use.

>the social care system is broken

Here, you are talking about social care for old folks. The relevant question here is - why has it got worse over the past 2 years? What we had before wasn't great - old folks basically sold everything they had so minimum-wage staff could care for them in their dying last few years, and needed constant attention from NHS-provided services. Which part of that is now properly broken, and why?

[ben_w]

Other thing that happened in the last two years: Brexit.

A post about this from two years ago: https://www.ageuk.org.uk/our-impact/campaigning/care-in-cris...

[543g43g43]

Paying cheap imported labour to care for isolated elderly people certainly was an "already broken" system.

[andyjohnson0]

> Which part of that is now properly broken, and why?

Residential social care (primarily for elderly people, but also for younger people with specific issues) is mostly provided by the private sector and part-funded by the state. The amount that the state will pay care businesses to provide that care hasn't kept pace with their costs, and private care homes are increasingly ejecting loss-making residents and/or closing-down completely. This has been going on since at least 2017 and is starting to accelerate as energy costs increase. The state has very little residential care capacity left.

Home-based care is also a mess - again due to lack of funding. Salaries don't compensate for the job stress, and people still working in the sector are over stretched and burning out. So people who might have been able to live semi-independently in their own homes are pushed into the residential care system which (except at the high-end) is crumbling.

Again, its a system/coordination problem. I'd argue that part of the problem is inherent complexity, but a bigger part is that the politicians who are setting policy are ill-equipped to deal with these types of problem because very many of them believe in market-only solutions. When a system gridlocks like this, they don't know what to do.

[ben_w]

Yes, many did; and yes, excess mortality is up; so I can sympathise with thinking that’s a smoking gun — but COVID itself also caused excess mortality, some of which was by the pathway “The hospitals are now full of COVID patients so we have to turn away others” followed by “OK, so the COVID has cleared up and we can get back to the others… oh, 10% of those others have since died”. And given this is about the UK, I can also point at Brexit, the final stage of which happened during the pandemic and which I specifically predicted would cause a non-specifically large number of deaths: https://kitsunesoftware.wordpress.com/2019/10/25/oh-no/

(I’m glad to say that Boris Johnson pattern-matches against what I wrote in the final few paragraphs).

I’m sure some deaths will have a causal connection to the lockdown, but I can confidently say that about literally every possible course of action or inaction by any major government on any topic no matter how mundane; to talk about risk to the NHS, one must show that the caused effect is also a substantial part of the total.

[453qtgreq]

The hospitals were never "full" of Covid patients. During the two years from March 2020 onwards, the NHS treated about 70% the number of people that it does during more normal years. These were also mostly not Covid patients. The only reason the NHS stopped treating people during those years is because it was determined that it was too "unsafe", not because the hospitals were full of Covid patients.

In fact, now that Covid is more or less over, our health service has become so dysfunctional that only now we are turning people away due to capacity issues (or leaving them in the back of an ambulance for 10+ hours).

We didn't save the NHS, we broke it.

[ben_w]

The current breakage is many things, including but not limited to:

* Overloaded nurses retiring early or shifting career (one of my in-laws switched from nursing to become a builder).

* Pay offer too low to encourage new nurses to join the NHS, as they are valued worldwide and have offers in other countries.

* Long-term systematic political footballing.

* Brexit (harder access to the UK from the rest of the EU combined with the exchange rate shock making the pay offer look worse).

* Many elderly patients have nowhere suitable to go after they’ve been treated, because community care is covered by council taxes not central government and the local councils can’t cope. Fixing this requires shifting the tax burden in ways that the government does not have sufficient support to get through even if they wanted to, and it’s not clear to me if they want to.

* Medical costs dominated by the elderly, combined with demographic shifts (important because the non-elderly not only pay the taxes but also do the actual work) which IMO was caused in part by newspapers in the 1980s and 90s deciding that the topic they wanted to treat as a social scandal was all the single mothers and teenage pregnancies, leading to government policy of making all the students of that era as frightened as possible of starting families ever, leading to later families, leading to smaller families, which combined with the social dynamics of basically ending the construction of new council housing (and any boost to the private sector being insufficient) meaning that poor people had a much harder time getting a home, and also the fact that effectively forcing widespread two-income-no-kids relationships without extra home construction leads to house price (and rent) inflation rather than people being able to afford more which again leads to the same demographic shift. Oh, and all that also makes the take-home pay of nurses much worse than it might otherwise be, making it even harder to get nurses from overseas or to keep nurses trained in the UK.

* COVID and long COVID

[orwin]

I don't know if it's as general as that. I just checked excess mortality, France VS UK [0] as they have a similar GDP and similar health system (and I know France situation better). This summer, we had three heatwaves, reached new record temperatures in 9/12 of all cities I've lived in, and had the longest heatwave ever recorded, as well as the earliest one. We had way more excess death during the 2020 summer, or even the 2021 summer (tbh, although it was pre-omicron, the excess death can probably also be caused by car crashes).

It seems to me that the excess death in my country will reach the baseline (maybe a bit higher since the average age is growing, but not much) as long as this summer is an outlier. UK data almost tell the same story, but I don't think you had the same heatwaves, and I don't know how to explain what is happening right now.

Putting that on the lockdowns only would need explaining why this effect isn't seen in France, as ours were both longer and more numerous I think (we had three, and only two in the UK, right?).

[0]https://ourworldindata.org/grapher/excess-mortality-p-scores...

[jinder]

How have you determined that the excess deaths are due to "covid restrictions" and not for example, long term sequelae of covid itself or other factors?

[rich_sasha]

I don't really know which way the balance goes, but that the calculus wasn't made is borderline criminal to me.

And I don't think it really was done, when UK decided to not implement any lockdowns initially (right or wrong, don't know), most of the response was emotional. How dare you not care about dying people???

[543g43g43]

Not forgetting the obvious problems with turning your entire population into "bubble people". I'm not very excited about the Scarlet Fever outbreak here in the UK, as I have two small kids of my own.

[lynx23]

Thanks for saying that, 100% agree! It was obvious from the start that the restrictions will do more harm then good. Almost everyone in my circles that has kids is reporting psychological problems. Teachers report that they have to care for three suicidal kids during a school trip. People having long term side effects from the vaccination. And still, the restriction-fanatics are trying to ignore the obvious.

[ben_w]

The trouble with anecdotes is that I have examples of people who were bed-ridden for 6 months with a COVID infection, and I was lucky because other people have examples of corpses from it. My secondary school 22 years ago had enough pupils that, if it’s the same size now, half a dozen to a dozen of those pupils will have faced relatives dying from it, and those stories will have spread around the playgrounds/social media.

Then there’s the fact that, even though it’s milder for pupils, they can still get: if you know what it can do to your granny before you get it, it’s going to be terrifying; and if you get it mildly and then granny dies from it, you’re going to feel survivor’s guilt and worry if you killed her.

Then there’s the fact that parents were already keeping their kids off school before the official lockdowns, because so many people saw the government wasn’t taking it seriously (which later became the PM almost dying from it, but it was obvious they didn’t care well before then).

[543g43g43]

What's worse than anecdotes is 3rd-hand anecdotes. I've heard so much about "those with Covid corpses", but have yet to hear from them. I'm sure they exist, but there are way fewer of them than people seem to think.

[453qtgreq]

.

[kevingadd]

I wonder what kind of psychological problems result when you watch your loved ones catch covid and end up hospitalized or worse for long periods of time? We'll never know, I guess.

[543g43g43]

There are rather fewer of these people (in fact, I haven't heard from any of them), than people who have had to tell their children they have to stay inside due to the horrible virus stalking outside.

[benjaminwootton]

Fortunately, most of our loved ones under 80 only suffered with a few days in bed, so the psychological scarring wasn't too deep.

And the ones over 80 ended up catching it anyway.

[453qtgreq]

.

[oliwarner]

Covid it's a red herring. As is the attention given to long ambulance queues, overrun A&Es. This isn't a front door admissions problem.

What we're seeing is a long and accelerating dissolution of social care in the community, mostly elderly nursing but also mental health.

Most hospitals are at least 40% occupied by patients awaiting discharge but who can't be discharged because there isn't a nursing home space, or enough community nursing to support them at home. They stay in hospital.

This blocks admissions. Which blocks ambulance transfer. Hospitals give surgical beds over to ease waits but this only makes things worse. Now people aren't getting surgical treatment, and it's more likely they'll end up coming in for the symptoms.

Covid made things worse, mainly by treating nursing staff horribly, but this was already a trend. We urgently need to pay nurses more, and desperately train a hundred thousand more. Neither look likely under this government.