I don’t usually like introducing myself as a doctor and I tend to try to avoid telling people my job unless they specifically ask. However, throughout this COVID pandemic most medical public figures and organisations have tended to back the lockdowns and today has been no exception with DAUK coming out in favour of a national lockdown (1). I mention that I am a doctor not to try to hold it over anyone that my opinion should be taken more seriously than anyone else’s, but to show that the medical profession does not speak with one voice and there are many, who despite knowing full well the awful realities of COVID, do not agree with lockdowns.
People talk about a COVID death as if it’s an avoidable death. COVID is unfortunately a communicable disease for which we don’t have a cure. People will die from communicable diseases with no available cure. This is a harsh reality which we fail to acknowledge in the western world with our obsession with not speaking openly about death.
COPD and lung cancer are number 1 and 2 biggest causes of respiratory death in the UK (2). COPD and lung cancer are usually caused by smoking (sometimes it can be caused by rarer things, but in almost all cases it is smoking). We don’t class these as avoidable deaths, even though had the patient not smoked they wouldn’t have died from COPD. Instead we accept that humans will engage in unhealthy behaviours and we encourage them to not engage in these behaviours by internalising the externality through taxation and educating them to make their own decisions. We do not ban smoking.
We’re told COVID is different because it can impact other people, however there are plenty of things we all do which can cause risk to another person. Plenty of other viruses and bacteria spread through person-to-person interactions. Alcohol costs the NHS £3.5 billion every year which could be spent on other treatments in the NHS (3). You driving a car increases the chances of someone else being killed in a road traffic accident. 26,000 people were killed or seriously injured in road traffic deaths in 2018 (4), but these are deaths that we accept because to ban all cars from driving over, say, 20mph is too larger price to pay.
What is avoidable is the person who turns up to A&E after taking a paracetamol overdose because they haven’t had any contact and can’t access health services. Also avoidable is someone who’s change in bowel habits and weight loss has not been investigated until they turn up to A&E with a perforated colon. Avoidable is the child who gets beaten by his alcoholic father and ends up in intensive care because social services weren’t doing home visits.
The rhetoric around COVID has been sold that 1 selfish act = 1 death. This is obviously not the case and it has pitched the population against each other and distracted away from the fact that the government doesn’t have a coherent strategy. It’s given people a sense of moral superiority for doing what they’re told and staying at home to protect the NHS. The NHS is here to protect us and not the other way around, and if it had been funded and/or run properly for the past 20 years we might not be in such a bizarre state of affairs where our national health system can’t do the most basic things such as operate on a cancer patient.
We are spending an extortionate amount on COVID which people aren’t talking about enough. The worst predictions of the pandemic in the UK were 500,000 deaths. Lockdown has an estimated cost of £300billion (so far) which means we’ve spent approx. £600,000 to save each life. This is far more than we would spend usually. NICE (for non UK readers, NICE is the National Institute for Health and Care Excellence and ultimately the people who decide if a drug or treatment gets approved for use on the NHS) will usually fund a treatment up to £20,000-£30,000 QALYs (5). Bearing in mind the average age of death is about 80, there’s no way this £600,000 price tag is justified. Let’s just bear that in mind the next time we hear in the news the NHS won’t fund a child’s cancer drug because it’s too expensive.
I think it’s fair to assume that doctors know more than the average person about health. I don’t think it’s fair to assume they know more than the average person about anything else. Doctor’s opinions are lauded as the only thing that matters in this pandemic, whereas in fact our opinions will be biased towards healthcare, and against arguments of liberty, rights, economics or the environment. These are important things to consider (I don’t think I need to point that out to this sub!) but as soon as you mention your concern about human rights or the economy you’re suddenly brandished as a selfish human who isn’t thinking about those ‘poor doctors and nurses’ struggling with COVID patients. You absolutely should not feel sorry for us. We have a job, we interact with people face to face, and we’re now getting the vaccine ahead of most. We should not be near the top of anyone’s list of concerns.
There’s plenty more I can say on the subject, but I’ll stop here. If anyone notes any flaws in any of my logic, please do say – I want to make sure my arguments are airtight.
In the meantime, best of luck to you all and I hope we can get life back to normal soon.
Edit: I’ve deleted the bit that says Pneumonia causes 29,000 deaths a year. It wasn’t supposed to be used in comparison to the number that COVID has killed, but more to show that communicable respiratory diseases often unfortunately kill people. I clearly didn’t word it very well so I’ve just got rid of it as it was distracting the debate from my main points.
Also, thanks for the lively the debate all including those from other subs this was cross posted in. To those who were questioning if I am a doctor, well, I am and I guess you’ll just have to take my word for it because I’m not posting my GMC number here! 🙂
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