Three years after a new coronavirus began to spread through Wuhan, and at least 6.6 million deaths later, the world is just beginning to understand its impact. The pandemic is not over, of course. Covid is ripping through China, where it originated but was suppressed, following the lifting of strict controls. Even in the UK, the number of cases rose above 1 million again in mid-December. Despite vaccines and improved treatments, some people remain highly vulnerable. On an average day in the third quarter of this year, almost 3,000 patients were in hospital primarily because of Covid-19. An estimated 2 million people are living with long Covid.
For many, however, the frustration or even despair comes from the realisation that there can be no simple return to pre-Covid life. Alongside the economic damage – and the UK’s recovery has lagged behind other G7 nations – have come the health and social consequences. The NHS is struggling with backlogs and the fallout from the pandemic and lockdowns on health. “There are worrying signs that rather than imposing a one-off, time-limited shock … Covid-19 has dealt a lasting adverse hit to NHS performance,” the Institute for Fiscal Studies warned this month.
Young children have been especially affected, with delayed social development and increased behavioural problems, as well as academic repercussions. The full impact may only become evident years or decades from now. “For the rest of our lifetimes we will see the consequences of this,” says the disaster recovery expert Prof Lucy Easthope. “We are all disaster survivors now.”
Families of the tens of thousands who died in the UK are still grieving for lost loved ones, and want answers about their treatment. Many lost jobs or businesses. Others may feel they have no right to complain when they did not experience bereavement, divorce or financial suffering. Yet months of juggling work with childcare, being cut off from friends, worrying about an isolated parent – these too have taken their toll. The soaring cost of living, or broader sense of an economic, political and social permacrisis, is proving the final straw. The emotional strain of living with ongoing uncertainty and threat is telling.
Calls for an inclusive recovery
That the repercussions can be so long-term and wide-ranging should not be surprising. A Swedish study found that for each flu death in the 1918-20 pandemic, four people went to the poorhouse, Laura Spinney notes in her book, Pale Rider. In addition to the lasting effects suffered by flu patients, there is evidence that some of those in utero at its height had, for example, an increased likelihood of heart disease after 60. Yet Ms Spinney also shows how progress came from grim circumstances. The 1920s saw growing interest from governments in universal healthcare; it no longer seemed credible to think of health simply in terms of individual responsibility and care.
In the earliest months of this pandemic, people began to talk about the need to “build back better”. The Organisation for Economic Co-operation and Development called for “strong, inclusive, green, resilient” recovery. Peter Hennessy, in his book A Duty of Care, sensed a widespread belief that there had to be a better Britain to emerge from it, clearly reminiscent of the atmosphere that gave rise to postwar reconstruction.
In part, this drive reflected the sense of a missed opportunity in 2008, when a very different disaster – the financial crisis – did not produce the kind of fundamental reform that many hoped for. In part it was because Covid-19 showed the inadequacy of markets – sometimes, big government is needed. But it was also because it exposed, and then exacerbated, so many underlying problems: grotesque inequality (with the poorest and black and minority ethnic individuals more likely to die, and the wealthy piling up savings while others endured financial pain); social polarisation and fragmentation; the disproportionate burden of caring responsibilities carried by women. The response to the pandemic was at times part of the problem. A UN report found that women were not only worse hit by the socioeconomic impact, but also far less likely to receive relief or social protection than men.
Yet these hopes have yet to bear fruit. In the UK, the die was cast when Boris Johnson offered just 10% of the £15bn that his own education recovery tsar said was needed. Then the government removed the £20 uplift for universal credit. Now it refuses to make nurses, whom it applauded for their courage and service, a decent pay offer.
Reconnecting with each other
The personal, social, health and economic effects of the pandemic are not separate but interrelated. The psychotherapist Graham Music has written that “if we had to create perfect conditions for emotional shut-down, for fear, anxiety and distrust – and, indeed, for addictive traits to flourish – we could hardly do better than Covid-19 … Solitude, isolation, the lack of touch are … proven risks to health and morbidity.”
People were not only distanced from loved ones, but lost the weak social ties – contact with acquaintances and even strangers – that are also critical to wellbeing. The dashboard of social capital measures from the Office for National Statistics shows that while four indicators improved in 2020-21, six declined – though both the pandemic and Brexit have disrupted the data. At both an individual and social level, recovery can only happen when interpersonal ties are prioritised – when children get not just tutoring, but more chances to play and explore together; when adults are encouraged to reconnect.
That does not mean delegating the business of recovery. As Sir Michael Marmot noted in a report commissioned by the Health Foundation, action across sectors from all levels of government is needed to “build back fairer”. Recovery is impossible without proper public funding. As the Conservatives pretend otherwise, Labour should be making this case, and making it clearly.
But it does mean recognising that policy and practice should be shaped and guided by the public, not just officials and politicians. It is not too late. Alongside the devastation caused by Covid came crucial lessons, from the importance of resilience to the need for green spaces and the possibility of making events and services more accessible. In financial terms, Britain can afford to build back better. In every sense, it cannot afford not to do so.
