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Dr Luke Evans is a member of the Health Select Committee, and is MP for Bosworth.

Two days ago, Angela Rasmussen, a Columbia University virologist, posted a series of tweets about how much we still have to learn about Coronavirus.

Acknowledging that we have already come a long way in a short time, Dr Rasmussen wrote: “Unfortunately the focus on who is “right” and when they were right is giving oxygen to the “infodemic” that is contributing to the extreme polarisation of public health priorities. Nobody can be “right” about a pathogen that is still mired in so much uncertainty.”

Since the beginning of the Coronavirus outbreak, our Government, which has no Ministers as far as I know who are trained epidemiologists, have had to listen to information and advice proffered by the respected science community.

That advice will have been given in good faith, and it’s right that ultimately the buck stops with politicians, but of course as we develop greater knowledge it may well be that some measures taken based upon it will prove ineffective or even potentially damaging.

It’s not a matter of apportioning blame, but rather of accepting there are a great many things that we still don’t know about this novel virus.

Every action we take potentially brings with it a cost, many know the concept of ‘opportunity cost’. Michael Levitt, a Nobel laureate in Chemistry, claimed this week that “I think lockdown saved no lives…I think it may have cost lives. It will have saved a few road accident lives – things like that – but social damage – domestic abuse, divorces, alcoholism – has been extreme. And then you have those who were not treated for other conditions.”

Whilst Professor Levitt is not an epidemiologist either, and his comments appear to serve as an outlier to the wider scientific community, it’s undeniable that, for each action, there is a price to pay, even if we don’t know what the cost is yet.

One incontrovertible truth is that the longer that lockdown continues, the likelihood of the United Kingdom experiencing an economic crisis increases.

Entering into this pandemic, the working worst case scenario was 500,000 deaths from the virus itself if nothing was done, and the working financial cost of the virus by the Treasury is up to £300 billion. Both are extreme positions in themselves, the only commonality between them is that hope that they are both overestimations.

We have to understand that whilst economy and health are, on the face of it, completely separate matters they are inseparably intertwined, too. There is an unsolvable and immeasurable balance between lives and livelihoods.

Political opponents will point and say ‘another Tory bothered more about money than health’, without ever acknowledging the fact that our economy has a direct impact on health outcomes.

Yet a decision on one directly and indirectly affects the other.

In a study published last month by the Institute for Fiscal Studies, it was claimed that there may well be some short term health benefits to a recession: drinking, smoking and unhealthy eating all tend to reduce when there are negative income shocks; improved cardiovascular health comes hand in hand with lower pollution; even viral transmission tends to lower with reduced inter-regional travel.

But in the long term, the health of many also deteriorates because, in general terms, our health improves in a growing economy.

In other research published by the IFS, Janke et al suggested that health conditions worsen when economic factors deteriorate, especially in industrial areas, where populations are older and where others already experience poorer health outcomes.

The ONS records that whilst overall life expectancy has continued to increase the rate that it has done so has slowed significantly since the 2008 recession.

We know that between 2008 and 2010 there were over 10,000 excess suicides attributed to the economic crash, and that according to The Lancet in 2016, there were an estimated 260,000 excess cancer related deaths across the OECD.

Over the coming months, Government has difficult decisions to make about the manner and speed in which it seeks to lift lockdown.

We’ve seen that there has been a concentration of Coronavirus deaths in less affluent areas, and a second spike may well see that replicated. We also know that those negative health outcomes which come together with an economic shock and are felt more keenly in many of the same areas too.

In seeking to mitigate the worst impacts of an economic crisis, we are going to need consensus across the House, we have to move away from making casual and politicised comparisons, or of framing the debate in a binary choice of health versus economy.

We still are mired in uncertainty about Coronavirus, but there will come a time when we can be clear that the price of severely mitigating the disease is higher than not doing so; and that means having a frank and open discussion about the impacts felt now and in the future.

And just like Dr Rasmussen we need to be able to say there are things that we don’t currently know, but that we will be willing to listen to lessons learned from both here and abroad in the future.

39 comments for: Luke Evans: The shutdown and economic crisis. The longer the first goes on, the more likely the second becomes.

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