Your Doctor Will Zoom You, Now

The pandemic has proven our NHS both invaluable and overburdened. Finding new ways to manage our wellbeing remotely could ease the strain

Vaccines normally take five years, sometimes decades, to develop. One for coronavirus could be ready in 12-18 months, though high-risk groups such as health workers may have access to experimental versions by the time you read this. That’s a big “could” and “may”, though. And even then, exactly how long any vaccine protection would last is not guaranteed.

Without a vaccine, major resurgences could still be occurring in five years, so in the meantime we’ll likely social-distance to varying degrees of strictness. Those measures could be eased by contact tracing: the NHS has an app for that, which monitors via Bluetooth other users who you come into proximity with and alerts you if they become infected or vice versa. It may also function as an “immunity passport” (if you can be immune – there are anecdotal reports of re-infection). And getting our act together on mass testing might be an idea.

Whenever the dust settles sufficiently, there needs to be “the mother of all inquiries into how government and its agencies have handled the emergency”, says John Appleby, director of research and health economist at the Nuffield Trust. A key question will be whether the NHS’s bare-bones efficiency pre-pandemic was in fact under-resourcing by another name. “I suspect the public will be willing to spend more money on health care,” he says.

A 1% rise in National Insurance to fund the NHS adequately would be applauded as enthusiastically as clap for carers. The knee-jerk reaction would be to pump it all into intensive care beds to cover for the possibility of another pandemic (our health service didn’t have enough), and away from places where it’s definitely needed. “So, there’ll have to be some balancing of that,” Appleby notes.

Tele-medicine will ring the changes. Outpatient appointments have vastly increased over the past decade: 100 million per year in England alone, a country of 56 million people. Appleby says that it’s probably not necessary for all of those to be conducted face to face, or to have a follow-up: “At least, not a third, or fourth, or fifth.” Tele-medicine could similarly relieve the pressure on A&E, where a quarter of the ever-rising attendances are unnecessary.

GPs, traditionally among the most, well, traditional services, will also see you now virtually. Appleby’s GP friends and colleagues are “radically rethinking” how they do things, as is the wider NHS. “Some parts of the service have needed this jolt to get them going,” he says.

It should also push us to train more doctors and nurses. Unlike, say, Germany (which has only reinforced national stereotypes with its efficient handling of the pandemic), the government caps the number of medical school places and so restricts the supply of doctors; the NHS has been forced to recruit from overseas as a sticking plaster to fill a massive number of vacancies.

Beyond shortages of beds, equipment and staff, the pandemic has exposed the limitations of medicine, with heroic hospital workers only able to relieve symptoms until COVID-19 sufferers hopefully battle through. One positive outcome could be a different attitude to public health messages and personal responsibility: looking after ourselves.

“We all know we should exercise and eat our greens,” says Appleby. The problem, in economics speak, is that we don’t “internalise” and do it – or we didn’t until soon-to-be-Sir Joe Wicks’s PE lessons hit home. “I think more people are internalising that.”

“The use of telemedicine could ease the pressure on GPs and A&E”