Expert urges cancer screening to restart if staff have PPE
The unintended consequences the coronavirus lockdown is taking on Scotland’s health could be worse than the impact of the disease itself, according to a leading public health expert.
Professor Linda Bauld said she suspected the long term damage on people’s mental and physical health would be “far greater” than the challenge posed by the virus and said cancer screening could restart if the correct PPE was available to staff and patients.
The Edinburgh University academic said the “stay at home to protect the NHS” message had resulted in people with real health problems staying away from their doctors.
Weekly figures have pointed to a significant rise in deaths unrelated to coronavirus, suggesting that efforts to contain the disease are having a fatal effect on the nation’s health.
“The consequences of the lockdown period and the longer term consequences for our young people – for jobs and the health impacts of unemployment, for example – in the fullness of time I suspect may emerge as far greater than the challenge we faced with addressing this virus,” she said. “We’ve already heard about the drop in urgent referrals for cancer of over 70 per cent, we know that accident and emergency admissions are down by about half. We know that hospital admissions full stop are down by about 42 per cent, looking at the latest data from Public Health Scotland. So it’s very obvious that the message ‘Stay home, protect the NHS’ has been interpreted as ‘Stay away from the NHS to protect it’.”
Prof Bauld, who chairs a key scientific group for Cancer Research UK, also told MSPS that hundreds of patients whose cancer would have been picked up through screening are currently undiagnosed, and while screening could start again better PPE provision was required to protect medical staff and vulnerable patients.
“We normally screen around 23,000 people a week 100,000 people a month are no longer being screened in
Scotland for bowel, breast and cervical cancer.
“Around 140 of those would probably get a positive result each month via screening programmes so if we imagine that is paused for two months that is 280 potentially late cancer diagnoses. Early diagnosis is basically what determines survival and treatment outcomes.
“Some of those patients will have poor outcomes and that is a direct consequence of the lockdown. To put into perspective, for the rates of deaths at the moment, you are still seeing one cancer death for every two Covid-19 deaths in Scotland. Cancer is still there, it is not going away and it needs to be addressed.”
According to Prof Bauld equipment provided in Scotland is inferior to protective gear supplied to medics in other countries like China. “I am no expert in the procurement or specifics of what is required but I did organise a session with colleagues from China and when you look at the type of PPE being used in China... it is a level above what we currently have in some of our settings.
“We really need to take this seriously and recognise that this is not going to go away, and PPE is going to be something we need to have an emphasis on in future.” not been tested, so there’s an inconsistency across the place – not just in Scotland. People who are suspected of having this virus all need to be tested properly.”
His comments came as a new think tank report said the Scottish and UK governments must agree a radical acceleration of testing if the country is to secure a clear path out of lockdown. The paper from Our Scottish Future said both governments must plan to move from minimal to mass testing within days, warning that the current ambition of 15,500 tests a day set out by Nicola Sturgeon is too low for the country post lockdown.
The report calls for ministers to co-ordinate a plan to begin frequent and regular routine preventative testing for 800,000 Scots including key workers, care home residents and people arriving in the UK.
However, Nicola Sturgeon yesterday said she did not agree with Sir Harry’s comments. “Everyone knows my deep respect and affection for Harry, he was the chief medical officer I had the pleasure and privilege of working with during my time as health secretary so he’s someone I think enormously highly of.
“There are lots of opinions out there, some of which like Harry’s I will always listen to, others perhaps less so. But I have to work with the team we have in here that is looking at the evidence we have, is making informed judgments on the basis of that and trying to take the best decisions.
“We are working on a testing strategy just now that has been developing as our testing capacity increases. The quality of that testing we are using are quality assured tests. We’re doing that in ways that is driven by medical evidence.
“As we build that up and evolve that into the test, trace and isolate strategy, we continue to take account of the estimates of the volume of the testing, and the contact tracing to do that. These are all decisions that are being made very carefully based on very solid evidence.”
Sir Harry, a Professor of Global Public Health at Strathclyde University, told MSPS that the lockdown restrictions had forced isolation, which had worked in suppressing the virus, and gave his backing to the NHS tracing app.
“If we’re going to move in a way that lifts lockdown and allows people to go about their businesses and meet their social needs then we need to know who is infected and who is at risk of spreading the virus to other people,” he said.