For many years, doctors and scientists have been telling us quite clearly what we need to do, individually and collectively, to improve our health.
We are repeatedly told that poor diets, poor sleep habits, inactivity and other lifestyle choices are significantly impacting our quality and length of life. The evidence is compelling that lifestyle choices drive everything from rates of depression and back pain to cancer and heart disease.
In spite of this overwhelming evidence and information, we are in the midst of decades-long epidemic increases in the rates of multiple chronic health conditions and fatal diseases.
The NHS has been creaking (many would say haemorrhaging) at the edges for years as a result not only of underinvestment but an exponential increase in the costs of dealing with lifestyle-affected or lifestyle-driven conditions. To take diabetes alone, the cost of diabetes to the NHS is over £1.5m an hour or 10% of the NHS budget for England and Wales. This equates to over £25,000 being spent on diabetes every minute (https://www.diabetes.co.uk/cost-of-diabetes.html). That doesn’t even include the cost of treating diabetes-related complications, or the associated costs of absenteeism, early retirement or social benefits.
How much better-prepared might the NHS now be for Coronavirus (all other things being equal) if it hadn’t had to spend £25,000 an hour on diabetes for the past multiple years?
In spite of all this; all the evidence, all the collective hand-wringing about the state and fate of the NHS, all of the impact on our individual health, many people – probably the majority – persist in these very same lifestyle choices that drive this. But why?
Firstly, it’s morally and scientifically wrong to blame individuals for their ‘poor’ choices. We don’t make choices in isolation; we make them as a best attempt to optimise our situation in the societal, economic and social context in which we find ourselves.
Surrounded by advertising and availability for low-nutrition, high-inflammation foods; under economic pressure to work harder and sacrifice leisure time and sleep; living in a country where – up until now – we’ve been able to keep making these choices and have the pieces picked up by the NHS. It’s perfectly natural and understandable why individual human beings would continue to make poor short-term choices that drive poor long-term outcomes.
Secondly human beings are evolved to respond more concertedly to new, imminent threats than to familiar, long-term threats (as explained here).
Somehow or other, up till now, we haven’t been willing or able, individually or collectively, to significantly change our behaviour in response to medical and scientific advice.
Enter Coronavirus Covid-19.
Events and evidence are developing at pace but this much seems clear:
- Whatever containment, delay and mitigation strategies individual countries employ, national health services are going to be inundated with an extraordinary level of additional demand – from the more basic testing / symptom checking right through to intensive care.
- People with pre-existing health conditions, older people (many of whom have pre-existing health conditions) and people managing pre-existing health conditions with anti-inflammatory pharmaceuticals that appear to suppress immune responses to Covid-19 are ALL more at risk from Covid-19 AND ALSO more in need of medical expertise to help them to manage existing conditions and risks in the current environment.
- There is a strong call from governments and communities for individuals to behave in ways that are public-spirited and protect the individual – to wash your hands, look out for vulnerable older people in your community and not stockpile basic commodities. All very valid and important but (we can only hope and pray) short term.
Both to help as many of us as possible to come through the coronavirus / Covid-19 crisis as well as possible and for the sake of our individual and collective long-term health, there are other equally and perhaps even more important lifestyle and health related choices we can make.
1) Don’t waste the precious time and resources of your GP or your A&E department with minor issues
Don’t book GP appointments for things you could speak to your pharmacist or NHS 111 about. Absolutely definitely don’t book a GP appointment and not turn up (this costs an estimated £216 million a year to the NHS).
Don’t turn up to A&E for anything that isn’t a significant accident or a medical emergency. There are out of hours GPs, NHS 111, minor accident departments, pharmacists and other information sources you can consult to determine whether you really do need to be rocking up.
Whether it’s taking up resources that could be going to coronavirus or to a coronary, it’s not on.
2) Take responsibility for your own health
For the sake of your long term health and life expectancy, your family and the wider community, treat your health and wellbeing like they are a valuable and irreplaceable commodity. Because they are.
In the coming months it’s likely that medical appointments, operations and medications will be scares, and re-prioritised. If you have a chronic condition, it’s possible that you’ll find it more difficult or experience more delay in accessing care. So it’s in your own interest to do anything you can to protect and improve your health.
This could include researching, informing and educating yourself; doing your very best to follow the expert advice and lifestyle advice you’ve been given; and seeking expertise from appropriate sources instead or in addition to your GP or NHS clinician.
3) Consider consulting non-GP, non-NHS health professionals and wellness practitioners where appropriate
If you are in a position to do so – for example if you have private health insurance, employer provision or the means to do so – consider seeking advice and treatment from non-NHS / GP providers.
For many chronic health conditions including chronic musculoskeletal pain e.g. back pain, mental health, and conditions significantly impacted by lifestyle choices, there are many healthcare and allied professionals who can help you just as well or better than your doctor.
Both for your own sake and the sake of public health, think about educating yourself and exploring self care options, lifestyle changes, and seeking the advice of alternative experts who are less likely than your GP and the NHS generally to be overloaded with Covid-19 related issues, and medical emergencies.
CONSIDER, for example
Counsellors and psychologists for mental health
Chiropractors, osteopaths and private physiotherapists for physical pain and injuries
Nutritionists and functional medicine practitioners for inflammatory conditions, digestive conditions and skin conditions
The consequences of these choices can be significant both for individuals and society:
- Protecting and preserving precious and overstretched NHS resources to support the most vulnerable people and the most urgent care in the midst of this pandemic
- Reducing the likelihood that you yourself will need NHS care either in the short / coronavirus term or the longer term – care which may or may not be available to you depending on how long and how deep this pandemic goes
- Improving your quality of life now and your life-expectancy in the longer term
- Supporting small businesses and self-employed healthcare practitioners through uncertain economic times
It is sad, yet depressingly predictable, that it seems to have taken such a catastrophic event as the Covid-19 epidemic to generate mass health-related behavioural change.
For the future of our individual health, our country, our children and our planet, there are far more things we can and should be doing than washing our hands.