The economic health impact of COVID-19

Tariq Jagnarine
MD, MMed FAM Med, CCFP

As the number of coronavirus cases (COVID-19) continues to grow, concerns are simultaneously mounting about both the short-term and long-term effects of the virus on certain demographics of society, e.g., youths, women, elderly population, refugees from Venezuela, and employees around Guyana.
The overwhelming pandemic has already led to a major health crisis in several countries and major disruptions of the global economy. Further, the Pan American Health Organisation (PAHO) Director and the World Health Organisation (WHO) Regional Director for the Americas, Dr Carissa Etienne, recently stated that they did not anticipate, nor were they prepared for, the magnitude of the current COVID-19 pandemic. She also warned the region to prepare for a full blast within the next few weeks.
The situation is likely to become even worse in the coming weeks and months, and the economic fallout from the pandemic might represent one of the biggest shocks of recent decades. Experts predict that hundreds of thousands of people could develop chronic health conditions or mental health problems in years to come because of the coronavirus pandemic. (Institute of Fiscal Studies)
The longer-term economic fallout could have persistent negative health effects long after COVID-19 precautionary measures such as social distancing end. The adverse health effects and recession may be greater than the increased morbidity and mortality within the pandemic itself.
* Many of those who are most exposed to the economic shutdown, such as low-income families, especially those with young children, are also most vulnerable to long-term effects on both physical and mental health.
* Older people and those from poorer backgrounds, including refugees, will be hardest hit by disruption to emergency and non-urgent care during the pandemic.
* Cancellations of non-coronavirus treatment and operations will lead to increased waiting times that could take years to unwind.
One public health expert indicates that the crisis will influence the quantity and quality of non-coronavirus care that can be provided as resources are prioritised.
The medical battle against COVID-19 is developing so rapidly that no one knows how it will play out or what the final casualty count would be. However, history shows that responses to a deep and long economic crisis, coupled with social distancing and other containment measures, would trigger health impacts of their own over the short and long terms. Some of these issues are:
* Domestic violence
Trapped at home with their abusers, some domestic violence victims, both male and female, are already experiencing more frequent and extreme violence. Many cities around the world are already reporting a drastic rise in the number of domestic violence cases, as much as 24%, as seen in New Jersey.
* Vulnerable students and Youths
Students, parents and teachers all face challenges adjusting to remote learning, as schools nationwide have been closed and online learning platforms are being launched. Some experts are concerned that students at home, especially those living in unstable environments or poverty, would miss more assignments, or be unable to access online resources. Without rigorous schooling and therapy, these students face a lifetime of challenges, which can affect their social, physical and psychological wellbeing. Special needs students with tailored curriculum and special teaching conditions are more likely to be affected, and possible regress from the progress previously made.
* Increase in suicides
In Europe and the United States, suicide rates rise about 1% for every one percentage point increase in unemployment, according to research published by author Aaron Reeves from Oxford University.
The conventional wisdom is that more people would kill themselves amid skyrocketing unemployment, but communities could rally around a national effort to defeat COVID-19 and help to provide social relief and care packages to those most in need. This will help cushion the negative impact of the virus on vulnerable persons.

Long-term consequences
Unemployment and mortality
Increases in unemployment during large recessions can set in motion a domino effect of reduced income, additional stress, anxiety, depression and unhealthy lifestyles, substance abuse, larceny, rape etc. Those setbacks in income and health often mean people die earlier. The general lifespan of individuals is reduced.
* Young people suffer
Young adults entering the job market during the coronavirus suppression may pay an especially high price over the long term. First-time job hunters seeking work during periods of high unemployment live shorter and unhealthier lives, research indicates.
* Burden on women
At the centre of it remains one demographic that likely bears the strongest impact of it all; that is, women.
The fact that women make up 70 percent of the global health workforce puts them at greater risk of infection, pushing back the limited gains made on gender equality and exacerbating the feminisation of poverty, vulnerability to violence, and women’s equal participation in the labour force.
Meanwhile, given such a large percentage of the workers are women, the need to care for her kids and family can hinder a woman’s ability to work during the pandemic.
Because mothers’ employment is especially likely to suffer when they cannot find reliable childcare like schools and day care, this can hamper their ability to work and earn.
Refugees and Tradesmen
Another demographic that is deeply affected because of the pandemic are refugees and tradesmen. Jobs are already limited for tradesmen, and as a result of the pandemic, social distancing and major lockdowns, this problem is further exacerbated when persons lose their jobs and are unable to earn an income to offset the expenses of their families during and after the pandemic. Many of the refugees are daily wage- earners, and now they no longer have an income to support their families.
Well-established policies not only address the pandemic and contain its spread, but also address the long-lasting impact of the crisis. These policies help to support the direct provision of resources to support workers and households, the provision of health and unemployment insurance, increase social protection, and support to businesses to prevent bankruptcies and massive job losses.
Efforts should also focus on protecting groups that are most at risk from the negative social and economic impacts of the pandemic. Government, private sector, non-governmental organisations and civil society can all work together to minimise the long-term detrimental health impacts by pooling their resources and expertise to devise effective national crisis responses to combat COVID-19 and protect the population.
As emphasised by the United Nations Secretary-General during the launch of a COVID-19 Global Humanitarian Response Plan on 23 March 2020, “We must come to the aid of the ultra-vulnerable – millions upon millions of people who are least able to protect themselves. This is a matter of basic human solidarity. It is also crucial for combating the virus. This is the moment to step up for the vulnerable.”
If our plan and strategies fail to work as they should, unemployment would rise even more significantly, economies would fall, and people’s health would worsen.