The Bishop of Exeter spoke in a debate on the effects of long covid on 17th November 2022, focusing on the impact on rural communities:
The Lord Bishop of Exeter: My Lords, I too thank the noble Baroness, Lady Thornton, for securing this important and timely debate.
I will focus my remarks on the rural dimension of long Covid, which is having an impact on many people in Devon where I am privileged to serve. I am concerned about rural sustainability and the need to ensure that the Government’s levelling-up agenda is not focused exclusively on urban deprivation. Rural poverty may not show up on government statistics because it is dispersed in pockets, but it is just as real. Research suggests that structural inequalities, including poverty, are important in the development and course of Covid-19 and may form an important context for long Covid.
As far as Devon is concerned, the picture postcard view of my county beloved by holidaymakers is only half the story. The best information we have is that there are currently around 16,000 people living with long Covid in Devon and, as I am sure the noble Baroness, Lady Watkins of Tavistock, will corroborate, it is impacting on the economic life of our county.
As in other parts of the United Kingdom, we know that the groups most likely to be affected by long Covid are people between the ages of 35 and 69; women; people living in more deprived areas; those in care; those with a high body mass index; those working in close-contact professions; and those living with long-term health conditions. Of the 16,000 people in Devon living with long Covid, only around 70% have been referred to long Covid treatment services. Research has revealed that children, older people, men and those living in deprived areas are less likely to seek help and be referred.
The pandemic has impacted people’s health and self-confidence, well-being and the demand for services. It has had an adverse effect on mental health, with higher levels of mental health anxiety and loneliness. For those suffering from long Covid, unsurprisingly, research has revealed that they have lower levels of life satisfaction and happiness, and some have lost hope of change or improvement. Overall, the pandemic has had a greater impact on those groups already suffering from greater disadvantage and higher health inequities than average across the county. In Devon, service providers have reported increased demand for mental health, domestic violence, and drug and alcohol support services. There have also been increased concerns over the safety of children, young people, and vulnerable adults.
Sadly, young people in Devon reflect the national picture, with a significant rise in child obesity during or after the lockdowns, especially among boys and those living in the most deprived communities. The noble Lord, Lord Dubs, highlighted that in his Question this morning.
The picture is not all negative. I am immensely proud of my county and the resilience of many rural communities, much of it, I am proud to say, fostered and supported by local churches.
However, one particular concern in Devon is the impact of long Covid on the workforce. National research shows that before contracting Covid-19 and then developing long Covid, two-thirds of respondents had been working in front-line jobs such as hospitality, schools, care homes, childcare, emergency services, retail, transport and delivery. Most respondents believed that they had almost certainly, 41%, or very likely, 18%, caught Covid-19 at work, pointing to the lack of PPE and the direct contact with Covid-positive patients. As one researcher commented:
“Key Workers are overwhelmingly paying the price of workplace Covid-19 exposure with loss of health, loss of employment and loss of income.”
As we move into winter, this is really serious.
This national picture is exacerbated in rural counties such as Devon. One of the problems facing the countryside post Brexit has been the shortage of workers, both in the care sector and agriculture. Not only is there a smaller population in rural areas from which workers are drawn but, on average, they have to spend more time travelling to and from their jobs or, in some cases, between jobs. Because long Covid disproportionately impacts lower-paid women in front-line roles, this has made it more difficult to recruit suitable staff in the countryside. This shortage is now being seen in many rural businesses in Devon, especially in the hospitality sector, which are closing for the winter period due to lack of staff and higher energy bills.
In conclusion, therefore, I ask the Minister: what research is being undertaken to assist the medium and long-term effects of long Covid, specifically in rural communities?
Extracts from the speeches that followed:
Baroness Masham of Ilton (CB): Services are patchy across the country in respect of so many health issues. People living in rural areas should not be forgotten, as the right reverend Prelate the Bishop of Exeter said. The key messages from the APPG on coronavirus are that long Covid is having and will continue to have a significant impact on both the UK’s health and economy, that Covid-19 must be recognised as an occupational disease, that a compensation scheme must be put in place for key workers living with long Covid, and that a comprehensive long Covid care system must be established to tackle the significant burden that it will continue to place on the NHS.
Long Covid impacts significantly on the UK population and will continue to do so, including on the UK workforce in both public and private sectors. Many of those living with the acute health challenges presented by long Covid were initially infected as a result of work they did during the pandemic on the front line—caring for patients, educating children and continuing to provide vital transport services—yet support from employers and indeed the state is hugely variable.
Lord Markham (Con, Parliamentary Under-secretary of State, Health and Social Care): I say in response to the noble Baronesses, Lady Scott and Lady Meacher, who spoke about trying to understand how long Covid might interact with, or have similarities to, ME and chronic fatigue, that funding is still available. The right reverend Prelate the Bishop of Exeter spoke about the rural impact, and I would say there is scope there. The noble Lord, Lord Kakkar, asked if we need to do more. Funds are still available within that £50 million, but it is something we believe in, and as we know from short Covid—if that is the right term for it—our research was vital and we remain committed to playing a leading role on the world stage.
We all know that research is only of any use or has any point if it actually creates treatments we can use within the NHS. As many speakers have said, only if these are substituted into services will they really help. The UK was one of the first countries to recognise and respond to long Covid, and we set up the national long covid commission guidance with new care pathways. As part of that, as mentioned by many speakers, including the noble Earl, Lord Clancarty, access to information and education for doctors is key. The Royal College of GPs and the HEE have put out information, but to judge from some of the examples given today, it has clearly not been disseminated widely enough.