There is a tipping point at which suicide, alcoholism, and domestic violence becomes too high a price in an all-out fight against COVID-19.
Originally published in The Australian Financial Review
When Greta Thunburg told us “I want you to panic”, she wouldn’t have imagined that on the anniversary of her Davos appearance a deadly new virus would be leaking out from China that would grant her wish.
The world has panicked. Country after country has locked itself down. Economies are sliding into recession. The governments of democratic countries have assumed draconian powers to tackle the emergency. Wherever COVID-19 has travelled, Chinese Communist Party-style social control has followed close after. We are doubly infected.
As of writing, we are at stage three restrictions, confined to our homes and households for what we’re told could be at least six months.
Six months in which children who have been separated from their friend networks will supposedly be “remote schooled” by parents who may or may not have the time, ability, or inclination to support their learning – or who may be struggling with the effects of the lockdown themselves. In which dysfunctional families are trapped together with their anxieties, violent abusers with their victims, lonely people with their aloneness.
Authorities have acknowledged that this situation is likely to lead to terrible outcomes – mental health and domestic violence services are being generously funded to help manage the fallout.
As the panic subsides, we must remember that we are sacrificing life-years to save life-years. And we must vigilantly watch for the tipping point at which the cure becomes worse than the disease.
People under the age of 60 have less than 1 per cent chance of dying of the virus – less according to some recent findings – but the lockdown increases their risk of suicide, domestic violence and the long-term health effects of reduced physical activity.
The moment of panic is passing and the critical faculties must be re-engaged.
Australian Bureau of Statistics data shows that nearly 3000 people aged 15 to 34 died of suicide in 2018, with the Mayo Clinic identifying feeling lonely or socially isolated, stressful life events or financial problems as risk factors for suicide.
The risk is particularly high for men, with 20.2 young men aged 15 to 24 and 22.7 aged 25 to 34 committing suicide per 100,000, which is not substantially different from estimates of their risk of dying from COVID-19.
Social isolation has also been shown to have negative health impacts. The health effects of loneliness have been compared to smoking 15 cigarettes a day or having alcohol use disorder.
For young women, the risk of domestic violence is significant. Calls for help with domestic violence matters have increased significantly where lockdowns are in place, from a 30 per cent increase in France to a doubling or tripling in the Chinese city of Wuhan. The Australian Institute of Health and Welfare estimated that in 2015, the lost disability adjusted life years from domestic violence was 1.9 for women under 24, 4.2 for women aged 25-34 and 5.2 for women aged 35-54.
The AIHW also reports alcoholism as a significant cause of death, with an expected 226,881 disability adjusted life years forecast to be lost this year due to alcohol use, with more of this burden of lost life years among younger ages.
Anecdotally, alcohol use has risen and the rush on bottle shops when essential service closures were announced was a clear statement of further intent.
Children, unemployed at risk
The restrictions imposed to control this virus are expected to result in over a million unemployed people. For a portion this will turn into long-term unemployment, typically defined as unemployment lasting over six months. Long-term unemployment is associated with poorer health and reduced life expectancy.
When a million or more people are expected to be out of work for six months, the health impacts of this are likely to be significant.
With gyms and sport clubs closed, the 60 per cent of people who engage in sports and recreation will have to find alternative forms of exercise. Given beach closures and instructions to exercise only close to home or, as Victorian Premier Dan Andrews suggested, “just take a walk around the block”, many will find it difficult to keep up their former levels of activity, shortening their lives in the process.
Children who are now driven to socialise online are more susceptible to bullying and more sensitive to isolation. Suicide rates among teen girls have tripled since 2009, a tragic statistic which social psychologist Jonathan Haidt attributes to social media usage. Boys, who spend less time on social media, are not harming themselves at anywhere near that rate. But now they will be increasingly forced off the sport field and onto social media and video game chat rooms.
Now that measures are in place to manage the spread of the virus, the moment of panic is passing and the critical faculties must be re-engaged. The lives lost to suicide and domestic violence are no less valuable than the lives that are lost to COVID-19. The CCP-like controls must be wound back before they corrode our ability to take calculated risks.
Society has shown it has a heart: now it is time to show we have a head as well. Both organs are required to ensure we don’t make a bad situation much worse.