Covid Scotland: Will the pandemic be over in 2022? The year ahead for health

When will the Covid-19 pandemic be over? It’s the question on everyone’s lips and it’s a very difficult one to answer.

In March 2020 most of us would not have believed Covid-19 would still be causing problems two years later, but unfortunately there is no doubt it will continue to have a major impact on our lives throughout 2022.

Restrictions

The most immediate impact is going to be continued restrictions and preventative measures. Nicola Sturgeon has already announced new rules around events and hospitality which will be in place until mid-January, and it is highly likely that some form of these will be extended beyond that.

A member of staff at University Hospital Monklands attends to a Covid-positive patient on the ICU ward on February 5, 2021 in Airdrie, Scotland. Photo by Jeff J Mitchell/Getty Images

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With the ever-present threat of new variants, it’s also hard to rule out restrictions beyond this next wave.

Even more certain is that preventative measures will continue. Unlike the UK Government, the Scottish Government has kept some of these in place throughout the pandemic, such as compulsory face coverings, contact tracing and the advice to work from home.

These will all continue into the near future. There may be pressure from businesses to rescind working from home advice as soon as possible, but compulsory face coverings are likely to be the last rule to be scrapped, and will probably remain advised long after that.

New variants

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No-one knows what the next major variant of Covid-19 will look like, but Omicron is unlikely to be the last. There are experts who believe the pandemic will eventually peter out with the arrival of a new variant that is more transmissible, but does not cause such severe disease. Some think this may be Omicron, others think it will be several years before this arrives.

Whatever happens, Scotland’s fate is inextricable from that of the rest of the world. New variants are not directly caused by unvaccinated populations, but they spread much more easily among them, and while vaccine coverage is devastatingly low in less-developed countries, Scotland remains at risk.

The cycle of vaccine-induced immunity means another round of boosters will be needed in 2022, especially in response to a new variant or before the threat of winter.

That said, it is becoming increasingly difficult for western countries to justify pumping round after round of vaccines into their populations while millions of people in less-developed countries have yet to receive a first dose.

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“No one is safe until everyone is safe” is a frequent warning from the World Health Organisation that has been echoed by leaders in Scotland.

Still, this has not stopped the Scottish Government rolling out three doses for all adults in 2021, and is unlikely to prevent a further booster round next year.

The Government is also expected to follow advice from the Joint Committee on Vaccination and Immunisation (JCVI) on the vaccination of children aged five to 11, which may be recommended early in the year.

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Emergency care

Unsurprisingly, the pandemic is going to have a continued impact on Scotland’s NHS in 2022. In January and February this is expected to be devastating, and among many leaders there is a palpable fear of overwhelm.

The worst-case scenario is similar to what happened in Northern Italy in spring 2020, and in New York and India later in the pandemic, where too many patients for staff, equipment or facilities to cope with, led to doctors being forced to choose who to save and who to condemn to mass graves.

Scotland probably won’t end up in a situation quite so apocalyptic as this, but there is unfortunately going to be a lot of bad news to contend with.

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In the first few months of the year the NHS will be hit with a triple-whammy of staffing shortages, winter pressures and Omicron. Health and social care was short-staffed before the pandemic, and this has only got worse with staff burning out after nearly two years of high pressure, taking sick leave or leaving the profession altogether.

Winter is always the worst time of year, with higher pressure sometimes stretching as far as April.

Scotland hasn’t seen too much damage from flu yet this year, but this may change in January after the festive season of contagion. Icy weather also leads to falls and other accidents filling up A&E.

And the pre-Christmas Omicron spike will also begin to translate into increased hospitalisations in the new year. A continued wave of case numbers will also cause added staffing shortages, as care workers or their family members become sick.

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All of this will manifest itself in more people waiting longer for ambulances, and at A&E departments. This, in turn, will lead to worse outcomes for patients and, according to analysis used by the Royal College of Emergency Medicine, more deaths than there would otherwise have been.

Routine care

Non-urgent care has taken an absolute battering over the course of the pandemic.

Health boards across the country began cancelling non-urgent operations and tests over the summer as pressure on services increased, and many will not expect to return to anything like previous levels until at least April.

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It is normal for this kind of thing not to be scheduled over winter, but because so many non-urgent services have been cancelled, and for so long, some of these are now becoming urgent. The backlog is mounting and patients are facing increasing waiting lists.

Even more worryingly, these cancellations have extended into some cancer services, which are usually protected further than other procedures. While the intense winter pressure on emergency care is expected to ease after April, this backlog will continue throughout 2022.

Other services, including GPs and dentists, will also see sustained pressure throughout the year, as the people who have been holding on to health problems during the busiest periods begin to ask for help.

It is this backlog of care, combined with the trauma and exhaustion imposed on healthcare workers, which mean the NHS will not return to pre-pandemic levels of operation in 2022, or perhaps ever.

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