Covid: Public health doctors have had an unforgiving year and much work still lies ahead – Dr Tamasin Knight

As we begin to take those tentative steps out of what we hope will be our final Covid-19 lockdown, I’ve been taking some time to reflect on what the last 12 months have meant for doctors on the frontline of fighting the pandemic.

Particularly public health doctors – we’re a relatively small group of doctors with, until recently, a low profile. We aim to improve the health of whole populations and to prevent people from becoming ill in the first place.

As a speciality, we were already facing significant challenges in Scotland prior to the impact of Covid. These included dealing with increasing demands and expectations on the existing workforce of senior public health doctors due to issues such as rising numbers and complexity of population screening programmes, which aim to detect serious health conditions before symptoms develop; rising numbers of people dying because of drugs in our local communities; and changes in the delivery of immunisation programmes.

Throughout the pandemic, public health doctors have been managing outbreaks of Covid in schools, nurseries, and workplaces; providing advice to care homes when they have residents who have confirmed or suspected Covid; and building and providing advice to the Test and Protect contact-tracing team.

And, like all of you, we have done this while managing how our own lives have changed: working from home and, in some cases, also home schooling. It’s been a huge challenge – even when cases dropped last summer because this, in some way, meant there was more for us to do, to try and keep Covid cases at a low level, working on managing isolated outbreaks and supporting Test and Protect.

Looking forward, the latest figures on Covid infections and the scale and pace of the vaccination programme are real signs of hope. However – from a public health perspective the receding of the pandemic will bring with it fresh and significant challenges.

Many of the public health issues we were tackling pre-Covid – such as childhood adversity and poor mental health – have worsened due to the pandemic and restrictions. We know that Covid has hit some of the most vulnerable in our communities – and indeed some of our most vulnerable communities in general – the hardest.

While intensive care staff have been working to save lives of critically ill patients, public health doctors have been managing outbreaks of Covid and helping contact-tracing teams in an effort to minimise the spread of the disease (Picture: Joe Giddens/PA)

As a public health doctor my first and foremost concern is for the people impacted by this and their families and communities – it is why I got into this specialty in the first place after all.

But from the viewpoint of my fellow professionals, the scale of work is daunting – like all doctors involved in this pandemic we need a chance to recuperate and recover from what has been an unforgiving year, but we know how much our local populations need us.

It is a privilege to be a public health doctor – and it is notable what we, together with colleagues across the NHS, have done in responding to this pandemic.

But there is a lot of work still to do – and in some ways greater challenges lie ahead. If we are to meet them, then Scotland’s public health workforce must be supported effectively now and in the future.

Dr Tamasin Knight is a consultant in public health medicine and co-deputy chair of the BMA Public Health Medicine Committee

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