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Originally published in: Healthy Debate
By Dr. Sonia Malhotra
Dr. Sonia Malhotra is a family physician practicing in Toronto who cares for immigrants, refugees and refugee claimants.
As a family physician witnessing the direct and indirect effects of COVID-19 lockdown measures on my patients, I have become increasingly disturbed by the continued use of policies without careful consideration of their effects on people’s health. If we were to weigh all health outcomes, not only deaths due to COVID-19 – be it years lost due to delayed cancer diagnosis, opioid overdoses, trauma from child abuse, domestic violence or suicides – would we continue blunt, sweeping lockdowns as our main public health strategy?
Despite mounting evidence that the lockdowns are having negative effects on our health, this is not being substantively reflected in the current discourse. This is not to deny the terrible health outcomes of COVID-19 infections; they are real and have been amply documented in both the press and the scientific literature over the past year.
Among my patients, however, the acute challenges created by lockdowns are much more apparent than the effects of COVID-19. I see patients with severe mental health problems experiencing worse symptoms and people with little or no history of mental health diagnoses suffering symptoms for the first time. These patients come to me often disconnected from family and friends and meet a health-care system with fewer resources for support.
As we enter the second year of the pandemic, I am experiencing a deep dissonance between ethical family medicine practice and the continued promotion of sweeping lockdowns by health professionals leading the COVID-19 response. I suspect this is a question of training. Emergency situations require a unique skill set: immediate action with singular focus. This is in direct contrast to family physicians who are skilled at weighing the long-term benefits and trade-offs of proposed treatments with both scientifically based evidence and the subjective experiences of patients. The patient decides, with the help of a physician, which costs they are willing to bear. Inherent in this is the capacity to hold ambiguity and uncertainty.
Family doctors are trained to consider not just mortality and morbidity but quality-of-life measures. To see a life as something more than to just sustain and “keep alive” has become a pivotal value of family medicine. It is for this reason that any conversation regarding substantive public health measures must include the voices of those trained in making holistic considerations on equal footing as those providing emergency responses.
Read the full article: https://healthydebate.ca/opinions/family-doctors-lockdown/