Reuters: How the COVID-19 lockdown will take its own toll on health

NEW YORK (Reuters) - It’s the most dramatic government intervention into our lives since World War II. To fight the coronavirus outbreak, governments across the globe have closed schools, travel and businesses big and small. Many observers have fretted about the economic costs of throwing millions of people out of work and millions of students out of school.

Now, three weeks after the United States and other countries took sweeping suppression steps that could last months or more, some public health specialists are exploring a different consequence of the mass shutdown: the thousands of deaths likely to arise unrelated to the disease itself.

The longer the suppression lasts, history shows, the worse such outcomes will be. A surge of unemployment in 1982 cut the life spans of Americans by a collective two to three million years, researchers found. During the last recession, from 2007-2009, the bleak job market helped spike suicide rates in the United States and Europe, claiming the lives of 10,000 more people than prior to the downturn. This time, such effects could be even deeper in the weeks, months and years ahead if, as many business and political leaders are warning, the economy crashes and unemployment skyrockets to historic levels.

Already, there are reports that isolation measures are triggering more domestic violence in some areas. Prolonged school closings are preventing special needs children from receiving treatment and could presage a rise in dropouts and delinquency. Public health centers will lose funding, causing a decline in their services and the health of their communities. A surge in unemployment to 20% – a forecast now common in Western economies – could cause an additional 20,000 suicides in Europe and the United States among those out of work or entering a near-empty job market.

None of this is to downplay the chilling death toll COVID-19 threatens, or to suggest governments shouldn’t aggressively respond to the crisis.

A recent report by researchers from Imperial College London helped set the global lockdown in motion, contending that coronavirus could kill 2 million Americans and 500,000 people in Great Britain unless governments rapidly deployed severe social distancing measures. To truly work, the report said, the suppression effort would need to last, perhaps in an on-again, off-again fashion, for up to 18 months.

In the United States, the White House this week said the final toll could rise to 240,000 dead. States have responded to the dire warnings, and the escalating number of cases revealed each day, by extending stay-at-home shutdowns.

The medical battle against COVID-19 is developing so rapidly that no one knows how it will play out or what the final casualty count will be. But researchers say history shows that responses to a deep and long economic shock, coupled with social distancing, will trigger health impacts of their own, over the short, mid and long term.

Here is a look at some.

Trapped at home with their abusers, some domestic violence victims are already experiencing more frequent and extreme violence, said Katie Ray-Jones, the chief executive officer of the National Domestic Violence Hotline.

Domestic violence programs across the country have cited increases in calls for help, news accounts reported – from Cincinnati to Nashville, Portland, Salt Lake City and statewide in Virginia and Arizona. The YWCA of Northern New Jersey, in another example, told Reuters its domestic violence calls have risen up to 24%.

“There are special populations that are going to have impacts that go way beyond COVID-19,” said Ray-Jones, citing domestic violence victims as one.

Students, parents and teachers all face challenges adjusting to remote learning, as schools nationwide have been closed and online learning has begun.

Some experts are concerned that students at home, especially those living in unstable environments or poverty, will miss more assignments. High school students who miss at least three days a month are seven times more likely to drop out before graduating and, as a result, live nine years less than their peers, according to a Robert Wood Johnson Foundation report.

Among the most vulnerable: the more than 6 million special education students across the United States. Without rigorous schooling and therapy, these students face a lifetime of challenges.

Special needs students “benefit the most from highly structured and customized special education,” said Sharon Vaughn, executive director of the The Meadows Center for Preventing Educational Risk at the University of Texas. “This means that they are the group that are most likely to be significantly impacted by not attending school both in the short and long term.”

In New Jersey, Matawan’s Megan Gutierrez has been overwhelmed with teaching and therapy duties for her two nonverbal autistic sons, eight and 10. She’s worried the boys, who normally work with a team of therapists and teachers, will regress. “For me, keeping those communications skills is huge, because if they don’t, that can lead to behavioral issues where they get frustrated because they can’t communicate,” Gutierrez said.

In Europe and the United States, suicide rates rise about 1% for every one percentage point increase in unemployment, according to research published by lead author Aaron Reeves from Oxford University. During the last recession, when the unemployment in the United States peaked at 10%, the suicide rate jumped, resulting in 4,750 more deaths. If the unemployment rate increases to 20%, the toll could well rise.

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