THERE is no doubt we all feel great pride every Thursday as we hear the clap for our NHS and social care colleagues, who have recently – alongside other key workers – made tremendous sacrifices, both personal and professional, in the ongoing struggle against Covid-19.

Our endeavours against the virus have been beyond admirable; and the changes that both we as healthcare professionals, and the wider population, have had to make to our day-to-day lives show how serious we are about protecting our NHS.

The battle against the coronavirus has been tough. Coronavirus was a bug we once shrugged off as the common cold, but whose most recent iterations – Sars, Mers and now Covid-19 – have highlighted our vulnerability to something for which we do not yet have an effective treatment. Whilst initial studies show some promise, we are still far from a cure for this virus.

The biggest challenge at the start of the Covid-19 outbreak was the huge number of unknowns we faced as the virus marched towards us. How many people can an infected person infect (the fabled R-number)? What are the typical symptoms of an illness that did not exist six months ago? Who is at greatest risk if they contract the virus? Some of these answers surprised us, but some features of the virus have remained chillingly familiar – such as the risk of those in the most deprived socioeconomic groups within our society.

Studies suggest that being diabetic, having high blood pressure, heart disease or respiratory disease increases the risk of dying from Covid-19. The more socially or economically disadvantaged a person is, the more likely they are to suffer from these largely preventable diseases.

Those in the most disadvantaged groups might also find it more difficult to isolate, because of poor living conditions, multi-generational housing and from the ongoing risk of exposures in workplaces.

It has come to light that nearly a quarter of cases of Covid-19 are in the poorest areas of Scotland, and that twice as many calls to NHS 24 are from those same areas as compared to the most affluent. This suggests the perseverance of the Inverse Care Law – where the access to good medical and social care is worst in the places of greatest need.

These communities are also at most risk of the wider effects of the pandemic – of recession, economic hardship and sustained unemployment.

For now, the immediate challenge for healthcare is fighting the coronavirus. Our future focus should be on changing our approach to our health and its impact on both our NHS and our society.

We know that as little as 10% of what makes us healthy happens in hospitals. The real battleground for health is in GP surgeries, our communities and our homes.

We need massive investment in primary care, so that GPs can do the job they are trained for – in promoting good mental and physical health and managing or mitigating the impacts of poor health.

We need a renewed focus on preventing avoidable illnesses. We should be celebrating the vigour with which people have taken to their daily exercise (in a safe and socially distancing way). We should be driving home messages to encourage people to stop smoking, to lose weight and eat healthily, and we should be exploiting the focus that Covid-19 has brought to health to do this.

Isolation and social exclusion can also be just as harmful to a person as having a chronic health condition. Whilst we must continue to socially distance and isolate for now, we should be learning the lessons of

this nationwide experience and working towards building stronger and more resilient communities where loneliness and isolation are a thing of the past.

Covid-19 has massively increased the health literacy of the nation, much in the same way that recent events in politics has done for our political literacy. Just like the grassroots movement in politics, it would be an amazing achievement in the post-Covid period to have a similar momentum for improving health and wellbeing.

We can’t pre-plan the cure for the next pandemic, but we can bolster our defences against it. By improving health and wellbeing and fighting the causes of avoidable disease we can make sure our most valuable resource, our people, are as well prepared as they can be. And by offering solutions for those issues beyond the health service – the social determinants of health – such as the social security system, education, our communities, the economy, good work and the environment in which we live, we can make wellbeing the centre-point of our society.

As politicos look forward to the Scottish elections in 2021, I propose that “health in society” should be the central focus of the next Scottish Parliament. If we can address the issues of health inequality, preventable disease and the protection of good health and wellbeing, we will have best served the people who clap for us every week.

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