APA
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Mansfield, K., Mathur, R., Tazare, J., Henderson, A. D., Mulick, A., Carreira, H., … Langan, S. M. (2020). COVID-19 collateral: Indirect acute effects of the pandemic on physical and mental health in the UK. MedRxiv.
Chicago/Turabian
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Mansfield, K., R. Mathur, J. Tazare, Alasdair D Henderson, A. Mulick, H. Carreira, A. Matthews, et al. “COVID-19 Collateral: Indirect Acute Effects of the Pandemic on Physical and Mental Health in the UK.” medRxiv (2020).
MLA
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Mansfield, K., et al. “COVID-19 Collateral: Indirect Acute Effects of the Pandemic on Physical and Mental Health in the UK.” MedRxiv, 2020.
BibTeX Click to copy
@article{k2020a,
title = {COVID-19 collateral: Indirect acute effects of the pandemic on physical and mental health in the UK},
year = {2020},
journal = {medRxiv},
author = {Mansfield, K. and Mathur, R. and Tazare, J. and Henderson, Alasdair D and Mulick, A. and Carreira, H. and Matthews, A. and Bidulka, P. and Gayle, A. and Forbes, H. and Cook, Sarah and Wong, A. and Strongman, H. and Wing, K. and Warren-Gash, C. and Cadogan, S. and Smeeth, L. and Hayes, J. and Quint, J. and McKee, Martin J. and Langan, Sinéad M}
}
Background: Concerns have been raised that the response to the UK COVID-19 pandemic may have worsened physical and mental health, and reduced use of health services. However, the scale of the problem is unquantified, impeding development of effective mitigations. We asked what has happened to general practice contacts for acute physical and mental health outcomes during the pandemic? Methods: Using electronic health records from the Clinical Research Practice Datalink (CPRD) Aurum (2017-2020), we calculated weekly primary care contacts for selected acute physical and mental health conditions (including: anxiety, depression, acute alcohol-related events, asthma and chronic obstructive pulmonary disease [COPD] exacerbations, cardiovascular and diabetic emergencies). We used interrupted time series (ITS) analysis to formally quantify changes in conditions after the introduction of population-wide restrictions ('lockdown') compared to the period prior to their introduction in March 2020. Findings: The overall population included 9,863,903 individuals on 1st January 2017. Primary care contacts for all conditions dropped dramatically after introduction of population-wide restrictions. By July 2020, except for unstable angina and acute alcohol-related events, contacts for all conditions had not recovered to pre-lockdown levels. The largest reductions were for contacts for: diabetic emergencies (OR: 0.35, 95% CI: 0.25-0.50), depression (OR: 0.53, 95% CI: 0.52-0.53), and self-harm (OR: 0.56, 95% CI: 0.54-0.58). Interpretation: There were substantial reductions in primary care contacts for acute physical and mental conditions with restrictions, with limited recovery by July 2020. It is likely that much of the deficit in care represents unmet need, with implications for subsequent morbidity and premature mortality. The conditions we studied are sufficiently severe that any unmet need will have substantial ramifications for the people experiencing the conditions and healthcare provision. Maintaining access must be a key priority in future public health planning (including further restrictions). Funding: Wellcome Trust Senior Fellowship (SML), Health Data Research UK.
