Lockdown legacies: how Covid continues to shape the world
Four and a half years ago many countries told their inhabitants they had to stay at home for weeks at a time to control the coronavirus pandemic. Many countries had never resorted to any such measure - which deprived citizens of their civil liberties to such an extent - in recorded history. And while it was successful at slowing the spread of the disease, at least initially, as the world has emerged from the pandemic, it’s become obvious that there’s a less than positive legacy of these lockdowns. So what have we learned, and what can we do, if anything, to prevent history repeating itself?
In this episode
00:60 - How did lockdown affect baby brain development?
How did lockdown affect baby brain development?
Pasco Fearon, University of Cambridge
How did the pandemic lockdowns disrupted the development of the babies born just before or during the pandemic? Deprived of the chance to play with others, and locked up in sometimes fractious family environments, have they paid a developmental price? Pasco Fearon is the director of the Centre for Child, Adolescent and Family Research at the University of Cambridge…
Pasco - For those of us who don't remember being two or three or one, you just have to kind of think for a second about what an exceptional period of development that is. A newborn baby changes so dramatically from the first days of life to the time that they turn, let's say, age three. By the time they're three, they're walking, they're talking, they're thinking, they're playing, they're doing an incredible number of things with sophisticated cognitive and language and communication skills. This is a period of life where the brain is developing at the most incredible rate, the fastest it will in the whole of the lifespan. And of course the brain, it has its kind of developmental genetically pre-wired program, but the way that it grows and matures is incredibly sensitive to and is in fact trying to build itself around all of the structured input that it receives from the environment. So if there is a major disruption to that, what could it do? We got quite a lot of concern and reports from the kind of professional sector working with young children that they thought they were seeing big delays in those sorts of developments in children. So particularly their language development and their ability to do basic things that they would need when they go to nursery like toileting, being able to tie their shoe laces, knowing how to relate to other children and so forth.
Chris - Must have been a double whammy really then because not only were children divorced from those normal social stimuli that you've outlined helped to mould us, but also if you've got a stressful situation going on and life at home is disrupted, the other major guide and influence on how we develop our our home, that's also potentially in jeopardy for a while, isn't it?
Pasco - That's a really important thing to draw out because at the time a lot of people were talking about school closures, nursery closures, and people like me were saying, yes we should be worried about that, but that's not the only thing that's going on. Actually, there's a lot of stress being experienced by families given what we know about child development. The family context is actually probably the most important driver of how well children do. And as you say, the risk was that it was a double whammy. So limited experiences outside the home, but also very stressful things going on within the home. It is worth talking a bit about why you might not see some negative effects too. We know from lots of research that brain development is extremely resilient in any child's life. They'll have various perturbations or things that kind of knock them a bit off course during their development. And actually if those perturbations are quite short-lived on the whole, the rule is that children tend to catch up. However, what we also know is that what tends to impact much more significantly children's development is factors that are quite persistent over time. So poverty, we know that poverty and all the things that go with that, which tends to be very stable over time, does have these long-term incremental negative effects on children's early learning and their longer term development. So for example, if the pandemic contributes to widening social inequalities, which it probably will do and has done, that's a more plausible influence on children's long term outcomes than the short term changes related to childcare, I would say.
Chris - Notwithstanding everything you've said in terms of the fact that there isn't a formal way of looking at this at the moment, what evidence do we have so far that there is an effect of these lockdowns, and what do you think is going to happen going forward?
Pasco - What do we actually know about the outcomes of children who are in the early years during the pandemic is a problem because actually the data we have are quite thin. Health visitors do a child development checkup when children are about two to two and a half years of age, and they use a standardised instrument for seeing how children are doing in terms of their language development, their cognitive development, and so on. And that has been collected relatively consistently over quite a few years, and we do have data from at least 2016-17 all the way through to now. If you look at the headline stats from which Public Health England publish, we're not seeing large changes in children's early development over that period. Having said that, there are some small declines that are kind of noticeable. So for example, if you look at 2017 to 2019/20 or something like that, about 88, 89% of children were reported to be achieving what we call the sort of expected level of development for their communication skills when they were two. If you look at 2021, it's about 85 to 86%. So there's some shift there, small 2-3%, something like that. But there's a clue that something might be happening. The other thing that's really important to think about, if you do get a small shift in where the average child is, let's say in the population, that might look small, but when you look at the extreme end, so the number of children over a threshold in terms of having quite significant developmental problems or delays, a small shift in the mean can mean quite a large shift in the proportion of children who are under that threshold in terms of their development. Of course, that's what the professionals will be picking up, is the children who seem to be really struggling.
07:22 - Did Covid lockdown make us vulnerable to other diseases?
Did Covid lockdown make us vulnerable to other diseases?
Brian Ferguson, University of Cambridge
We know that the lockdowns had the intended effect on reducing transmission rates of the SARS-Cov-2 virus that causes COVID-19, but what was the impact on the normal pattern of circulation of other infections, and how did they change in the aftermath? And has this had any effect on our immunity and disease susceptibility as a result, producing, at a population level, what some have labelled an “immunity debt” that has triggered a subsequent surge in disease and even new disease manifestations to appear. In 2022 an alarming spike in children with hepatitis was picked up and subsequently put down to a virological “one-two punch” caused by vulnerable individuals catching multiple bugs in quick succession. Brian Ferguson is an associate professor of innate immunity at the University of Cambridge, and began by outlining what the rationale for the lockdowns was when the pandemic began...
Brian - There was a lot of understanding of a new and lethal virus infection spreading out of China through Europe and towards the UK. And at the time there wasn't any understanding of what really this virus was, why it was lethal. And there weren't any drug treatments or vaccines available at the time. So a lockdown was proposed in order to try to stop people from interacting with each other and therefore to reduce the chances of this new and deadly infection from being able to spread between people. And at the time that was proposed, it was one of the only mechanisms which would have been seen to be effective way of, of stopping this virus from spreading in a way which would buy some time in the population so that scientists could as quickly as possible, develop drug treatments and vaccines that would help to combat the virus.
Chris - Had we ever done anything like that before or was this a completely new manoeuvre?
Brian - In the UK, this is a completely new manoeuvre. It wasn't something that had been tested before at a population level in the whole of the UK.
Chris - And was it effective? Did it actually do what it said on the tin?
Brian - Yes, it did. It did what it said on the tin. So the number of infections went down as lockdown was introduced and that was the idea. So it bought some time for people in the background to start as quickly as possible developing the drug treatments, testing them, developing vaccines, testing them so that they could be introduced later.
Chris - If it stopped or interrupted the circulation of one disease that was SARS-CoV-2 that causes COVID-19. It must have had the same kind of impact on everything that we spread amongst ourselves.
Brian - Yes, that's absolutely true. And we saw that at the time and subsequently by looking back at data where people have counted the number of infections of other respiratory diseases during that period and seen a massive reduction in the whole host of other infectious diseases during that period of time when there was lockdown. And that includes things like influenza, flu virus infections, and RSV, which is respiratory syncytial virus, which causes the disease to be especially nasty for young children. So those virus infections dropped off dramatically during that lockdown period as well.
Chris - Now when we talk about infections like the ones you've just mentioned, there's two considerations. There's the acute effect stopping infections spreading right now, and then there's the longer term seasonal trends. Because if we look at those viruses you've mentioned, they tend to have a season. We have a flu season, we have an RSV season. So notwithstanding what you said about interrupting the acute spread, have there been any repercussions for the long-term seasonal trends we see with those other viruses of these lockdowns?
Brian - That's something that people are still monitoring very carefully. And we have seen immediately in the year after lockdowns, there was an increase in RSV infections that came back through the winter of 2022 and potentially the winter of 2023 in some places, but not others. There may have been an increase in some of those infections as they came back into the population after having been kind of restricted or locked out of circulation of those populations during the period of when we were in lockdowns for SARS-CoV-2.
Chris - Why do you think that is? Why did we see the fact that we get a resurgence but it's higher, it's a bigger bounce back, effectively?
Brian - Yes. I think that's something that genuinely isn't understood very well. It may be that there are people at that time who would've been infected, therefore, were not developing longer term immunity during lockdown. And when they've come back into the population, there are more people who are slightly more susceptible to that infection. That's one option. There are also lots of other potential explanations, which I think are worthy of consideration retrospectively as we gather more data about the exact numbers of those infections over subsequent years. because don't forget, this is not actually that long ago that we went through this process and these seasonal trends of viruses do change all the time, irrespective of the lockdown. So it needs a longer term view in a global way to understand whether there are short, medium, or long-term implications of the circulation of those other viruses impacted by lockdowns due to SARS-CoV-2.
Chris - We also saw possible speculation that lockdowns interrupted the sequence in which, particularly young people, were catching things for the first time, leading to some co-infections occurring with agents that were then having more severe consequences than if they had just caught them at a normal time. What did you make of those hepatitis cases in young people a couple of years ago that was quite dramatic in a number of countries. The UKHSA suggested it might have been down to people catching an adenovirus and something on top of that which was causing a ‘one-two’ punch in susceptible individuals.
Brian - This is another interesting area of research, understanding whether there are specific consequences to having co-infections at the same time. This is people trying to causally link clinical manifestations of clinical infections with the amount of immunity people have, and the amount of co-infections people have at different times. We’re currently at the place where there isn't enough information about that to say for certain whether there are those casualties between circulating infections working together, and then on top of that, weather that was altered during those lockdown periods.
14:57 - Did lockdown increase depression in teens?
Did lockdown increase depression in teens?
Nicky Wright, Manchester Metropolitan University
What impact did long periods of lockdown with little or no contact with friends, peers and families have on older individuals, and specifically teens? Nicky Wright is senior lecturer in psychology at Manchester Metropolitan University and she put together an elegant study that was one of the few to help unpick the confounding effect of the ageing process, disclosing in the process a formerly hidden impact on young boys…
Nicky - There has been a lot of interest as to whether these kinds of interventions such as lockdowns will negatively impact the mental health of the general population. And overall there does seem to be evidence mental health symptoms increased during the lockdown. Of course it's difficult to separate out what's the effect of actual lockdown and what's the effect of other aspects of the pandemic. So for example, fear of Covid. There are some studies which have compared different countries that had different levels of restrictions, which suggest that there may have been an effect of greater restrictions on worsening depression symptoms.
Chris - Were any groups particularly susceptible?
Nicky - Yeah, so the evidence seemed to suggest that women were more aversely affected and younger people. So that includes young adults and children and adolescents. People from lower socioeconomic circumstances were more aversely affected, but some studies have actually shown that people living in higher or middle socioeconomic circumstances, mental health was more affected. We actually found that in our data and we speculated that it might be that people who were doing okay before the lockdowns and the pandemic might have experienced more changes to their lives.
Chris - That's an interesting perspective because you wouldn't automatically jump to the conclusion someone who's got a nice life, who's robbed of it, would end up worse off than someone with a worse life with less to lose.
Nicky - Not worse off, the same. We actually called it a levelling up in our analysis because people who were worse off already had higher mental health symptoms. There was more change in those who were better off.
Chris - As you saw this when we went into a pandemic with those restrictions being applied, one would therefore anticipate that things should improve on the way out. Again, if there is a cause and effect type relationship. Do the sorts of studies that got done bear that out? Do we see that as restrictions, these things go back to normal, these levels go back to normal? Or is there a lasting psychological scar on the population as it were and we're seeing a legacy effect on people's mental health?
Nicky - When we look at overall mean levels, there does seem to be evidence consistent with what you suggest, that in the months after the lockdown symptoms do improve. But again, these effects are always quite small and there'll be certain subgroups that continue to be affected, absolutely.
Chris - You went after adolescence specifically, why were you very interested in them?
Nicky - From age 11 onwards, females experience this rapid increase in depression symptoms. And that marks the start of a lifelong transition that we're all aware of. We were really interested to ask, firstly, did the pandemic exacerbate this increase but also to try and disentangle the effect of the pandemic from this developmental effect that we know is there. So we know that, with time passing, young adolescent female depression symptoms will increase anyway, whereas boys' depression symptoms will slightly decrease over that time.
Chris - Yes, I understand the subtlety and the nuance of what you're saying, which is if you've got something going on over a long-ish period of time, which the pandemic did, multiple years, people are going to grow up over that time. So you could be misled into thinking a person's becoming depressed because of the pandemic, but just through the aging process they were going to become depressed anyway. So I suppose the question becomes, did we see an excess risk of depression in these young women or the boys accordingly in response to the pandemic?
Nicky - Exactly. So we were in a really fortunate position to answer this question because I work on a birth cohort of parents and children. And we have a group of young people who were born in 2007 to 2009 who had been following up repeatedly since birth. And we just so happened to be collecting data on them before the pandemic hit. And they were 11, 12 years old. And then we collected two other Covid surveys, one in June 2020 just after the lockdown measures were easing and children were returning to school and then another a year later. So this allowed us to carry out this analysis that actually separated out the changes with age from the time in relation to the pandemic onset. What we found when we just looked at the data simply, which is what most studies have done, it appeared as if girls did experience a dramatic increase in depression symptoms immediately following the first lockdown and again a year later. But then when we actually corrected for the age related change over that period, it really reduced the effects of the lockdowns. For boys, when you looked at their simple scores, it looked like they did have a small increase after the first lockdown. But then actually when we corrected for that age related change, we saw that an effect of the pandemic had been masked. Boys were actually more aversely affected by the pandemic. And it's not to say that girls aren't suffering because girls have very high rates of depression in adolescence, but boys were actually more aversely affected by the pandemic. And we also measured behavioural problems. And behavioural problems actually decrease during early adolescence as children grow up and learn to regulate themselves better. And we saw that behavioural problems had increased in both boys and girls in response to the pandemic.
Chris - We spoke recently to a researcher in America, Patricia Kuhl, who has done MRI scans on older individuals, they're the late teens into early twenties, over the pandemic. And she found accelerated brain ageing, but it was very pronounced in the girls compared to the boys. So it seems interesting that when you look at the younger ones and you look at specific aspects of behaviour, you see this effect in boys and girls are relatively shielded. Whereas when you look at the brain changes that were being detected in these other groups who were otherwise relatively comparable to those that you've looked at, you see a different story. So why do you think you are getting this impact on the boys and what's helping the girls?
Nicky - Patricia Kuhl's work, which is quite similar to ours in that it does correct the age as well, they haven't measured the emotional outcomes. So they've observed these differences in girls, but they haven't yet linked them to outcomes. So it may be that that's created a vulnerability in girls that will express later. Another kind of explanation I would have is that it does seem that the mechanisms for mental health problems in males and females are different. So female mental health problems are more linked to social connectedness, whereas male mental health problems are more linked to achievement. So you can imagine that during the lockdowns, boys' ability to achieve in school was reduced, extracurricular activities that boys would normally achieve in such as sports access to that were removed. Also because of these differences in how males and females typically spend their time, males do spend more time outside and physical activities and so their peer interactions are conducted more in those settings, whereas girls may have been better able to maintain their peer interactions with texts and phone calls remotely. So our data that we collected was actually a year after the pandemic. So we don't know what the long lasting effects are. So we're collecting more data from our sample now to try and try and establish whether these changes that we saw have persisted.
23:05 - How lockdown has affected the working world
How lockdown has affected the working world
Vicky Pryce, Centre for Economics and Business Research
What did the Covid shutdowns do to the global economy, and has it changed the way we work forever? Here’s Vicky Pryce from the Centre for Economics and Business Research…
Vicky - The lockdown that was implemented in quite a lot of countries led to the global economy contracting very significantly because basically production was closed down, people didn't go out to spend, transport wasn't used, airlines weren't flying. So it was a complete sort of stop of the normal economic activity that you would expect to see on a normal day. So it was pretty substantial and pretty shocking. And the interesting thing is, of course, that it was pretty global. There were different things that were done in different countries and different types of lockdowns and their length and intensity if you like. But overall the impact was one of real contraction in the world economy to begin with.
Chris - With any kind of knock, there are both short term and long-term effects. You've just described short term what the impact was. What about longer term? Did everything bounce back and are we back to where we were pre pandemic? Have things surged? Have some things not come back?
Vicky - There were differences in different countries. A lot of the knock on effects of Covid and lockdowns was that as we were coming out of it, there were real problems with the supply chains. People found themselves located away from where the factories would be. The goods that were being produced in places like China were just not produced because all sorts of things were closed down for a while. You didn't have the ships in the right place to bring things over. So it all continued even when lockdown restrictions were gradually being lifted to have a serious impact on economic activity. And with it of course, because demands suddenly surged because people hadn't been able to travel or do anything at all very much. You saw prices starting to rise quite significantly with some real shortages in lots of parts of the economy, not just in the UK but also globally.
Chris - Different countries did different things, you pointed that out earlier. That must afford us some opportunities to ask, well, does a more severe lockdown translate into a bigger economic hit or is it just a short term thing with a bounce back? What does that picture look like?
Vicky - Governments borrowed an awful lot of money and spent a lot of money keeping the economies going. So in the case of the UK and European countries, we had the furlough scheme, which basically kept people on payroll even though they weren't working because they were getting money through the companies that they were on the payroll of. And governments became incredibly indebted. Debt went up, sovereign debt went up very significantly. And also the support given to firms has left a legacy as well. And right now we're trying to roll back a little bit that fiscal generosity that was there. And it was only really made possible by the fact that central banks went out and bought a lot of the government debt, interest rates came down very significantly since then, of course they've gone up very significantly. So the world has recovered, but with serious problems left from the time of Covid because of the way in which governments intervened if you like. Some countries didn't even do lockdowns, but overall they all had to spend a lot.
Chris - What does the economic argument look like in the wake of things like these furlough schemes? Are we better off for having preserved everyone at work and taken on the debt or would we have been better off not to end up so indebted in the first place?
Vicky - When you look at what happened to the US, which did not do furlough, they in fact put huge amounts of money back into the economy to keep things going more than, as a percentage of GDP, than the UK and a number of European countries. So doing it one way or another doesn't seem to have necessarily helped governments' fiscal position. One had to intervene and intervene very heavily.
Chris - One of the other massive shifts has been towards working from home and we've seen a mixture of messages about that. Some companies have been very enthusiastic, some industries unsurprisingly very unenthusiastic because it just wouldn't work for them. We seem to be seeing a move back towards the office. What's the economic argument for that?
Vicky - Well, IT systems have proved to be pretty good. You know, communicating with people not needing to travel. When you look at airline travelling, that's now been frowned upon for business reasons alone because we found ways of communicating without necessarily needing to go anywhere and meet people in their offices. We could do it electronically. And I think that's been amazingly useful. That has of course also encouraged people to work from home a lot more. They got used to doing so during Covid, but of course it was only the people who could do it. Remember health workers and lots of others who kept the economies going, had to go out to work so they didn't benefit the same way that those white collar workers have benefitted from this because now of course it's become quite entrenched. Hybrid working has become the name of the game. Laws are changing in terms of workers' rights to allow flexible working from day one. Well, the truth is our flexible working helped productivity quite significantly. All the studies suggest that the problem we've got, and the reason why a number of firms are trying to get people back is first of all, of course all their offices, if they're left empty, commercial real estate suffers quite significantly. And loads of businesses that depend on people going into work also suffer. We saw a huge decline in the use of transport at the beginning. Lots of companies were not doing very well, rail companies and others, is one of the reasons why the government has intervened taking over either ownership or changing the way in which rail companies are run, for example. So you've got that problem, but we also have a serious issue about how you manage people. The reason why people are encouraged to go back to work is because I don't think HR systems are developed enough to be able to supervise or at least feel reasonably happy about what people are doing when they're not in the office. That does not mean that one has to develop real controlling measures. You know, check every movement you make in your house or wherever you are, but trust in your employee is really what needs to happen. I think that's very welcome. It's one of the good things that we have seen come out of Covid and even though people have tended to go back up to a point, I think there's a big percentage which is going to remain hybrid.
29:18 - Will lockdown affect our future civil liberties?
Will lockdown affect our future civil liberties?
Jon Silverman, University of Bedfordshire
What did lockdowns to civil society? The restrictions introduced in 2020 curbed freedoms to an extent that had not been seen since the Second World War. Has this softened our stance and eroded our resistance towards defending our rights in future? Here’s Jon Silverman who used to be the BBC’s home affairs correspondent and is now emeritus professor of media and criminal justice at the University of Bedfordshire…
Jon - The Coronavirus Act 2020, which came in fairly soon after the pandemic became known, was probably the most draconian set of laws that this country had introduced outside of wartime. And because the virus was spread by contact through people, it really was based very much on restricting people from meeting other people, from moving around, from gathering outside in public places. And that had a wider impact, of course, in terms of businesses being shut down, restaurants, places of entertainment being closed, and people being restricted to their own household, or at various times where measures were lifted a little bit meeting people in other households. So in terms of societal impact, it was absolutely extraordinary. And of course, that did have consequences for arguments around civil liberties. I mean, in a functioning democracy such as the UK, human rights, the European Convention on Human Rights are a kind of foundational text, respecting the right to family life and private life and assembly and that kind of thing. They were basically ripped up.
Chris - Indeed. And in fact, even when some liberties were allowed, like going for a walk, it seemed almost like there was a draconian police response. One is minded of the two women who went for a walk and a coffee and were accused of having a meal together almost. I mean, there were police issuing people with drones. That seemed uncanny.
Jon - It was, and of course the police were put in a very invidious position. We don't have a national police force in this country. And what made it even more confusing was that individual regional forces imposed different interpretations of the laws. So some police chief constables were fairly laid back and tried not to intervene too forcibly. Others, as you say, were patrolling parks and arresting people and finding them for maybe having three people involved in a picnic when only two people were allowed to gather together. So this did have terrific consequences, I think, in terms of people's confidence and trust in the police, because policing by consent is a watch word of many liberal democracies such as the UK, and there was very little consent to be seen during the lockdown periods.
Chris - Were you surprised that people by and large just went along with it?
Jon - You know, if one takes a wider look at how people react in times of great fear, we've seen it during terrorist campaigns in this country during the 1990s. It was seen after 9/11 in the States when flights were grounded and people, again, were restricted in terms of movement. People are prepared to accept curtailment of individual liberties when they are scared, when the evidence that's presented to them suggests that they're going to be better off by staying in their own little bubble, and less at risk than meeting other people. I mean, that was certainly the situation early on. And I think most of the media, whether it was on the right or on the left, took the same view that protecting individual health and society's more general health was paramount. I think it was only after a time, and there were various waves of lockdown when bigger considerations came in about how civil rights are being limited during these sorts of campaigns. And people began to think, is the trade off worth it?
Chris - Obviously, the thing that concerns a lot of people who look at things like civil liberties is that once you've done it once, there's an argument that it sort of softens us up. It makes us a bit more receptive and susceptible to just accepting more of the same again or later. Because you said, well, it's a bit like what happened during the pandemic, and it almost becomes normal.
Jon - That's certainly a strong argument. I think, in this country, as I've suggested, there were certainly in the latter stages of the various lockdowns very strong cases being put forward for creating much more room for civil rights for people to be able to gather in public protests and that kind of thing. We saw a big protest over the murder of a woman called Sarah Everard, as it turns out by a police officer. And when the police intervened to prevent a big demonstration by women, they were heavily, heavily criticised. And I think, you know, in future, if there was another pandemic or a reason for locking down, I think it might even be the reverse, that there'd be less support for the kind of restrictions that we saw this time. Because I think we know an awful lot more about how lockdown restrictions can impact adversely on communities which are already marginalised in some way and make life a lot worse for those people who are discriminated against anyway. And there were far more cases of domestic abuse because people were confined to their homes. I don't think these considerations are going to go away, even if there is another overriding reason to curtail liberties. My feeling is that in this country anyway, there would be a strong resistance to the kind of measures we saw last time.
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