GPs fear 'tsunami' of mental illness if Covid-19 shielding extended
Extending the shielding period for vulnerable people in Northern Ireland will have a "significant impact" on their mental health, a leading GP has warned.
Dr Laurence Dorman, chair of the local branch of the Royal College of General Practitioners, said GPs across Northern Ireland were bracing themselves for a "tsunami" of mental health cases after the easing of lockdown.
Dr Dorman spoke out after Professor Ian Young, the Department of Health's Chief Scientific Officer, said that in the absence of a vaccine or effective treatment, vulnerable people may have to shield for a year.
"I think there will have to particular cautions taken around shielding for quite a long time," Mr Young told BBC Radio Ulster's Nolan Show.
Approximately 80,400 people across Northern Ireland have received letters from advising them to self-isolate and remain indoors for 12 weeks.
The letters were only issued in April, but pressure to extend the period is already mounting on the Department of Health.
At yesterday's daily Covid-19 briefing, Health Minister Robin Swann urged people with letters to continue shielding and said the Executive would consider extending the isolation period.
"That is something that we as an Executive will look at when that advice and guidance comes forward and when that additional period of 12 weeks comes to an end," Mr Swann added.
"When we ask someone to shield, it's not about removing themselves from the community and it's not about taking themselves away from their family or loved ones. It's about shielding them from the virus itself so we can protect their lives and support them in doing that.
"There is a role for the wider Executive to play in regards to how we support people with food boxes, community pharmacy deliveries and looking at where we are on our program to see that those who are shielding can be given additional support or access to loved ones or family members, even should that be to a closed numbers of individuals."
Dr Dorman, meanwhile, told this newspaper that shielding was having a huge impact on vulnerable people's lives. "It's massive. If you are full shielding and you live with someone else, you have to be in a separate bedroom and you have to eat your meals on your own. It's really, really tough. Those are very stringent and difficult circumstances," he said.
"At the moment, it's an initial 12 weeks. If that is to be extended, it will have a significant impact on people's mental health."
He stressed that doctors were already beginning to see the adverse impact of the lockdown on the population.
"GPs are very keen to offer support and we're already seeing an increase in our workload on mental health, particularly the low moods and depression," Dr Dorman said.
"But we also know the population is at an increased risk of domestic violence and increased risk of alcohol consumption, so all things tie into the holistic health of our population."
He stressed his peers were poised to support those who required mental health support and maintained that any decision to extend the shielding period would be made by the Executive. "In general practice, we are very keen to support people through this, whatever is decided at a higher level above us," he added.
Dr Dorman said some GPs would be relying on their multi-disciplinary teams - made up of a physiotherapist, social worker and mental health practitioner - to offer support to those who need it.
"Those social care and mental needs will be massive. We can see a tsunami of mental health needs coming down the tracks in primary care," he explained.
Brian Bell and his wife Phil, both in their 80s, started shielding on the advice of their family nine weeks ago, when the first community case of coronavirus in Northern Ireland was reported.
Since then life has been very different for Mr Bell, who despite living with Parkinson's enjoyed an active life, including the gym, shopping and daily Mass.
From his home in Eglinton, Mr Bell said not being able to spend time with his family remains the biggest struggle.
"Along with our family we decided to shield as soon as the first community case of coronavirus happened because my wife and myself have underlying health conditions," he explained.
"I have Parkinson's and my wife is a recovering cancer patient.
"Before March 14, I was very active and went to the gym for a swim on the recommendation of my doctor.
"I also went into Derry shopping and I drove to our local chapel for daily Mass and it has been frustrating staying inside.
"We are lucky in that we have a garden and I am a keen gardener so being outside has helped enormously.
"I learned how to make better use of the internet so we watch Mass on the webcam and we have had video calls with our grandchildren. It is great to have that, but nothing beats the real thing.
"We have two new great-granddaughters we have not met yet and we marked our 59th wedding anniversary - all big family occasions that couldn't be celebrated.
"We are thankful to be safe and well, which is the main thing, but we're eagerly looking forward to the day we can open our front door and our family can come inside for hugs."
Jonathan Bell, a Belfast Telegraph journalist, has had to shield with his family after one of his children received a letter.
He said it was important to remember that not all of the 80,000+ who have been told to shield are elderly.
"Our entire household is shielding because our four-year-old, Conan, received the letter," he explained.
"He's been told to minimise his time with others, avoid face-to-face contact, eat on his own, use different utensils, towels and even bathrooms.
"He is to keep two metres away from everyone. He's only four, so it's impossible. And we have two others, aged six and seven months. So we all shield to protect him.
"Conan is our little barbarian - sometimes he thinks he's too tough. He has had minor complications with regulating his temperature and chest problems. He is on inhalers and tablets and is possibly asthmatic. Although we are told he is too young to be diagnosed."
Jonathan said that when the letter arrived advising his family to shield, "ice flashed down the spine".
"And when the roadmap out of lockdown only mentioned shielding twice - that it was tough on them and they should not meet up with family members in stage one - there was a hot flash of anger," he added. "The information for those shielding has been nothing but overarching and general. And they are supposed to be among the most vulnerable.
"There has been suggestions if someone had to go to school, they should go and stay with someone else. And with relatives also shielding, there is not that option for us."
He added: "Those shielding are yet another group that have been forgotten about and more needs to be done."
Walter Mitchell has lived in self-isolation for the past seven weeks. Now the 83-year-old from Co Armagh just hopes the world returns to normality as soon as possible.
Walter, from Lurgan, and his wife Eileen (85), have been prevented from doing their everyday activities and leaving their home due to the Covid-19 lockdown.
Mr Mitchell, who regularly attends church and his beloved Glenavon Football Club, misses the social aspect of getting out and about.
"I haven't been out in seven weeks and I miss taking the dog out for a walk and going out in the car for a wee run," he said.
"I would have walked the dog, gone to Mourneview Park or gone to church and things like that.
"I would have gone shopping with the wife and taken her to the hairdressers. I miss my football something desperate. It's not just the game of football, it's the socialising with it.
"I miss going to the Glenavon Triangle Supporters Club. I really miss going to Lurgan park too.
"I'm 83 now and my wife is 85 so we just can't get into the car and go down to the park.
"My children and grandchildren would come to the door and see us but they keep their distance and stand at the gate, which is 10 yards away."
Looking to the future, Mr Mitchell is hoping the lockdown in Northern Ireland can be lifted sooner rather than later.
"I just want everything to get back to normal as soon as possible," he added.
"I would just love to get out, take my wife to the hairdressers, go to the barbers myself, go down the town for a wee dander and a walk and meet all my mates down there."