by Dr Tom Wingfield, Reader in Tuberculosis and Social Medicine, Deputy Director of Centre for Tuberculosis Research, LIV-TB Lead, and Honorary Consultant Physician in Infectious Diseases and General Internal Medicine
I started at LSTM in June 2019 as a Senior Clinical Lecturer. This was an exciting – but daunting! – new position, spending one half of my time as a new hospital doctor consultant on the infectious disease wards in our local hospital and the other half doing research.
Six months later, just as I was starting to find my feet, COVID came along. No matter how many years of training any of us had had as healthcare professionals, I don’t think anyone could have been fully prepared for the months that followed.
I had three main roles during the initial wave of COVID in the UK. First, helping to mobilise the emergency response at LSTM to protect staff and students. Second, playing an active clinical role in our unit, which is part of the national High Consequence Infectious Diseases (HCID) team. Third - which was very new to me – conducting media interviews and writing broadsheet pieces to help the public understand what was going on.
This third role rapidly became one I felt really passionate about and committed to. I've always believed in public and community engagement and COVID exemplified why this was critical. There was a mountain of misinformation (and some disinformation) about COVID, especially in the massively changing landscape of the first year and on social media. I became increasingly convinced of the public health benefit of this engagement. However, interviews and writing were outside of my normal duties and way beyond what I usually felt comfortable with – but on a local, national, and even international level at times, it proved extremely important.
TB and other diseases
As well as a clinician, I’m also a TB specialist and researcher. During this time, I tried my hardest to keep our international TB projects going, but it was very difficult. It is commonplace in science, even during ‘normal’ times, that emerging infectious diseases and the latest potential silver bullet or new technology dominates the headlines. This often means that we forget a lot of other globally significant diseases, especially those concentrated in low- and middle-income countries. During COVID, I felt this acutely. We did not appear to have learnt the lessons from previous outbreaks to prepare ourselves adequately for COVID. For example, the critical response to Ebola in West Africa in 2014 showed not only the importance of working with and harnessing trust of communities but also the perils of prioritising a single disease: malaria deaths increased because the focus was, understandably, on Ebola.
During the COVID pandemic, many other health and social conditions and inequalities were put to one side – and that was hard to deal with. Complex diseases like TB - that has been around for thousands of years - didn’t go away, they were just neglected.
Of course, it was the right thing to put the resources that we did into developing treatments and vaccines for COVID. But any pandemic plan must include how you maintain and promoted equal health and social care access for all people with any condition or circumstance.
It may not have been so obvious at the time but the repercussions of COVID will be felt for decades to come in terms of physical and mental health and wellbeing, and also socially and economically. Indeed, last year, TB has since regained the unenviable top spot of being the leading killer from an infectious disease globally, ending one person’s life every 25 minutes.
Legacy
During COVID, we all became familiar with seeing scientists and healthcare workers dominating the airwaves. A positive legacy of this is that people’s general engagement with health and science is probably much higher now than it was pre-pandemic. However, the sheer amount of information available and circulated on social media was - and remains - a concern, making it much harder to sort the wheat from the chaff.
In the Liverpool region, we can address this by building on the trusted relationships that grew very strongly here during COVID, when we had senior figures from LSTM, the local authorities and hospitals appearing in the media and online. This kind of work is an opportunity to see and hear from people who are living and working in our community and who care about our community. In reality, there is no “them and us”, we are all just people trying to get by and support each other.
We also saw some great partnership working in the city between our scientific, educational, health and public bodies during the pandemic. What we now see through the Knowledge Quarter and the innovation in the city, and the projects like HELP and ReCITE that are looking to reduce the frankly stark health inequalities that we have as a major urban centre in the UK have their roots in partnerships created or built up during COVID.
Learning the lessons from COVID and building on some of the collaborations that were forged during this terrible time are both critical. We can and must use these lessons and collaborations as a force for good to improve our health and wellbeing now and protect it in the future, both in Liverpool and around the world.