https://www.bbc.co.uk/news/hea...4483547?xtor=ES-211-[36459_PANUK_NLT_41_ENG_TheTrumpShow_RET_O35]-20201012-[bbcnews_doctorsdiaryaheartbreakinginsightintotheimpactoflockdown_coronavirus]

A survey of 2,000 families in Bradford indicates just how bad lockdown is for health - and how being furloughed is enough to tip those on the lowest incomes into financial difficulties. Dr John Wright of Bradford Royal Infirmary considers how to achieve the twin task of protecting people from the virus, and from poverty.

The city is bracing itself for the next surge. The incidence for the last seven days has climbed to 270 per 100,000 but not as steeply as our neighbouring northern cities, where rates are approaching 600 per 100,000 - perhaps a result of early restrictions in Bradford, perhaps just a question of time. Testing in the community is also showing a higher rate of positive results - 17%, compared with 8% a month ago.

After three months of relative calm in the hospital the number of patients on the wards with acute Covid-19 has steadily risen to over 70. Our mortality rate is lower, due to more effective treatments, but sadly and inevitably it will also rise in the coming weeks. There is a physical and mental weariness among the staff, though no dip in the compassion that guides them.

Over the last six months my diary has tried to capture the remarkable stories of fear and bravery from staff and patients at Bradford Royal Infirmary. My lens as a hospital doctor has inevitably focused on the clinical and health impacts of Covid-19. But while the pandemic was receding we looked up from our drug charts and test results to explore the impact of the lockdown and the pandemic on the rest of the city.

Ten days ago we published the results of our survey of over 2,000 families in our Born in Bradford research study. As the virus continues to spread across our communities and the number of patients admitted to hospital continues to slowly rise, the results of this study provide a heart-breaking insight into the impact of lockdown on lives beyond the hospital walls.

These are some of the key short-term experiences of families living in the deprived and ethnically diverse city of Bradford in the period from 23 March onwards, as revealed by the survey.

• One in 10 said their food didn't last and they couldn't afford to buy more, so they were eating less or skipping meals entirely
• One in 10 said they had real concerns about being evicted or having their home repossessed
• One in three said they were worse off and 37% said they were worried about the job security of the main earner
• One in five mothers had clinically significant depression and one in six had clinically significant anxiety - many also raised concerns about the mental health of their children
• One in three mothers said they were lonely some of the time, and one in 10 said they were lonely most or all of the time
• One in six mothers said they were worried about their health most or all of the time

Financial, employment and housing insecurity were all particularly common in those where the main earner had been furloughed, was self-employed and not working, or was unemployed.

While the furlough scheme and support to self-employed workers was designed to provide support during this difficult time, our findings suggest that the loss of 20% of a low-income wage may be enough to tip families into financial difficulty, and potentially further exacerbate health inequalities.