Life after Lockdown: Interview with Linda Bauld

Linda Bauld on her optimism for the coming months and her concerns about the long-term challenges the pandemic will leave behind

Before the pandemic, Linda Bauld was a frequent flyer, regularly clocking up thousands of miles a year in the course of her work.

And it was important work. In 2017, she and her colleagues were awarded funding to examine the public health implications of tobacco use in Africa and South Asia, research which followed on from her earlier studies into the impact of UK policies such as England’s smoking ban.

Bauld says she was travelling so much that her husband bought her a fridge magnet which accused her of being solely responsible for climate change.

Since last year, however, in common with the rest of us, Bauld’s travelling has come to an abrupt halt.

A regular contributor on TV and radio, the Edinburgh University professor has become one of the reassuring voices of the pandemic, helping explain often difficult ideas of science and public health to an anxious public desperate for information. 

And she’s under no illusion as to where the biggest risk to the continued success of the vaccine rollout comes from.

“If I had to point to a single thing that concerns me, in terms of our policy response not how the virus behaves, it’s what we do with international travel,” she says.

“I’ve talked to Edinburgh Airport and it’s just all awful for that sector, but that’s where we are. 

“We’ve become used to going on foreign holidays. I think it’s reasonable (at this point in the pandemic) to say it’s unwise and we should have guidance that says going abroad for a holiday this year should be strongly discouraged and that a quarantine system needs to stay in place.”

Bauld says a ban on all international travel is impractical, but she believes the public should be discouraged from taking foreign holidays.

She says the decision to open up for travel last summer was one of the factors which led to the second wave and the winter lockdown, a scenario which we should all been keen to avoid repeating.

“The genomics studies from Wales and Scotland show very clearly that we re-seeded new lineages of the virus from international travel, particularly in July, August and September. That directly contributed to the second wave. We caused harm to ourselves.”

Born in Scotland, Bauld spent her teenage years in Canada, a formative experience which can still be heard in her transatlantic accent.

After completing a degree in political science at the University of Toronto in the early 1990s, she returned to Scotland, earning a PhD in social policy at Edinburgh University.

Her easygoing style and ability to explain complex, and sometimes worrying, developments has made her a go-to pandemic pundit for the media.

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If I had to point to a single thing that concerns me, in terms of our policy response not how the virus behaves, it’s what we do with international travel.

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But while she has spent much of the past year commenting on the public health response to the virus, she has also seen first-hand the impact it can have. 

“My uncle went into hospital with it and was in hospital for a couple of weeks. He didn’t have to go on a ventilator; he was on oxygen. He made a full recovery and has been back at home for a couple of months now.

“There’s no one in my family who has become very unwell or passed away. The kids have been tested a couple of times either due to contacts or symptoms, but I have been well throughout. The biggest impact on me is that I’ve had six days off since February 2020 and that includes Christmas.”

Bauld’s university colleague Devi Sridhar has faced criticism on social media, including from MSPs, for airing her views on the politics of the pandemic, notably that an independent Scotland would’ve done better at meeting the challenge.

And while Bauld does her best not to stray into overtly political territory, she does makes it clear that she believes mistakes have been made.

“Public health is always political,” she says.

Asked if she thinks the successes have been scientific and the failures political, she says: “I talk about a system failure because it’s not just politicians. There are a lot of people in the system who might have taken a different approach or adopted a different strategy earlier on. 

“I think there are some differences between the UK and Scotland, particularly in the second wave, when there were lower levels of mortality in Scotland than elsewhere and that’s because of a more cautious approach.

“The slower easing [of restrictions] and the more rapid response when there has been a rising number of cases. The communication with the public up here has been better and you can see that from the UCL social study that happens every couple of weeks. The trust in the Scottish Government is significantly higher than in England.”

For all the UK government’s undoubted failures at the start of the pandemic, the one bright spot of late has been the vaccination programme.

At the time of writing, nearly 28 million people in the UK – more than half the adult population – have received at least one jab. 

According to statistics from Oxford University’s Our World in Data, Britain has vaccinated a higher rate of the population than just about any other country on earth, far outstripping neighbouring countries in Europe.

The UK has vaccinated a higher proportion of its population than any other country in Europe

Yet all that good work could be undone by a growing prevalence of problematic variants against which the vaccine is less effective.

Even more worrying is the emergence of a new variant which renders the current vaccines useless. 

That is a growing concern amid an uptick in cases in continental Europe, where the vaccine rollout has been slower.

Bauld, however, thinks that for the time being at least, we are through the worst.

“I’m really optimistic about the next six months. The vaccine rollout is going really well, and I’m hopeful that I’ll get away for a week in July, somewhere in Scotland. I’m really hopeful that my son, who’s been unemployed since he left school last year, can get a job this summer before he goes to university and that many people will have more opportunities. 

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Someone asked me if we need to continue with hand washing – why would you not continue with hand washing? You should have been washing your hands anyway.   

 

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“We have to see what the autumn and the winter bring, but we’ve learned a lot. I’m really hopeful that for the university sector, we can have our students back and get back into lecture halls.”

But while the most immediate threat from the virus will hopefully recede in the short term, the long-term impacts on education, on employment, and on health will continue to be felt for some time, Bauld says.

While there has been much discussion of the long-term impacts of COVID on the body, Bauld says she’s more concerned with other illnesses which have continued to rage unchecked as the NHS battles the pandemic.

“To be perfectly frank, I’m much more worried about all the other conditions that people have not been treated for over the last year. The burden of disease for those individuals is going to be really substantial.

“I’m still seconded to Cancer Research UK as their cancer prevention adviser and it’s very clear when it comes to cancer, that early diagnosis is key to survival.

“There will be hundreds in Scotland, thousands around the UK, who have either developed a cancer during this period and it’s not been picked up, or they’ve not been treated. Therefore, there will be directly attributable mortality related to non-treatment. There will be people dying from cancer who might have survived for longer.”

But could the impact of the pandemic be even more profound, potentially reversing some of the public health advances that have been made under devolution as a result of interventions such as the smoking ban or alcohol minimum pricing?

“Inequalities in health have been made worse during this pandemic,” Bauld says.

“We’re going to have a legacy of that which we’ll be dealing with for some time to come. I don’t know if there’s a direct impact in terms of undermining smoke-free legislation, for example, but I do think life expectancy has stalled and I don’t think that’s going to improve soon.

“I think the long-term implications are from the economic and social impacts of the crisis. There’s research that suggests the 2008 recession caused about 900,000 cases of preventable illness.

“Unemployment causes health harm, so we will have harms associated with the economic crisis that we’re in now and will continue to be in for some time to come.

“Then there are the mental health impacts of the pandemic which will be chronic for some individuals, particularly those who already have a long-standing mental health condition.

“And then the loss of education could affect the speed with which some young people are able to move into employment and realise their potential. All of those things will have harms.”

But if many of COVID’s legacies give cause for concern, there is one recent development which Bauld believes should continue even after the pandemic: the wearing of face masks.

Common in Asian countries, including those which have done well in terms of limiting the impact of COVID, face coverings have proved a contentious issue in the UK ever since the government gave its belated backing to the wearing of them last summer. 

While not universally popular, Bauld believes masks will continue to be worn during the winter months by the elderly or those particularly at risk.

“It’s kind of a no-brainer,” she says. “Why would we not encourage people to wear them, particularly older and more vulnerable people in the winter months? If you go to Hong Kong, that’s what they do. 

“It’s a very emotive issue, but I think there may be a cultural shift. I would be pretty confident that an older, more vulnerable person will wear them by choice.” 

Bauld says that if the number of infections remain low, then most of us will be able to return to something approaching normality during the summer.

“I would expect, if things continue to go well, that we would have most things open. The exceptions to opening will be big mass gatherings. There will be some exceptions to that – the pressure to get the Euros and other events running is huge. You will need testing, probably vaccine certification, for those events. I think mass gatherings are difficult. Nightclubs? I don’t know. The nighttime economy is another tricky area. 

“We need to have a preparedness plan for the autumn and winter. The vaccine is not 100 per cent effective, children are not going to be vaccinated, so we will probably have flare ups and will have to take action.”

But if the past 12 months have been hard, Bauld says the pandemic has shown us that small changes can make a big difference, with social distancing and mask wearing all but eliminating flu over the winter.

She laughs as she recalls some of the questions she’s been asked over recent weeks.

“Someone asked me if we need to continue with hand washing – why would you not continue with hand washing? You should have been washing your hands anyway.”