What major health risks does the UK face in the years ahead - and what can be done to reduce them?

1. PANDEMIC VIRUS 

In today’s globally connected and ever developing world, Covid-19 will probably not be the last pandemic. The threat of another novel viral pandemic remains high.

Increasing population mobility, urbanisation and encroachment on wildlife habitats increase the risk of a virus spreading from animals to humans - the source of many epidemics and pandemics. Although these viruses rarely present serious harm to their host animals, they pose serious risk to humans, who have no natural immunity to them.

This risk, combined with a high level of transmissibility, can result in pandemic. Failure to act rapidly can have serious consequences for both people’s lives and livelihoods. For example, in just 3 months, Covid-19 has: 

  • caused nearly 40,000 deaths in the UK, including the deaths of 106 healthcare workers
  • had a major impact on businesses, the economy and people’s livelihoods - with many jobs looking likely to be lost 

How can we reduce the risk of a novel pandemic virus? 

PREVENT: Reduce the likelihood of cross-species transmission of disease, by:

  • Limiting contact between humans and wild animals
  • Implementing flexible surveillance strategies for the emergence of novel disease, particularly in areas of high animal-human contact
  • Supporting global action to restrict the trafficking of wild animals and dangerous wildlife consumption practices 

PREPARE, by:

  • Taking public health seriously, making healthy choices easier for people, to reduce preventable illnesses that can significantly increase the risk of mortality in a viral pandemic
  • Ensuring the NHS can cope – with enough trained health professionals and sufficient PPE, CPAP machines and ventilators
  • Establishing a robust UK diagnostics industry to enable rapid, large-scale testing
  • Being ready to rapidly close borders or introduce quarantine for those entering the UK

 

2. ANTIBIOTIC RESISTANCE   

Over time bacteria can develop resistance to antibiotics due to excessive and irresponsible use. This makes infections difficult to treat, with potentially fatal consequences.

Before antibiotics, an estimated 50 in 1000 women died during childbirth and infectious diseases, like TB, pneumonia and diptheria, were leading causes of death. Without the use of effective antibiotics, surgery, minor injuries and common infections will once again become common causes of mortality.

That’s why antibiotic resistance has been declared ‘one of the biggest threats to global health’ by the WHO. 

The discovery of novel antibiotics has declined over the last few decades and is beginning to fall behind the rate at which bacterial resistance is emerging. In 2018, an estimated 60,788 antibiotic resistant infections were recorded in England, a 9% rise from 2017. 

If no action is taken, bacteria will continue to develop resistance, causing some antibiotics to become redundant in just a few decades time. 

How can we reduce the risk of antibiotic resistance?

The threat of antibiotic resistance can be reduced by decreasing the number of opportunities for bacteria to develop resistance - through minimising the risk of infection and using antibiotics responsibly. 

Healthcare professionals can take steps to reduce the risk. For example: 

  • Doctors and dentists should only prescribe antibiotics when there is a genuine need – and ensure that patients understand they must complete their course of antibiotics and never share their prescription with others
  • Both healthcare workers and patients should take all reasonable steps to reduce infection - by ensuring hands, equipment and environment are clean in healthcare settings and by patients having recommended vaccinations, washing hands frequently and covering coughs and sneezes. 

The agricultural industry must ensure antibiotics are used responsibly. This includes: 

  • Vaccinating livestock and ensuring high levels of animal hygiene to reduce the risk of infection and subsequent demand for antibiotics
  • Stopping the unnecessary use of antibiotics to promote livestock growth or to prevent infection in healthy animals – and only administering antibiotics to animals under veterinary instruction. 

To combat antibiotic resistance, there is a need to invest in the discovery and production of new antibiotics to reduce the burden on current antibiotics, as well as investment in the development of alternative therapies that don’t encourage antibiotic resistance. One potential alternative therapy is the use of bacteriophages: viruses which kill bacteria. Despite some promising studies, further work is needed to develop this therapy to ensure its safety and effectiveness.

 

3 AIR POLLUTION

Research over the last three decades has linked respiratory and cardiovascular disease to pollutants emitted from agriculture, industry, domestic fires and road transport.

The World Health Organisation (WHO) has classified diesel engine exhaust, particulate air pollution and outdoor air pollution as carcinogenic. Additionally, pollutants, such as NO2, SO2 and particulate matter (PM), are associated with acute and chronic pulmonary and cardiovascular health problems. Recent studies have also suggested that exposure to PM is a risk factor for type 2 diabetes.

Short term exposure to air pollution can exacerbate asthma and increases hospital admissions due to cardiovascular or respiratory problems.

Long term exposure can increase the risk of lung cancer and other respiratory conditions, stroke and cardiovascular disease, and is estimated to cause between 28,000 and 36,000 deaths annually in England.

How can we reduce the risk air pollution poses to health?

In 2019, the government’s Clean Air Strategy set out plans to improve air quality in the UK. This included closing all coal power plants by 2025 and banning the sale of new petrol, diesel and hybrid cars from 2035. This should reduce the risk of air pollution in the UK over the coming years. However, further improvements are required to significantly reduce risks further. For example: 

  • Government provision of efficient and reliable low emission public transport
  • Development of sufficient infrastructure to support widespread use of electric and plug in hybrid vehicles
  • Continued investment in the R&D of cleaner technologies within industry, farming and transport sectors e.g. the development of low emission fertilisers, tyres and brakes
  • Prohibiting the sale of highly pollutant fuels and improving public awareness of the health impacts of domestic burning

Alex Ellicott June 2020