#shortthoughts In current arguments I don't believe we always distinguish sufficiently between the effects of lockdown & the effects of the pandemic. It's also easier to 'blame' the lockdown because it represents our own frustration – & allows for anti-government sentiment /1

In the past few days, healthcare practitioners have highlighted worrying drops in primary healthcare visits and testing/compliance for TB & HIV in particular. This is often framed as a consequence of the lockdown – but it's actually/also a consequence of the pandemic /2

By which I mean: people are avoiding clinics not because they are 'locked down' but because they are worried about getting sick with COVID at the clinic.

+ If we had not locked down & had a wider + larger initial wave of infections, many clinics *would* have been affected /3

(We know that healthcare workers are at high risk for exposure & infection, and even under lockdown we have seen pharmacies, healthcare facilities & hospitals close when staff became infected. Imagine how many MORE facilities would have closed with fewer controls?) /4

On this thought: imagine if we had not stepped in to limit [the rate of] the initial infections – we talk about how unpleasant it is that elective surgeries have had to be put on hold, but (again) this is not because of lockdown. This is because *we are living in a pandemic*. /5

Even now, we have seen the knock-on effects of infections in many areas: police stations shutting, home affairs offices closing when staff members test positive. This is because of the virus, not the lockdown.

Now imagine if that was even 10x more widespread?

/6

At this rate, weekly birth and death data is not useable because of home affairs closures, and people delaying or not being able to file birth and death notices.

Again, this is an impact of the *virus* not the lockdown.

/7

There is no doubt that the trade restrictions and regulations of lockdown have had a specific & negative impact on people's incomes, and on their ability to access services including social services, food, etc.

/8

But many of these effects are linked to the pandemic, not (only) the lockdown. Plus without a lockdown the effects of the pandemic would be much larger – and would also trigger/exacerbate poverty, hunger, lack of access to services etc. as more people became ill.

/9

This isn't a 'lockdown at all costs' thread. Just a reminder that – if you want to look at the root cause of several of the most concerning issues right now – it's because of the effects of the pandemic, even at this early stage, not lockdown.

/10

And while humans can change the conditions or regulations of lockdown, changing the impacts of the virus are going to be a lot more difficult. You don't get out of dying like going from level 5 to level 4.

/fin