The view from here: A family doctor’s perspective of a population under lockdown

As a family physician witnessing the direct and indirect effects of COVID-19 lockdown measures on my patients, I have become increasingly disturbed by the continued use of policies without careful consideration of their effects on people’s health. If we were to weigh all health outcomes, not only deaths due to COVID-19 – be it  years lost due to delayed cancer diagnosis, opioid overdoses, trauma from child abuse, domestic violence or suicides – would we continue blunt, sweeping lockdowns as our main public health strategy?

Despite mounting evidence that the lockdowns are having negative effects on our health, this is not being substantively reflected in the current discourse. This is not to deny the terrible health outcomes of COVID-19 infections; they are real and have been amply documented in both the press and the scientific literature over the past year.

Among my patients, however, the acute challenges created by lockdowns are much more apparent than the effects of COVID-19. I see patients with severe mental health problems experiencing worse symptoms and people with little or no history of mental health diagnoses suffering symptoms for the first time. These patients come to me often disconnected from family and friends and meet a health-care system with fewer resources for support. I suspect, as do many of my peers and patients, that contributing to these outcomes are isolation, the incessant media narratives promoting fear instead of rational caution, and the inability to access mental health protective activities, including exercise facilities, religious services, support groups, gatherings with friends and escape from stressful home environments.

I hear parents describe crippling anxiety in their children, some from fear of contracting COVID-19 and others from depression due to lockdown rules. With school closures, these problems are compounded, especially for my patients who experience marginalization due to poverty. They cannot afford childcare and most do not have paid sick leave or the luxury of working remotely. With fewer resources and therefore less support for remote learning, their children suffer. I am concerned about a widening gap in the performance of children from low- and high-income households, undermining a primary objective of an equitable public education system. The lack of consideration of these outcomes is in stark contrast to our society’s supposed growing awareness of the effects of poverty, the importance of access to education and the effects of trauma and its ability to transcend generations. It is surprising that public health officers have largely ignored these facts.

The health-care system as a whole is affected. For example, cancer screening, including mammograms, colon cancer tests and pap smears, were put on hold for months. And now, even after positive screening results, there are delays in obtaining specialist appointments for potentially curative surgeries or procedures. For decades, we have championed the importance of cancer prevention through early detection and treatment. This too is being undone and will undoubtedly have a human cost. The question is how much. 

Through a forced sedentary lifestyle and isolation, the lockdowns are also having a toll on chronic diseases such as diabetes and hypertension. For example, key components of the prevention and control of diabetes include specific dietary measures and adequate exercise. I have seen years of prevention and control undone in months through reduced physical activity coupled with poor mental health that results in poor food choices. Importantly, chronic diseases are known to have a transformational effect on patients’ lives, both physical and psychological. For many of these diseases, this regression can lead to irreversible outcomes. 

As we enter the second year of the pandemic, I am experiencing a deep dissonance between ethical family medicine practice and the continued promotion of sweeping lockdowns by health professionals leading the COVID-19 response. I suspect this is a question of training. Emergency situations require a unique skill set: immediate action with singular focus. This is in direct contrast to family physicians who are skilled at weighing the long-term benefits and trade-offs of proposed treatments with both scientifically based evidence and the subjective experiences of patients. The patient decides, with the help of a physician, which costs they are willing to bear. Inherent in this is the capacity to hold ambiguity and uncertainty.

Family doctors are trained to consider not just mortality and morbidity but quality-of-life measures. To see a life as something more than to just sustain and “keep alive” has become a pivotal value of family medicine. It is for this reason that any conversation regarding substantive public health measures must include the voices of those trained in making holistic considerations on equal footing as those providing emergency responses.

For this reason, I invite my colleagues to voice their clinical experiences, whether they are similar to mine or not, as these may be the only evidence we have at this juncture. In addition, I ask policy-makers to include the known long- and short-term effects of lockdowns on people’s health and well-being when planning for the future of this pandemic.

If not, I fear that the negative effects we are witnessing will be considered the unfortunate side effects of an appropriate COVID-19 response when in fact the response is one with poor consideration of preventable measures. Above all, I fear that the toll of the lockdowns may be worse than COVID-19 itself.

The author would like to thank Cristian Rangel, PhD, assistant professor at the University of Ottawa, Faculty of Medicine, for his guidance and contributions to this article.

The comments section is closed.

  • Suzanne Rerrie says:

    Very well put!

  • Linda Browne says:

    Hi Dr. Malhotra,

    I really enjoyed your article, although I do myself support strong lockdown measures at this time. I wonder specifically what kinds of measures you would like to see going forward? I’m assuming that equitable vaccine distribution and paid sick days would be of primary importance to the communities you work with. You also spoke very eloquently about inequitable access to quality of life, which COVID isolation measures have worsened. Are there more nuanced approaches to pandemics that you and other doctors think should become part of public policy in the future?

  • Brigitte Knapp says:

    Thank you for speaking out. This virus is hurting everyone. 4 young men in my connected circle have died of a drug overdose in the last 4 months. Seniors are languishing alone in nursing homes without a visit or a hug from their families. My kids are on remote learning (again) and hate every second of it. They are getting anxious and depressed and they are not alone. 5 families I know personally are facing financial ruin. Many more financial hardship with no end in sight. And mental health problems are through the roof. Yes, Covid is a nasty numbers are not the only metric to consider.

  • Jane MacDonald says:

    I don’t believe that family doctors have coped well and have served their patients well during covid. I have been a patient of a medical clinic for 47 years. I have seen my family doctor once in over a year now, just substitutes, trainees, locums,etc. I have had a hip operation which I basically arranged myself, virtual physio, now apparently my blood pressure is awol, I’m facing a knee replacement soon and there is just no continuity of care. I am 77 years old and I am in dispair.

  • Zeta says:

    It’s a crime against a nation to cover up well researched and proven drugs against COVID. There are entire hospitals in US and Europe that have 0% mortality due to use of generic drugs and implementing different treatment methods from Canada. Our government took huge kick backs to let private companies file for re-branding of these generic drugs and delay doctors from using them today. Isn’t what health care suppose to be about?

  • Dounia says:

    Bravo! This needs to be said and re-stated. Social scientists could also weigh in with their perspectives. This one thought approach with the absence of any consultation is against the democratic values of this country

  • Amanda Lac says:

    Thank you! I worry this too. I worry about our children who are being forgotten in this process.. Or the third world countries that are suffering due to the inappropriate response. Please be loud and stand up for our children

  • Christine Ross says:

    Please tell the truth about these so called vaccines as Netherlands has suspended their Astra Zenica due to blood clots. The main stream needs saying they are safe yet they are experimental.

  • Damilola says:

    Thank you for being courageous and going against the crowd. You’ve voiced out the thoughts I have had ever since lockdowns were implemented. It’s unfortunate that some people have decided to use this situation to their own gain, at the expense of the population. I always thought that before a policy or rule is enforced, it is evaluated to ensure that the pros outweighs the cons. However, it appears to be the opposite in this situation . I fear for the young ones who have had increased mental health issues due to this lockdown.
    Thank you once again.

  • Peter Frost says:

    Thank you for having the courage to speak out against the groupthink of eternal lockdowns and Covid Zero at all costs..

    It’s high time politicians and public health ‘experts’ employed mitigation methods other than the blunt instrument of blanket lockdowns.

  • Lori says:

    What is more germane than the experiences of doctors dealing directly with all the issues of Covid and being able to assess first-hand the differences between what’s happening now and what was occurring pre-Covid. The same applies to the patients coming in and relating their health problems (both mental and physical) to their physicians. Both doctors and patients can certainly determine the impact Covid measures and lockdowns have had on their lives (personal and working), especially with respect to health outcomes.

  • John says:

    Absolutely agree. We also need far more transparency and clarity. My sister died recently in care home. I do not believe she died with or from Covid but I cannot get the clinical details. These details should be provided together with the death certificate. Covid was on the death certificate.

  • Eva Ryterband says:

    Thank you for your article. The lockdowns are causing irreparable harm to all.
    Children, adults and seniors. This needs to stop now.

  • Michael says:

    Thank you for this article. I am 23 years old and have had feelings of depression, suicidal thoughts and heightened anxiety. This is directly correlated to my routine being taken apart as it was revolves around my daily exercise (going to the gym). It was a form of therapy like no other, a stress reliever, and a way to clear my mind. Without it I am broken, my physical body is deteriorating and mental well being took such a hit. I am still grateful to have a job however the rest of my life is in shambles.

    • Jen says:

      I’m sorry to hear about your struggles. Just wanted to remind you that this is not the new norm…
      The clouds will part soon enough to let the sun in once again. I feel for you because I also dealt with depression in my 20’s. I can only imagine how much harder it would have been if I had to live through this back then. You are not alone! The public is finally starting to see the big picture and push back more and more on these draconian lockdown measures! So better days are on the way!

    • Heather says:

      Hi Michael,
      I am sorry to hear about your experiences. You’re certainly not alone in what you’re going through (not that that makes it any better). The shakeup to our routines, especially our health routines, has been really difficult to adapt to, hasn’t it? The toxic narrative in the media also makes it hard to believe in things get better. They will. It’s coming. In the meantime, are you interested in connecting with people who are working toward making the Covid situation better?

      Have you looked into any of the health advocacy alliances, such as the Canadian Covid Care Alliance (https://www.canadiancovidcarealliance.org), Canada Health Alliance (https://canadahealthalliance.org) or Take Action Canada (https://takeactioncanada.ca)? These are non-profit, voluntary alliances started by health professionals and health scientists who are trying to get more honesty, clarity and critical analysis about the impacts of the measures on Canadians, Canadian society and global society. These alliances are eager to hear from young adults and engage them in the work they’re doing because your generation and younger are the ones who will carry the impacts of this for the longest time. They want to know what you and people like you are going through, what would be meaningful change and improvement to your circumstances. Of course, they also would love to have you involved, contributing to the efforts to move toward improvement in the situation. Change is so much more effective and meaningful if the people it is intended to help contribute to the improvement.

  • Vanessa Acheson says:

    I agree
    As a OR and endoscopy RN I am horrified at the damage done by lockdowns and restrictions to care. When I think of not only the tumors we find with regularity, but the pain and suffering alleviated by having access to surgery and therapeutic endoscopy, I begin to nearly panic for those denied access to care.
    OR time was already at a premium, with “ minor” cases like excruciating anal fistulas put on the back burner well before COVID-19…. so now what happens to them that we are so backlogged with cases?
    Worse, what are the consequences of cancelling and delaying swaths of procedures that would have found cancers?
    Our communities’ health is about more than COVID-19 and we clearly cannot thrive in a bubble. The decisions to lockdown our communities and in the process obstruct access to care was clearly unbalanced. From what I witnessed in the hospital, it was also misguided and lacked transparency as the care burdens described in the press did not correlate with what I witnessed in the hospital.
    Measures need to be put in place to ensure this never happens again
    I suspect the future will reveal lockdowns equivalent to bloodletting of days past

  • Nanik Lakhani says:

    You are absolutely right, Dr Sonia. Lockdown has caused a lot of hardship and stress not only for people with health conditions, even normal people are feeling loss of enthusiasm and are getting depressed.

  • CL says:

    We’ve all accepted the “Community Standards” in order to comment, but I’m posting them here for reference.
    Community Guidelines
    As its name suggests, Healthy Debate is a forum for the spirited exchange of differing perspectives. Allowing readers to comment on the articles we publish is critical to making Healthy Debate the sort of virtual public square where people from diverse backgrounds can weigh in on healthcare in Canada. To ensure that the discussions in the comments sections of Healthy Debate are productive, we require commenters to abide by the following community standards:

    Be respectful of the people with whom you disagree. If you wish to voice your disagreement, critique what they have written with clear, polite, and evidence-based counterarguments.
    Discriminatory, abusive, or threatening language will not be tolerated.
    Profane or vulgar language will not be tolerated.
    Conspiracy theories and misinformation will not be tolerated. We accept that evidence-based, analytically astute arguments over the accuracy of information are integral to the advancement of both science and journalism, and we welcome comments that contain this sort of pushback. But we will not tolerate comments that assert obvious falsehoods, like that COVID-19 is “fake.”
    Do not give medical advice or reveal the personal health information of others in a way that could identify them.
    Do not post irrelevant or off-topic comments.
    For a comprehensive list of our community standards, see our terms and conditions.
    We will remove comments that breach these community standards. We do not discuss comment moderation decisions on the site. If you have questions about our standards or believe one of your comments was improperly deleted, please email contactus@healthydebate.ca.

  • CL says:

    Some of the criticisms here are that there’s no proof of lockdowns causing more harm than good.

    I encourage people to do some research for themselves rather than unquestioningly absorb and repeat narratives. News is not a public service. It’s a paid business venture. It takes a little bit of effort, but the information is out there. TIP: Use different search engine than Google, so you can bypass tailored and censored hits coming back to you.

    I did a quick search and found this article: “COVID-19: Rethinking the Lockdown Groupthink” Although I’m not a fan of the ‘Build Back Better’ https://www.preprints.org/manuscript/202010.0330/v2 , the paper has useful data showing the negative consequences of lockdowns in countries around the world.

    I’m deeply concerned with how people are becoming hateful and intolerant towards each other. Love is the real cure. If we love each other and care for one another, we’ll get much farther than we will if we continue on the path we are on.

    Lastly, regardless of where you stand on the issue, please think about this one, single, vital question:
    Can you name one government that has ever, willingly given freedoms back to people after those freedoms were taken/relinquished?
    I can’t.

    With faith, hope and gratitude,
    p.s. God is Love!

  • Chris says:

    Fabulously said, very wise. I can rhyme off a dozen cases just off the top of my head of patients who are clearly harmed by lockdowns. The autistic child who is now 1 year without developmental support classes. The mother of that boy admitted to the psychiatry ward after months in a 1 bedroom apartment with her 3 children and no supports. The patient with a bowel cancer that was found to have small mets in liver, by the time his scope and surgery happened after an 8-month COVID delay. The 60 year old whose pancreatic CA Dx was several months delayed, and his treatment another 2 months delayed, due to COVID shutdowns. The 3 NH patients who stopped eating and getting out of bed, and soon died, when their families stopped visiting. These are just the ones I came across in my small practice – the tip of an iceberg. For every case of serious harm I can name, there are many cases of lower level harm, or harm that won’t become apparent for months or years.
    I find it ironic that pre-COVID there was a massive push to combat loneliness, particularly in seniors, because it was clearly associated with higher mortality. Now we tell them to stay home and don’t interact. We talked about the importance of cancer screening but then stopped doing paps and breast cancer screening.
    We have to care about finding the balance. A monomaniacal and blindered approach where the only important measure is COVID deaths is likely more deadly than doing nothing.
    For all those who say “lockdowns have worked”, I recommend looking at the data that folks at Oxford have put together which graphs COVID deaths against degree of lockdown. It’s a scatter plot, not a measurable relationship. Maybe they help a bit, maybe they don’t. Even if they do we still have to question if it’s worth it.

    Thanks to Dr. Malhotra for being brave enough to write this. Most docs I know wouldn’t dare, as several colleges pre-warned doctors not to question the accepted narrative, nor the MOH’s supreme power to define our lives. And I know there are several doctors under investigation for speaking up.

  • Margaret says:

    Lock downs flattened the curve in BC. Most citizens were also willing to wear masks and take other safety measures to protect themselves and others, at least in my downtown neighborhood.
    But, now we have varients, and vaccines that don’t actually prevent illness, they boost immunity to severe symptoms. That means the virus and varients can still spread, but we expect, with lower mortality rates.
    So at work and in our private lives we still need personal safety measures. Now, while the science is remarkable, covid it seems will be among us for while yet. We cannot see-saw between lock downs and release for another year, imo. People can’t sustain it, business can’t sustain it. Also, new research crops up and changes the rules, which leads to distrust.
    I think at this point, Canada needs to really step up appeals for public involvement in personal and community safety efforts. We need to start thinking about how we work, socialize etc during this recovery phase. It’s a patriotic duty to yourself, your family, your community. If you self protect, you automatically reduce the load on health care systems. Protecting hospitals should not be the message because we all believe that hospitals protect us. When you say ‘do it to protect hospitals’ , you generate fear. You admit health system failures, which are obvious anyway. Instead, we need to generate public empowerment. The public is the front line, we are covid’s target, but we can also stop the spread. I think that message could make all the difference going forward. Workplaces need to open up, but with mandatory health, cleaning and safety regulations.

    • Chris says:

      “Lockdowns flattened the curve in BC”. Please explain your evidence for this assertion, on which all your subsequent statements rest. Look at a curve of COVID cases/hospitalizations/deaths in BC and where on the curve lockdown measures were implemented. Show me the bend in the curve. As well: Please explain countries like Portugal, UK, and Italy (severely locked down) versus Sweden (minimal lockdown) and their COVID numbers. Please explain North vs. South Dakota and their near-identical outcomes despite very different approaches to lockdown and masking. Please explain the difference between Florida and Ca, and their very different approaches to lockdown and masking, and almost identical outcomes.
      Once you do all this, then you can go on to make some other assertions based on your first assumption.

  • Bharati Gogia says:

    Very good article dear Sonia. I agree with your concerns and opinions.

  • Audrey Armour says:

    You fear that lockdown may be worse than COVID itself and from what you’ve written I can understand why. First, you are allowing your judgment of the situation to be based on your personal experiences and perceptions and the personal experiences and perceptions of others with whom you interact. While personal experience and perceptions are not to be denied as valid, they are not a sufficient basis for make conclusions one way or the other about the costs and benefits of lockdown. Second, nowhere in your article do you talk about offering your patients coping strategies to deal with missed social contacts and anxiety and to protect their health. Nor do you talk of ways you help patients to check the validity of their perceptions and fears and to learn cognitive behavioural techniques to use to moderate fearful reactions. Third, you choose negativity and exaggeration over a more measure view of the situation. For example, you talk of “forced sedentary lifestyle” as if people are being required to forego any and all exercise and just sit all day in their homes. Similarly you highlight “isolation” and say people are being denied access to mental health protective activities such as exercise facilities, religious services, support groups, and gatherings with friends. Really? I look out my kitchen window on my neighbourhood and see more engagement in mental health protection activities than I saw before COVID lockdowns — people going for daily walks with their spouses and children, people greeting neighbours as they pass by, and adults and children stopping to chat with others out walking, all the while social distancing. My neighbours tell me they Zoom church services and, having used Zoom, are now joining with friends for Zoom delivered art classes and knitting circles as well as doing things with their grandchildren on Zoom such as baking cookies each in their own kitchen. Fourth, you choose to project dire consequences. You point out that access to cancer screening services was delayed for several months and then go on to say that as a result decades of championing cancer prevention and early detection is being undone. Again, really? And there weren’t delays before COVID?

    More concerning to me given your education and professional status is your willingness to make unsupported and one-sided statements such as there’s “mounting evidence” showing lockdowns are having negative effects on our health. First, there’s is no single definition of “lockdown” but rather a range of lockdown measures depending on jurisdiction. Regardless of how it is defined, lockdown is part and parcel of the wider non-pharmaceutical intervention thrust of public health policy aimed at containing and controlling the spread of COVID-19 and, as such, needs to be assessed in context and not as a single factor. Second, as to the “mounting evidence” that lockdowns cause harm, I’d say this is a case of finding what you look for as there’s certainly no shortage of peer reviewed research papers, some country focused and others multi-country studies, documenting the benefits and effectiveness of lockdown NPI measures. Third, as any credible research professional will admit, separating the adverse effects of lockdowns and other NPI measures from the effects of simply living in a time of pandemic is difficult, to put it mildly. And fourth, it is far too early to come to any conclusions about the cost and benefits of the strategies taken to protect people from COVID-19 and prevent its spread while waiting for vaccines.

    I respect that you are concerned about your patients and the difficulties they are having during the awful pandemic. But rushing to judgment that “lockdowns” are doing more harm than good and in that way undermining the concerted efforts of our public health officials in guiding us through this health crisis is not helpful.

    • Margaret says:

      Good response, imo. I agree personally and professionally there are negative outcomes to lockdown. But they have lowered the the curve, which is an overriding concern. Ontario was forced into more lockdown because so many people refused to wear masks or take other precautions, it seems.
      But lockdown can’t go on forever, right? People can’t be locked out work for months at a time. Not anymore.
      Individuals and worksites have to step up with PPEs etc. Come summer, I just don’t think people can sustain any more lockdown or travel restrictions. I think testing should ramp up along with the vaccination roll outs.
      Obviously it’s a complicated problem though, for schools, long term care homes, health clinics and essential services.

    • James H. says:

      I found the issue of forced sedentary lifestyle unusual as well. My family has spent more time outdoors over the last year than I can remember having done before.

      As to the discussion of lockdown, this country has not seen the type of lockdown that has worked best, i.e. those employed in Australia, New Zealand and many Asian countries. As such, we’ve had this revolving series of restrictions which were never going to “work” to either get cases to zero or substantially lower in cool months or allow for sustained economic opening. This rests on the politicization of responses (largely conservative leaning politicians not representative to urban areas most heavily affected), federal/provincial divisions, and lots of politicians of all stripes not wanting to make tough decisions such as meaningful travel restrictions.

  • Iain Climie says:

    Some very good points in there and there are similar concerns in the UK where I live. It is perhaps worth noting the lessons to be learned from New Zealand, Taiwan, S. Korea, Australia and Vietnam i.e. minimiaing the flow of people into the country and testing people coming in. The Isle of Man has pursued a similar policy and even locked up people turning up or not self-quarantining although that is a bit drastic.

    There will be another pandemic (even if “only” flu – Spanish flu killed my great grandfather at the end of WW1 while there were flu pandemics in the 50s and 60s ) while zoonotic diseases will spread further. Few people want travel shutters to go up but the UK’s death toll from COVID is now (4th March 2021) around 120,000 so I would suggest it is the lesser evil. Hope for the best and try for it but prepare for the next such incident.

  • ed bernacki says:

    To clarify, we need a different discussion on what lockdown actually means. Here, we closed a few businesses, schools and public services, and make recommendations for people to stay home. People do not stay home. I also lived in New Zealand and Australia. Their lockdowns were very effective. The strategy was…. go hard and go fast to stop Covid from spreading. These lockdowns included: limits of 5 kms for personal travel, police checks to ensure people did not leave their area without permission, curfews, and police roadblocks. Both countries also had high-quality communication strategies to ensure people accepted these conditions. Both crushed covid and then slowly reopened society. And yet, they will shut down society to prevent tiny outbreaks from growing. What we are going in Ontario and most provinces is a lockdown in name only — it is shutdown. It is not working. Linked to your article, I would also say countries like NZ were far more effective in communicating with citizens. UBC’s study of national covid communication strategies also looked at Ontario. It rated poorly to nine other countries. Right now, we should have extensive communication to manage expectations for the vaccine. We get nothing. AU is spending $20m.

    • CL says:

      Well said. Elderly people in Ontario are dying alone, sad, scared and oppressed.They are being locked down in their rooms even for one non-symptom like runny stool for a single day, even if that symptom turns out to be due to a mis-prescribed laxative. The decline in those people during just a few days while they wait for their (faulty) test results is heartbreaking. Ones with dementia can not understand the rationale and are screaming in emotional pain, even as they die, because they think their families have abandoned them or are punishing them. Family are threatened with security even when they are obeying all the rules, and are denied access even to their dying parents. These are first hand accounts I’m repeating here, not rumours, and it is happening all across Canada. our not-news (I call it Meanstreatm Media) does not tell us the truth. See the poem “Yet they slept’ and related links in the discussion on brand new tube. This torment and cruelty is Satan’s work. His time for eternal torment is coming.

  • Adeoye Alabi says:

    I quite agree with your views. It is obvious that most stake holders don’t have wholistic approach when making some regulations. Thank you for your thoughtfulness.

  • Shelley McKeen says:

    Right on Dr Malhotra! Thank you for speaking out and outlining all the issues that are related to this lockdown.Our Public Health Agencies and our Politicians both provincially and federally,respectively, are failing the citizens of this country in a most disastrous way.No one wants Covid-19,but, people are entitled to the right to life and living their chosen lifestyles.TIME FOR A CHANGE IS NOW BEFORE THERE IS A CONTINUING FALLOUT FROM LOCKDOWNS AFFECTING SO MANY IN SO MANY NEGATIVE WAYS.

  • Elena Kuznetsova says:

    You are absolutely right

  • Margaret Kelly says:

    Couldn’t agree more with the statements and logic of this article. I for one have type 1 diabetes and have undergone cancer treatment during the pandemic. Having to go through, surgery, chemo and ongoing treatment all alone without the support of my family by my side was/ and still is mentally draining. One feels so terriblely lost going through such an ordeal all alone in the hospital, and I can’t imagine how those seniors in homes locked away from family for months are feeling. I for one am so over this now… at a point where my mental well being is taking presidence over Covid19.

  • Keren says:

    Thank you Dr. Malhorta for speaking out and telling the truth. I am aware that health care providers are being silenced and sanctioned if they dare to speak out.Thus, your comments also speak to your integrity, bravery and regard for sound ethical practice. The government and health officials failed to demonstrate that they engaged in valid and reliable evidence based risk analysis of all of the interventions. Consequently, the harm of the measures exceeds any good. Harm is apparent in all domains and at all levels of society, including but most certainly not limited to severe systemic and officially mandated elder as well as child abuse. A public health suggestion to socially isolate children with seemingly positive tests for COVID-19 from family and others exemplifies the outright immoral and unethical mismanagement of this crisis. The excuse that the intervention was misinterpreted reinforces officials’ failure to demonstrate accountability. Rampant signs of lost democracy accompany this medical crisis similar to other times in history. Unfortunately, the health and government officials continually fail to demonstrate accountability, likely fearing repercussions to their credibility and career. Hopefully, more health care providers and citizens will speak up so that we can begin to repair the damage and return ethical health care and associated democracy.

  • rossita says:

    yes dear my husband was let die as supposedly what not worth finishing the operation supposedly heart was too damaged maybe ? and the paramedics did not lift him even his sys pressure was only 40 he had to get up twice and sit on chair then sit on the bed to be f=rolled to ambulance well they just might speed the clot faster to his heart and hospital let the heart beat lowly down till it stoped and NO ONE asked me if i was ok to keep him on pumps waiting for eventual donor just let him die …
    well my hubby had writen on our computer desk a note before he died that:
    the LOCKDOWN takes more casulties then the PANDEMIC and he might have been right

  • Sushma Gera says:

    A great article. Thanks for bringing the real issues out in public domain.

    I totally agree with what you said. No doubt, there is a need for multi pronged approach. More so now, when we are hopeful to have a round of vaccinations done over the next few months, all related issues can’t stay in the back burner, we need to address them.

  • Vern Scott says:

    Good points brought forward however what is really happening is that pre existing issues have unfortunately just become worse because of the extra pressure of the Covid restrictions to everyone’s daily life. A bigger concern I have with the article and comments is that there is criticism towards the authorities but no solutions given ! Would the doctor and other’s be willing to accept responsibility for all the additional deaths due to removing the lockdowns? Also where would any additional doctors and medical professionals be found to treat all the fallout in either scenario? Without addressing or providing alternatives this is only a comment on where we are today brought forward by an unconcerned virus

    • Adriaan Janse says:

      That’s a ridiculous question/statement to make. If your asking and expecting them to take on responsibility for extra deaths from COVID if they stopped these dreadful measures then I must ask the most obvious question. Why is no one taking responsibility for the destruction of our communities for these measures? Why are they nkt taking responsibility for lives lost due to restrictions? Why are they not taking responsibility for all the tragic effects of their lockdowns and these insane public health measures to stop a virus that the overwhelming majority of people survive just fine without any treatment or therapeutics? How is it you think they should be held accountable for canceling the destruction of our country and communities through fear and lockdowns yet they not be responsible for all the deaths and damages associated as a result of these measures?

      • Iain Climie says:

        Basically politicians and policy makers will do anything they can not to take responsibility for the consequences of their actions whether health, financial damage, reduces liberty or other. If that seems cynical, Have a look at events like the Hillsborough stadium disaster, the Boeing 737 Max 8 crashes, the challenger space shuttle loss and many incidents with (relatively) low death tolls although that will hardly console relatives. Nobody stood up and accepted blame, perhaps understandably. So who is actually going to carry the can for the after-effects of all this and who will identify and implement the measures needed to cope with the next pandemic?

  • Sandra Scott says:

    Thank you it is a GOD SEND that you are speaking out. This has gone on too long and real people are suffering but our governmemt of the day is not listening. I have a valid medically proven health condition and can not wear a mask. I have been wearing a shield. I attended ST.. STEPHEN hospital on February 26th 2021, a little town in NewBrunswick where at the curent time has zero cases. When i arrived to emerge i explained my condition and showed my note. The nurses went to get their head nurse who took me into her office for more info, after which she said we will see you . We can take you through the ambulance doors straight to a room, but go to your car and a nurse will call you in. A nurse did call me but to ask me more questions and to tell me the ER doctor will not see me unless i wear a mask. I kept explaining that i just can not. The nurse said well the doctor will see you if you wear a paper mask. I told her i can not cover nose or mouth at all, she said well its only temporary. I told her my condition is not temporary that i cant just tell it to behave. She said well the doctor will see you if you wear a mask my shield was not good enough. Ultimately i was refused care and told them i was calling my local governmemt representative as this was against my human rights. The nurse proceeded to tell me i was not being denied care. Sent an email to local government for attention to the matter and the email i received back told me to deal with the hospital myself. Thank you for sharing and i pray more REAL DOCTORS come forward for the sake of our children and seniors this governments behaviour is causing more harm than this flu itself.

    • CL says:

      I”m so sorry that happened to you. I’m in a similar situation and my GP’s office is refusing to give me the medical care I need to treat warts and skin conditions. I’m in BC. The first time they refused they said it was for my protection and they due a risk/benefit analysis to decide if they will let me in or not. The next time they refused they said it was for the protection fo their immune compromised and elderly patients and it was part of their ‘safety plan’. I myself an immune compromised and it my own GP who wrote the letter. I’ve had open lesions on my body for 6 months and have other skin problems that we were getting under control until COVID 19 restrictions hit. I’m starting to get frustrated. They’ve decided I’m not worthy of medical care. What’s the next step? Have me exterminated?

  • Acave says:

    Whilst acknowledging the truth in what she/ he says about adverse effects of lockdown, it seems that Dr X has few patients who died hideous deaths from COVID due to persons not heeding or openly flouting PH management strategies. If vaccines were available this time last year , I suspect the advice may have been more in line with Dr ax’s hopes. But they weren’t and people were dying in hundreds. Hind sight is 20/20 but the decision to lockdown was one that was available then. Another GP.

    • Brian S. Seaman says:

      Well maybe Acave you can explain how we can sustain continuing lockdowns for the millions of us who have to work to earn a living or own small businesses that have been completely gutted and are teetering on bankruptcy. You would be surprised by who has to go to the food bank here in Calgary on a regular basis. COVID19 isn’t destroying the economy, hasn’t driven millions to unemployment or underemployment, and isn’t undermining mental health. The response to it is. By the way, Dr. X has a name. She is Dr. Sonia Malhotra.

    • Gabor says:

      The initial lockdown in March 2020 was understandable and appropriate to “flatten the curve”…
      The repeated lockdowns have had NO demonstrable benefit; just widespread, huge, collateral damage to millions
      of people.
      One of my medical duties is reviewing insurance files. Many with serious chronic conditions (IDDM, SLE, RA, COPD, IBD, Cancer, &c) have not seen a doctor for a year; telehealth at best – delayed Dx and Tx.
      Their condition deteriorates.

    • Sanda says:

      Obviously you dont have perfectly healthy children , now siucidal but hey as a parent watching my child die inside and out, because of isolation , rules, and constant brainwashing in everystore or business even at achool, with a PA syste. Stand 6 feet apart, sanitize, wear your mask, rat on your neighbour, remember not to hug your loved ones, over and over every 5 minutes so we dont forget. That my friend is not encouraging health practicies that is brainwashing through audio, can you say government over reach for power?? My bad you onviously get some sort of something to keep pushing the narrative.

    • CL says:

      Respectfully, our beloved elderly people have been dying in droves of influenza outbreaks for years and nobody gave a hoot. It never made the news.. They have suffered abuse and neglect in care home for decades and nothing’s been done about it nationwide. Hospitals overflowed and hallway beds were filled every year during winter flu seasons. Nobody gave a hoot about protecting the elderly and vulnerable then, especially not the media. What’s changed? Why has influenza ‘disappeared’ this year? Is it being reported as a COVID 19 case?

      question – why isn’t COVID 19 on Health Canada’s List of Notifiable Diseases?
      Influenza is there. Plauge is there. SARS is there. COVID 19 is not.
      If you follow the SARS link it takes you to a page that was archived in 2009.

      If COVID 19 is so communicable that we have all lost our freedoms, business and families have been destroyed, BC’s overdose crisis is killing more people than ever, suicides are way up (especially in youth), and our economy has been destroyed, then why isn’t the disease listed here?
      I started asking this question in November of 2020 but I no longer even know who to ask and I no longer believe any government agency or politician will ever reply – they aren’t replying to most of my questions.

  • Vinay Sharma says:

    Greatly narrated the issues , not being discussed by media and politicians.
    Thanks for a great article.

    Vinay Sharma
    Columbus OH

    • Kesh Gelda says:

      Dr. Sonia Malhotra
      Well written article and today we see reality
      From a concerned Doctor’s view point .
      We are all facing some sort of depression
      As seeing our close friends get sick and not getting full medical treatments as needed.
      We have only seen the tip of the iceberg.
      There will be many more people coming forward with depression and loudness as
      We have now in 2nd year of COVID 19.
      I feel excise is the key factor for good health
      And we should under control measures open
      Gyms; fitness centers and community centers.
      This is great article Dr. SONIA
      THNAK YOU.

  • Brian S. Seaman says:

    Dr. Malhotra, this is the one article that I have needed to read ever since I began having in the weeks before Christmas to have my layperson concerns about the response to COVID. I have been reluctant to talk with even friends and family about my concerns because, among other things, our sensationalistic media has framed and is framing the public discourse into two mutually incompatible groups. You are either a supporter of lockdowns until we get the rate of infection to zero or you are right-wing, knuckle-dragging anti-masker who would put making money ahead of saving lives. Thank you for speaking out. Yours is the expert, nuanced voice that so many of us need.

  • Dinesh Malhotra says:

    Excellent observations. I am glad physician like you are making aware to the authorities who are ignorant of the realities, what people in Canada are facing with.
    Proud of you

    • Bruce Stephenson says:

      Agreed. That said, Canadian ‘authorities’ are very clearly NOT LISTENING. Rather than respond or engage they CENSOR opposing views. They CENSOR science about C19. Medicine now knows (for those willing to look at the science) that early treatment and prevention works. That’s the source of India’s success. Yet Canadian authorities continue to deny that early treatment is valid, in spite of overwhelming evidence. This “therapeutic nihilism” has made the C19 pandemic in Canada far worse and has certainly killed many who otherwise have lived. While at first I thought this might be due to incompetence and ignorance, those excuses are long past disproved.

      It made perfect sense to follow official directive so long as one believes the “authorities” are trying to be helpful. I certainly believed this. HOWEVER, after careful observation of how the Canadian “authorities” censor treatment options, it’s very clear that Canadian health “authorities” are acting in bad faith. Why else would they CENSOR scientific content? Why else would they SUPPRESS effective treatments? Once an “authority” has demonstrated BAD FAITH then that authority’s dictates are invalid. Canadian “health authorities” have clearly demonstrated that they are acting in bad faith. For that reason, ALL their recommendations are suspect. Canadian “health authorities” have lost all credibility.

      I don’t know what is the proper path forward. We are experiencing the sort of bad faith betrayal by Canadian “authorities” that bring down governments. The sooner they are removed from power by proper legal means the better off will be the citizens of Canada.

  • Karolina Ugljesic says:

    Bravo! These are excellent points that have to be taken into consideration. Our health policies should take into consideration all conditions and diseases, including, but not limited to covid only. Other patients should not be marginalized. The effects to the living can’t be ignored, as continuing with the current course ignores the effect on the living and it’s causing the stress on the health system that will create an eruption of prolonged demand as a consequence. It is the time to consider the best solution, not the easiest one.

  • Joan Conrad says:

    This an excellent article and reflects the thinking of many. Patient and Family Advisor

  • Gurmeet Gill says:

    Very good read and thanks for the further insight. I agree with all points and I have noticed the wealth gap having a significant toll on many people afflicted with addiction and mental illness. The help required in many instances is public gatherings. These are no longer available and I haven’t been able to lead a bipolar support group for over a year now at CAMH. Free social aspects from these meetings, arts and crafts, sports were an important aspect of their health/growth. Quite a few people who are able to get further support through family for private training, sessions and so forth are doing very well. This is a small minority who have access to these types of outlets.

    Thanks for sharing..

  • Vibha says:

    Thank you
    We all feeling the effects of isolation, in depression. Not being able to see or help our families and friends and trying to cope on our own makes one sad, helpless and unmotivated


Sonia Malhotra


Sonia Malhotra is a family physician practicing in Toronto who cares for immigrants, refugees and refugee claimants.

Republish this article

Republish this article on your website under the creative commons licence.

Learn more