independent advocate reducing alcohol harm

The ‘lethal interaction’ of alcohol and COVID-19

Alcohol consumption and how it interacts with COVID-19 across a range of individual and societal dimensions represent a “major public health challenge”, a comprehensive new report on the topic has found.

The report “Alcohol and the coronavirus pandemic: individual, societal and policy perspectives”[1] finds that COVID-19 and alcohol consumption has played a crucial role in the transmission and propagation of the pandemic. “In short, alcohol and COVID-19 has been, and continues to be, a lethal interaction,” it states.

While the report is an international look at the landscape, it bears out what we are seeing in Ireland in relation to alcohol and COVID on a number of fronts – that alcohol has been a key amplifier of the pandemic with major social and economic implications. It also highlights how vested interests have moved quickly to shape policy and public perceptions in ways that benefit their objectives and often with little or no opportunity for public health, enforcement or non-government social service sectors to respond.

“Key to this development has been the designation of the sale of alcohol as an ‘essential service’ or alcoholic beverages as ‘essential products’ by governments in many countries. Interestingly, this has especially been the case in many high and middle income countries,” the report notes.

We know from alcohol sales data that Ireland’s alcohol users substituted most of their drinking from regulated licenced premises to consumption in the home.[2]

Surveys carried out by Ireland’s Central Statistics Office found a number of interesting points regarding consumption patterns during the COVID lockdowns. For example, around 20% of respondents to surveys carried out in April and again in November of 2020, said their alcohol consumption was higher than before the COVID-19 crisis.[3] The CSO surveys also found 27 per cent of those in households with children reporting an increase in alcohol consumption.[4]

Apart from the long-term health implications of increased alcohol intake, the social fall-out is already being documented.

A report by Ireland’s Economic Social Research Institute (ESRI) stated:

“Emerging evidence indicates that family violence in the home may be increasing during the COVID-19 restrictions. This trend is associated with a number of interlinked factors, including economic stress, difficult relationships and reduced or non-existent support structures.”[5]

The ESRI also noted that during 2020, many researchers and policy experts noted that combined stressors such as unemployment, difficult relationships, extended isolation perhaps coupled with alcohol or substance misuse, are likely to have an adverse impact on parental mental wellbeing, which is likely, in turn, to affect children’s relationships and outcomes.[6]

This point is also illustrated in the Alcohol and the Coronavirus Pandemic report, stating that: “Government responses to the virus such as ‘Shelter in Place’ orders and ‘lockdown’ restrictions, appear to have affected locations and patterns of drinking by both men and women and in some cases increased the risk of problems for which alcohol already has a major role such as domestic violence and mental health problems.”

It further highlights the burden that alcohol places on healthcare resources, which even in normal circumstances are substantial.

“It is foreseeable, that in countries where governments intentionally or unintentionally expand access to alcohol during a pandemic, the capacity of health services to manage the immense challenges they face in treating large numbers of patients while minimizing workforce infection will be placed at further risk,” the report states.

The report concludes by making a range of recommendations both for individuals and government, including: the introduction of minimum unit pricing (MUP), imposing daily limits on retail off-trade purchases/sales and home delivery, if allowed at all; making clinical and treatment provisions for people experiencing all types of alcohol-related problems, including withdrawal; and increasing access to mental health services, including online services.

And, as noted by the report’s authors, “many aspects of the complex and multifaceted relationship between alcohol and COVID-19 remain in flux,” and it will be some time before we fully get to grips with the long-term implications of this relationship and it impacts on the health, wellbeing and safety of individuals and societies across the world.

The weight of evidence we have around the increase in alcohol consumption in the home means there will undoubtedly be fallout not just for the drinker but for children and families. Yet again this report makes the case that policy levers such as MUP should be initiated as soon as possible.  MUP is on our statute books but remains unimplemented. This lack of action means more lives will be lost not to COVID but to another avoidable cause  – alcohol.

[1] Alcohol and Society 2021: Alcohol and the coronavirus pandemic: individual, societal and policy perspectives. Stockholm: Swedish Society of Nursing, SFAM, SAFF, CERA, The Swedish Society of Addiction Medicine, SIGHT, Movendi International & IOGT-NTO. Available at: https://movendi.ngo/wp-content/uploads/2021/01/Alcohol-and-the-coronavirus-pandemic_Alcohol-and-society-2021_report_en.pdf

[2] See Alcohol Action statement on sales figures here: /provisional-revenue-receipts-demonstrate-durability-irish-alcohol-market-despite-covid-19-crisis/

[3] See: https://www.cso.ie/en/releasesandpublications/ep/p-covid19/covid-19informationhub/socialandwellbeing/

[4] https://www.cso.ie/en/releasesandpublications/ep/p-sic19/socialimpactofcovid-19surveyapril2020/changesinconsumption/

[5] https://www.esri.ie/system/files/publications/SUSTAT94_3.pdf

[6] https://www.esri.ie/system/files/publications/SUSTAT94_3.pdf