Three groups of people can be identified as suffering the greatest impact. First, there are those suffering under an existential threat, either patients being treated for COVID-19, or at high risk of poor outcomes from infection, or those who have been unable to access medical care for prior life-threatening conditions, . Secondly, there is a clear economic threat to people with a risk of diminished income or loss of employment,and for fewer jobs for those seeking to enter the workplace . Thirdly, there are the social and psychological risks due to lockdown and isolation – these include the increased levels of depression and anxiety in adults; emotional and behavioural problem in children, but also missed academic development with constrained school opportunities; and possible increased rates of violence and substance misuse in some homes. .