Wednesday 6 May

The COVID19 death toll has naturally focused more attention than usual on the ways death and mourning are observed. Funerals, now very restricted, have always been a way to mark an individual’s passing but in this extreme situation it could be argued that a much more public commemoration is called for. ‘It’s very weird how there’s been no collective mourning for all the dead. No television specials honouring them, almost no mention of them, nothing at all’, tweeted a Radio 4 listener. As is well known in the field of bereavement, what Freud called ‘the work of mourning’ will be arrested, suppressed or exacerbated by the absence of public ritual. Surely an acknowledgement and commemoration of those losses should be urgently considered, not just left till when the pandemic has run its course.

What a shame ‘Professor Lockdown’ Neil Ferguson let himself down and had to resign from SAGE because of breaching the lockdown he’d so strongly advocated. But perhaps, as is evident all around us, there’s a limit to people’s tolerance of lockdown, which has been gradually breaking down over the last few weeks, not to mention the persistent illogicalities like packed public transport and allowing in flights with no quarantining of disembarking passengers. Could this resignation mean we will now see more mainstream media attention directed to the deliberations of Independent SAGE?

“There has to be the development of a local based primary care, social care, locality based approach to this whole process of being able to continue to monitor infections”, suggested IS member Professor Deenan Pillay (UCL), in direct contrast to the government’s continued centralisation policy. This raises interesting issues about the nature of authority: if the de jure source is seen to be lacking people will look for de facto guidance elsewhere and perhaps Independent Sage will now come more to the fore.

Amid calls for a public inquiry on the government’s handling of the pandemic, statistician David Spiegelhalter said: “Well over 3,000 [of the excess deaths] weren’t labelled as Covid. So nearly a third were from something else. There is a continuing anxiety that many of these are due to the lockdown itself. The one thing we do know is that the health service has been hugely disrupted, not just in terms of routine care, cancelled chemotherapies and radio therapies and elective surgeries, but also of people with symptoms not going to hospital.” This is another area which seems to divide opinion: those wishing to avoid or delay scrutiny and reluctant to challenge authority arguing that we don’t have the full picture and that will only be possible post-pandemic, and those pressing urgently for an inquiry so that lessons can be learned now and used to inform how we go forward. It seems quite common to see comments eg on social media suggesting that the government ‘is doing its best’ and we should ‘leave them alone’ and ‘not whine’ – aka holding the government to account. Not surprisingly, one who presented the defensive argument was Home Office security minister James Brokenshire on the Today Programme – ‘now is not the time’ – allowed by presenter Justin Webb to get away with it.

There’s not much time before Sunday for the government to take this on board for its lockdown exit strategy but it’s positive that a more nuanced approach than the hitherto simplistic one has emerged from researchers at Edinburgh. They’ve suggested ‘segmenting and shielding’, based around relaxing restrictions on more than half of the population and beefing up protection for those over 70 and vulnerable people, eg their contacts being only carers and family members free from infection. These ‘shielders’ would be tested regularly and the entire strategy could be phased in over a 3 month period. It makes one wonder why such a sensible plan hasn’t been thought out before in government circles, especially bearing in mind that the policy of lumping together all over 70s, condemning them to many more months of isolation, has been very stressful for them. If this approach can be incorporated into the exit strategy it will provide some sorely needed reassurance.

https://bit.ly/2yoqBCk

Adding to private sector inroads already made into the NHS, it seems more privatisation by stealth is being facilitated by the pandemic. Doctors, campaign groups and academics have raised the alarm that Serco was being positioned to win a deal to supply 15,000 call-handlers for the government’s tracking and tracing operation. It’s also not commonly known that Deloitte, KPMG, Serco, Sodexo, Mitie, Boots and the US data mining group Palantir were given contracts to manage Covid-19 drive-in testing centres, the purchasing of personal protective equipment (PPE) and the building of Nightingale hospitals. These arrangements haven’t been scrutinised because special powers have been used to bypass normal tendering, awarding numerous contracts without open competition. It’s also been suggested that the move from individual NHS trust procurement to centralised purchasing will lead to more control by Deloitte and co. Surely this should have been raised at PMQs today.

The Guardian quoted Tony O’Sullivan, a retired paediatrician and co-chair of the campaign group Keep Our NHS Public, who said this was a “dangerous time” for the NHS, and that the “error-ridden response” from government had exposed a decade of underfunding. ‘Now, rather than learning from those errors they are compounding them by centralising decision-making but outsourcing huge responsibility for the safety of the population to private companies’. Labour MP Rosie Cooper and Health and Social Care Committee, said these contracts must have a sunset clause, enabling the arrangement to be reviewed after 3 or 6 months. Who knows whether these contracts have such a thing?

Health Secretary Matt Hancock is the Guardian’s parliamentary sketch writer John Crace’s subject this week. In a withering but funny article, he alludes to ‘the battle between his (Hancock’s) career and his conscience’….The career is still winning. But the gap is closing. Part of him longs to tell the truth. About the uselessness of his predecessor, Jeremy Hunt, who ran down the capacity of the NHS to unsafe levels. About the self-indulgence of a prime minister who prioritised celebrating Brexit and sorting out his private life over trying to make sure the country was prepared for the pandemic. Yet he can’t quite go there yet. So instead he attacked Allin-Khan for adopting the wrong tone. In time, he will see that it was he who got the tone wrong’. A major point he makes is Hancock seeming not to understand why he’s being challenged on the failings as he’s expecting to be congratulated on the 100,000 tests, when this has widely been seen as a meaningless goal. But his increasing tetchiness may also be due to being hung out to dry by his boss.

Finally, it’s positive that public libraries, a hugely undervalued community resource, are doing a roaring trade online, producing online content, answering queries and phoning elderly readers for a chat. An amusing Twitter exchange between librarians focused on interesting ‘bookmarks’ they’d found in books, including an After Eight mint still in its wrapper and a Blockbuster card (“a proper ancient artefact”). From librarianship days this brought back memories of the stories (mythology?) which grew up around this topic of weird bookmarks encountered in returned books, including a fish spine. Quite often, though, the less obvious ‘bookmarks’ don’t come to light until the next reader borrows them. Numerous library users will have found various items over the years, including old bus or train tickets, receipts and heaven knows what else. Feel free to let me know what you’ve found left in a library book!

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Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

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