Tuesday 19 May

I won’t have been the only one shocked at the news that the loss of taste and smell is only now being included in the list #COVID19 symptoms to be tested for, when the World Health Organisation has recommended this for some time. Experts warned that tens of thousands of cases of Covid-19 were being missed because the government only recognised a fever and a cough as symptoms. ‘The UK needs to get in line with the rest of the world’, said one. British exceptionalism again but how many lives lost due to this hitherto exclusion? The Deputy Chief Medical Officer for England, Jonathan Van-Tam, seemed to make light of this, suggesting this would only pick up 3% more cases. Different stances taken by scientists make it difficult to know.

Despite Matt Hancock saying anyone over the age of 5 with symptoms was ‘entitled to’ a test, last night those trying to book one online were told: “There is very high demand for tests at the moment. People in hospital and essential workers, including NHS and social care staff, are getting priority. Even if you are successful in requesting a test, we cannot guarantee you will get one. It depends on how many tests are available each day in different parts of the country.” This seems just one more demonstration, as with PPE and care homes, that the government doesn’t know what’s happening on the ground.

Lack of transparency and delayed disclosure of important findings is a continuing concern. It’s emerged that up to a fifth of patients with Covid-19 in several hospitals contracted it while already being treated there for another illness. In some cases it was passed on by hospital staff  unaware they had the virus because they had no symptoms, so another failing of the limited testing regime? In another change of tack, ministers and clinicians have more recently been telling people not to avoid hospital if they have serious health concerns but this will surely make them think twice.

In the House of Commons Matt Hancock has just defended the government’s performance on COVID deaths in care homes, yet this is trying to defend the indefensible because it’s manifestly untrue that ‘a protective ring was thrown around our care homes’ in March. A quarter of all COVID19 deaths have been in care homes and, in another example of delayed disclosure, it only now emerges that temporary care workers transmitted Covid-19 between care homes as cases surged, according to an unpublished government study which used genome tracking to investigate outbreaks. This was allowed to happen despite a 2019 Public Health England study about flu pandemic preparations (Infection prevention and control: an outbreak information pack for care homes) urged care providers to “try to avoid moving staff between homes and floors”. The Department of Health and Social Care appears to have ignored or overlooked this because its Social Care Plan, published on 16 April, has nothing about restricting these movements in its chapter “Controlling the spread of infection in care homes”. Although the DHSC knew about the findings of the more recent PHE study since April, it only disseminated them to care home providers, councils and public health directors last week.

Shadow care minister Liz Kendall, criticising this damaging delay, said the crisis had “brutally exposed how insecure, undervalued and underpaid care work is’. Former PM Gordon Brown weighed in, calling the care home deaths debacle ‘a major public policy failure’. How much else could the government be suppressing? Thank goodness for investigative journalism, without which we would know a lot less. Meanwhile, with the continuing non-appearance of the PM, #WhereisBoris is trending on Twitter. Could he have unofficially taken paternity leave but not told his colleagues or us?

Many could be wondering how the contact tracing app trial in the Isle of Wight is progressing and the BBC tells us it’s a ‘mixed bag’. Although sufficient people have downloaded it, many are in lockdown so are unlikely to have come in contact with the virus. It only asks about two symptoms, high temperature and a continuous cough (not the latest loss of smell and taste symptom) and also doesn’t tell people what to do about their contacts because it’s not possible to enter your test result. So now a version 2 will be trialled and meanwhile the clock is ticking, delaying its rollout throughout the UK, and what about the other issues eg concern about legal challenges due to privacy concerns?

It’s timely that during Mental Health Awareness Week gambling addiction is again in the news, research suggesting it’s an even worse problem that we’d thought and that half of those experiencing this aren’t getting help. This is especially interesting given that incomes of companies like William Hill have plummeted because of the lack of sporting events and closure of their shops, probably pushing more gambling activity online, which is more difficult to monitor. In a survey commissioned by the GambleAware charity, YouGov estimated that up to 2.7% of adults in Great Britain, or nearly 1.4 million people, are problem gamblers. Some experts urged caution over the figure but one has to wonder at the source of these doubts, eg coming from the industry regulator and some bodies funded by the gambling industry itself. And besides the problem gamblers themselves, we shouldn’t forget those negatively affected by someone’s gambling, as many as 7% of adults, or 3.6 million people. Treatment for gambling addiction is very patchy indeed and it’s another area under the mental health service ‘umbrella’ which will need reconfiguring when this crisis has abated. Or perhaps it’s not too early to expect DHSC civil servants, policymakers and clinicians to start planning this work now.

Meanwhile, Matt Hancock’s tweet at the start of MHAW yesterday drew some flak: ‘It’s Mental Health Awareness Week. This year of all years it’s so important we look out for one another. Seeking help and support is vital – the NHS is open to us all’. Of course, this ignores the longstanding underfunding of the NHS and of mental health services in particular and his exhortation to ‘look out for one another’ could be found somewhat galling in the circumstances.

It’s a sad fact of life that fraudsters will take advantage of anxiety and crisis-heightened anxiety to devise new ways of scamming us. Although it’s been going on a while, ‘romance fraud’ has come to the fore again because of more isolated and vulnerable people trying to find company and establish relationships in these surreal times. The BBC reports on Victim Support research which suggests men and women equally are falling prey to fraudsters, losing on average £47,000 each. Scammers obviously think it’s worth their while to play a long game, investing months in grooming victims, encouraging them to believe they’re in a genuine relationship with someone who cares about them. Then the requests for money start, sounding convincing at first eg funds for hospital treatment, to prop up their struggling business, and so on.

One victim admitted: “In a fantasy world, I let myself think he is going to turn up and be real. You can be too emotionally involved in it. “This “addiction” to hear someone saying nice things to you, and which blinds you to the reality, is common among victims’, according to Lisa Mills, senior fraud manager at Victim Support in Sussex. The problem could be much worse than we think because many will be ashamed and embarrassed to report such a crime and this in turn could exacerbate their sense of isolation.


A reminder about this series, based on what’s considered the oldest book in the Western world exploring ‘the causes, symptoms and treatments of that universal human experience’, Robert Burton’s The Anatomy of Melancholy (1621). I’ve found it a bit of a mixed bag but quite good today, on depression, the effects of isolation and loneliness, and the benefits of social prescribing.


Finally, we can only look on with envy at Italy re-opening after weeks of lockdown and restrictions much more severe than our own. In the Guardian Erica Firpo describes what’s happening in Rome, some shops open, a long queue for the post office, customers back in cafes hugging and kissing each other (while wearing masks) and the bike shop preparing for a brisk trade. A flower seller told her: “It’s much quieter, less people. But we’ve been given a chance to see a Rome that perhaps we lost for a while… Will it pick up? We need to wait before we have an idea what reality will be like … before we have equilibrio.”  While they wait for customers and for post-pandemic life to reassert itself, at least Romans can now go to bars, restaurants, shops and beauty salons, when all this still feels like a distant dream here.

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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