Saturday 18 July

The death toll is now 45,233 and it’s been another very eventful news week. It started with the U-turn announcement (following confusion caused by ministers not singing from the same songsheet) that facemasks must be worn in shops, but oddly, not for another ten days. Various commentators have rightly said shop workers shouldn’t have to police the wearing of masks, but surely this is the job of security staff for shops big enough to have them, like supermarkets. Some small shop proprietors are worried they won’t be able to force the issue, especially as there’s a militant element seemingly determined not to wear them and it’s still common to see public transport users not wearing them.

In another significant U-turn, Health Secretary Matt Hancock has finally realised that (as Independent SAGE experts have stressed for some time) a locally focused strategy is crucial for tackling the pandemic. Unfortunately, it’s still taking a week for local authorities to receive vital postcode data from centralised sources, obviously too late for the optimum response.  Meanwhile, unease about the death toll figures increases: we learn that Hancock has asked Public Health England to check their statistics after it emerged that they may include recovered former sufferers who could have died of other causes. This makes it sound as if numbers have been overestimated but some commentators are concerned they’ve been underestimated. And the so-called ‘excess deaths’ are also often attributed to COVID19.

Perhaps the most explosive and riveting news this week was the election by Intelligence and Security Committee members of Julian Lewis (experienced in intelligence and security) to the chairmanship, rather than the PM’s much trailed candidate Chris Grayling (zero experience of intelligence and security), indicating a marked increase in backbencher backbone. It was clear the PM’s choice of ‘Failing Grayling’ was an attempt to control this committee, particularly when its first job could well be publishing the long-delayed Russia Report, likely to cause embarrassment to the government. If anyone was still in any doubt as to the Machiavellian  Cummings-led tactics at play, the immediate removal of the Whip from Lewis on the risible grounds of ‘lack of integrity’ must be more than adequate proof.

No 10’s swift and vengeful gesture has spectacularly backfired, though, as Lewis himself and key political figures like Sir Malcolm Rifkind and John Bercow have wasted no time in demonstrating that the decision was not the PM’s to make and in pointing up Grayling’s lack of suitability for this role. Bercow, during a Sky News interview, castigated the PM’s ‘outrageous’ attempt to control this election, saying of the preferred candidate ‘He is congenitally incapable of seeing a problem without making it very considerably worse’. The Lib Dem spokesman spoke for many when he said: ‘I hope we now have a committee with real teeth that can hold this government to account. That starts by publishing the report into Russian interference of our democracy before the summer recess so MPs can scrutinise it fully’.

Cynically timed, we could suspect, to coincide with the exhortation of workers to return to their offices, thus boosting the lunchtime economy, came the announcement of £3bn for the NHS, to ‘reassure’ the public that it was prepared for a potential second wave of COVID19. The funding is expected to be used to keep the Nightingale hospitals open until March and increase testing capacity to 500,000 a day, but what about funds for the mental health pandemic? The mental health workforce is set for a 21,000 expansion, but there was no mention, amongst the allusion to mental health social workers, of the counsellors and therapists many patients need. It’s been a longstanding issue between the government, NHS and psychological therapy professional bodies that a qualified and experienced workforce of therapists already exists but these organisations’ overtures have been routinely ignored in favour of training new cohorts of inexperienced graduates.

Further easing of restrictions were announced as part of the grandiosely-named ‘roadmap’ for the questionable goal of ‘getting back to normal by Christmas’ , with decision making on whether or not employees would return to work now firmly handed to employers. As is now par for the course for the government, local authorities were not alerted in advance of the accompanying announcement of special powers to implement local lockdowns, should the need arise. Or should that be when? What’s never mentioned with these trumpeted policies is the lack of police to actually enforce these local ‘whackamoles’, another example of strategies not being properly thought through and planned with those who have to implement them. On the controversial return to work issue, a Today listener tweeted: ‘It’s not that people aren’t eager to return to work as Justin (Webb) says – but some are not eager to give up newly-experienced working from home. Three hours daily commuting for the sake of a possible “water cooler moment” may not seem all that good an investment’.

Regarding the latest lockdown restriction easing, when the PM was asked whether Sir Patrick Vallance and Professor Chris Whitty had approved, he said the pair had briefed the Cabinet on Friday morning but it was ‘for ministers to make decisions….I must stress that the Chief Scientific Officer and Chief Medical Officer give us advice, which we of course take very, very seriously, but in the end decisions are taken by the elected politicians’. This is another indication of the increasing distance between the government and these two key advisers, but there’s cheering evidence that they are belatedly wising up to the strategy to throw them under the bus by blaming ‘the science’ when things turn out badly. Both advisers were doubtful about the PM’s return to ‘normality’ plan, think social distancing should remain in place for some time, that there’s a high risk of a second wave this winter and that some lockdown measures may have to be reimposed.

Continuing the mental health theme from the last blog post, there’s more evidence from work undertaken by King’s College that many are experiencing poorer sleep, showing just how unsettling the pandemic and lockdown measures have been, and a longer article focuses more generally on mental health. There now seems to be more stress, anxiety and anger in evidence than during the strict lockdown conditions, when at least most people knew and understood the rules (even if they decided to flout them). This is likely to be partly due to the confusing ‘guidance’, lack of confidence in the easing of restrictions and in our leaders, but largely due to continuing uncertainty and grieving for what’s been lost, as we’ve come to realise there won’t be a return to ‘normal’ and COVID19 will be with us for some time to come. A psychiatrist captures this well, describing it as a ‘curve of disillusionment’. ‘There have been different phases to the pandemic….The initial phase for some people was real opportunity, a sense of hope – the volunteering, connecting with neighbours and friends, this collective spirit. It was a honeymoon phase. We’re now in this curve of disillusionment. And we’ve had other major events during that period – all the issues around racism, the anger that’s fomenting within society, distrust of public figures.’

Several sources have now predicted a ‘mental health pandemic’ to follow this one and research by Mind found that two-thirds of adults and three-quarters of 13 to 24-year-olds with a pre-existing mental health problem said it had become worse during lockdown. One fifth of vulnerable people in Britain have considered self-harming or killing themselves during lockdown. The Royal College of Psychiatrists reports that 43% of psychiatrists have seen an increase in urgent referrals.

Another issue with marked mental health consequences is domestic abuse, and the significant increase in calls to the police during lockdown is testament to the chilling realisation of how much previously went under the radar, in addition to that which openly presented itself. The domestic abuse bill, currently with the House of Lords, will take some time to implement.

The Guardian’s parliamentary sketch writer, John Crace, has excelled himself this week, with three eviscerations, of the PM and of ‘Mattbeth’. Of Matt Hancock (always mentioning the perennial pink tie) he told us: ‘Oh, and by the way, Matt had now decided that masks in shops were a good idea after all. Though not such a good idea that they would be introduced immediately. Far better to wait another 10 days for that as the government had top level intelligence that the coronavirus had declared an amnesty and wouldn’t be infecting anyone before 24 July. Which will come as a huge relief to shop workers who have a mortality risk 60-75% higher than the rest of the general population. After 24 July, there would be a £100 fine for refuseniks: before then just a possible death penalty’.

And Boris Johnson’s ‘PMQs rocky horror show’ was described as ‘a travesty of its true purpose and an insult to the country. People are dying. People are losing their jobs. People are terrified about the future. And yet to Boris it all still feels like a big game where the only thing at stake is his fragile ego’.

Some positive news, relating to the B-lines project described in the last post, is the wildlife development collaboration between three East Anglia landowning farmers – WildEast. Between them these three own 8,000 acres across Norfolk and Suffolk and their aim with WildEast is to get other farmers and councils, schools and individuals across the area to pledge a fifth of their land to wildlife. The farmers want to dedicate 250,000 hectares of East Anglia to wildlife over the next 50 years, work with schools to help develop children’s knowledge of farming and wildlife, and create an accreditation system to incentivise wildlife-friendly farmers. Good for farmers, who don’t always get a good press because the intensive agricultural practices often used are the opposite of wildlife-friendly.

Fans of the curmudgeonly but charismatic fictional Sicilian detective Salvo Montalbano will be pleased to know that the last novel produced by author Andrea Camilleri, who died last year, has now appeared in Italian bookshops. Camilleri had stipulated that Riccardo, in which the author himself makes an appearance, shouldn’t be published until after his death. In a literary conceit very suited to his bowing out, Camilleri has himself phone Salvo to tell him off for seeming reluctant to get on with the new case, according to an extract published in the newspaper Corriere della Sera. ‘I offer you a lead and you mess around, and I find myself in trouble. As a writer, I mean. We can’t go on like this, you have to start investigating’. True to form, Montalbano hangs up on him.

How long before a translation appears here and before it’s televised? Lucky for those whose Italian is good enough to read the original.

Finally, there are some amusing stories about what can go wrong with online shopping, given the huge increase during lockdown. One shopper was taken aback to see what arrived from eBay. ‘My wife ordered an ice cube tray from eBay. What turned up was a neoprene face mask [pictured above], which she initially thought was some form of S&M equipment. Holding it at arms length, she got back in touch with the seller to let them know not only what had happened but to ask what on earth it was for’. One woman ‘should have gone to Specsavers’: instead of the individual bags of flour she thought she’d ordered, a 16 kg bag turned up. ‘At first I offered it for free to people on the local Facebook group formed to help during the crisis, but got no takers. In the end I set up a table in the front garden, bagged it up and made a sign asking people to help themselves on their daily walk. The women were very interested, but the men couldn’t get away quickly enough. My last bag went to two teenage boys; I hope their mum was pleased’. The best one must be (especially if you had a fancy dress party to go to) the shopper who bought a new wig for her 90-year-old mother. ‘The delivery was very slow and the wig was the wrong colour and the wrong style. I ordered a stylish ash-blonde wig; a Donald Trump orange cowpat wig arrived’.

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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