Sunday 26 July

With the COVID19 death toll now reaching 45,738 (which would have seemed unbelievable back in March) it’s been a busy news week, starting with the long-awaited publication of the Russia Report, described by some commentators as ‘damning’. Following the appointment of Dr Julian Lewis to the chairmanship of the Intelligence and Security Committee, the imminent release of this delayed report was a given. Needless to say, the findings were greeted by denial from the PM and his colleagues, who seemed to think it was ok to keep heads in the sand rather than see the evidence of Russian interference with our democratic processes. Nevertheless the 55-page report is thought to ‘paint a worrying picture of the UK’s vulnerability to a nation that sees foreign policy as a ‘zero-sum game’ and believes any action it can take to damage the West is fundamentally good for Russia’.

The Guardian’s John Crace carries out his usual evisceration of the PM’s PMQs performance with an even sharper tool than usual: ‘Boris is the emperor with no clothes and it’s not a pretty sight – what the UK really needs is a grown-up in charge. And what we’ve got is an infantile narcissist’. On being challenged by Keir Starmer on the delayed release and content of the Russia Report, rather than going for ‘damage limitation’, the PM ‘ignored the question and went on the attack. No one cared more about national security than him, and the reason successive Tory governments had failed to even wonder whether the Russians might have influenced the Brexit referendum was because Vladimir Putin had assured them that such an idea was totally unthinkable…’ Visibly rattled, Boris now just lapsed into meaningless, disconnected phrases and a lame gag about ‘more flip-flops than a Bournemouth beach’. He really does need to get himself a new scriptwriter. Starmer merely sighed that this was a bit rich coming from a man who as a journalist had two contradictory columns for every occasion.‘We are delivering as the people’s government, Johnson insisted. Only I don’t remember him promising us the highest death rate in a global pandemic, a disastrous no deal with the EU and the likelihood of the biggest recession in decades’.

In other news, there have been touching stories of relatives reunited after months following the easing of restrictions on visitors to care homes, some seeing a marked decline in the elderly person due to lack of social contact. We must hope the decline isn’t irreversible and that regular visits can bring them to life once more. Yet again, though, the advice is thought to be too late. Professor Martin Green, Chief Executive of Care England, which represents private care homes, said ‘This guidance should have been with care providers last month. We are at a loss to understand why the Department of Health and Social Care cannot act quickly in a crisis or why it is deaf to the comments and input from the sector’.

As the uncoordinated test and trace system continues to be talked up as a great success by the government, statistics demonstrate that thousands are still being missed. Whereas government advice body SAGE stipulates 80% of contacts must be identified for the programme to be successful, some areas like Leicester and some Yorkshire towns were only managing 50-70%. Meanwhile, there’s been much excitement about the promising progress made with developing COVID19 vaccines. We’re told that besides a £93m investment in an innovation centre near Oxford, the government is also investing £100m in buying and repurposing a manufacturing site in Essex. But it could still be some time before a vaccine is developed, tested and made generally available. Globally, 140 teams of researchers are working on a vaccine (but to what extent would any results be made available outside that country?): in the UK the University of Oxford/AstraZeneca vaccine is in a combined phase 2/3 trial in the UK (meaning it’s trialled with hundreds (2) to thousands (3) of people and phase 3 in South Africa and Brazil. It’s to be hoped BigPharma plays fair on this as there have been opposing views, some commentators seeing evidence of cooperation etc but others citing unfair practice like overpricing and retention of intellectual property rights despite some research funds coming from the public sector.

There was shocking but no longer surprising news during the week about the number of MPs who voted against the measure to protect the NHS from overseas ‘sale’ as part of the post-Brexit trade bill: 248 voted to protect the NHS, 337 against, and 260 voted for ‘parliamentary scrutiny of trade deals’, 322 against. Labour’s proposal to exempt the NHS from the bill was rejected. Labour’s Emily Thornberry said: ‘By rejecting Labour’s proposed amendments, the government has left our health service at the mercy of hungry US corporations’. A petition (called We Own It) is doing the rounds to prevent the NHS being available for ‘sale’ but after Monday’s vote hope now rests with the House of Lords in the autumn when it will debate the Trade Bill.   

More than a few viewers must have fallen off their seats during the PM’s interview with the BBC’s political editor, Laura Kuenssberg to mark the first 100 days since taking office, when he conceded re pandemic management that things ‘could have been done differently’.  Understatement of the year? The PM claimed that all manner of things known now could not be known at the start, when there had actually been plenty of lessons from the experience of other countries. And there was another attempt to throw the scientists under the bus: ‘There are still very open questions as far as scientists are concerned, and there will be a time, obviously, to consider all those issues’ (aka not any time soon).

The coup de grace this week must be the sudden decision, catching out thousands including Transport Secretary Grant Shapps, to impose quarantine on those returning from Spain – Costa del Quarantine, as the Sunday Mirror apparently called it. What’s the betting that Shapps (who worked as a “multimillion-dollar web marketer” under the pseudonym Michael Green for at least year after becoming an MP) will find some kind of exemption?

Besides being the laughing stock of Europe for the way the government has handled the COVID19 crisis, it seems we’re also the fattest in Europe.  This week the government will launch its new strategy for tackling obesity, especially important in the context of findings which strongly suggest a link between weight and susceptibility to COVID19. Since other strategies have clearly failed, not least because the proposed measures don’t get to the roots of the problem, it’s difficult to be optimistic about this. We hear that banning pre-watershed junk food tv advertising will be one measure, but previous experience suggests this doesn’t work because the concept of the watershed has changed and there are so many more platforms carrying advertising than before. A key issue is the underlying reluctance to clamp down on processed and junk food manufacturers because of the possibility of upsetting party donors and supporters. Public Health England spokesman Professor John Newton said it was a ‘shocking statistic’ that only 18% of men in his age group (60+) were of normal weight.

The PM’s own weight struggles and serious brush with COVID have apparently brought about what some media outlets have called ‘an epiphany’: ‘I’m not normally a believer in nannying, or bossing type of politics. But the reality is that obesity is one of the real co-morbidity factors’. The government’s £10m campaign, called Better Health, will ask GPs to contribute substantially by recommending activity via ‘social prescribing’ and by referring patients to healthy weight coaches provided by the practice. But clinicians have often shown themselves reluctant to talk to patients about their weight, because of the possibility of offence being taken. Surely it’s not just GPs who need to be involved but all clinicians, for example those consulted during hospital appointments. Unfortunately, these strategies are often too biomedical to access the often psychological reasons for obesity, and unless these are addressed, it’s doubtful this campaign will reach its potential.

An impatient tweeter said: ‘STOP DEMONISING obesity. We need to demonise the socioeconomic deprivation, stress, mental health illnesses and the DIET INDUSTRY which is causing people’s health to be affected. This isn’t a weight issue, it is a wellbeing crisis. We need to invest in wellbeing not dieting’.

With statues still very much in the news, following the guerrilla erection and subsequent removal of the Jen Reid statue in Bristol, there’s an interesting take on them in the Guardian. It suggests that after World War 1 our concept of the connection between history and statues changed significantly. The author believes statues reduce history to celebrity culture, based on ‘great men’ such as generals rather than the rank and file, but this changed after 1918. ‘When Britain erected a national monument to the war dead on Whitehall, it took the form of the Cenotaph – a stark, abstract image of infinite loss and a suffering too vast to be contained in a statue of some supposedly heroic figure’. He believes that only by conveying the scale of the tragedy of slavery, via a sense of a void (as in some commemorations of the Holocaust) will we do justice to the crime of 12 million Africans being forced onto slave traders’ ships.  The author concludes: ‘Instead of another statue, another token symbol, we could use the full scope of 21st-century art to express both the nature of Britain’s slave trade, and the impossibility of making art that can restore millions of stolen lives’. The Mayor of Bristol, Marvin Rees, has impressed many so far by his calm approach to dealing with the statues debate. It will be interesting to see how he resolves the controversy surrounding this particular statue at the same time as bearing in mind the bigger picture of how such events are commemorated.

Continuing the mental health theme of previous posts, an interesting and very useful article tracks the ‘psychological toll’ of the pandemic, suggesting five main clusters: grief, including the phenomenon of complicated grief; worry and anxiety; ongoing uncertainty; relationships; loneliness. The toll is within the context of 65,000 deaths, equating to all those endings and funerals which could only take place very briefly, with minimal attendance, profoundly affecting those who had to be excluded besides those close to the deceased. The omission of the public mourning aspect is significant and it would be interesting to see if any difference is made to people’s experience if larger memorial services could be organised at a later stage. It’s now becoming better recognised that, in comparison with the early days of lockdown, when we were mostly clear about the ‘rules’ and guidance, the easing of restrictions has resulted not only in confusion and anxiety but also differences of opinion on levels of risk taking. As various experts have said, we now have to be our own personal risk managers, but not everyone is happy with the uncertainty and anxiety this can provoke, or the level of government abdication of responsibility it represents. One concern is about what the new ‘rules’ of social interaction are, some perhaps feeling uneasy about ever returning to hugging and kissing friends.

The researchers found that almost a quarter of Britons with a partner (23%) said in mid-April that the circumstances were placing pressure on their relationship and Relate found that while spending more time together has been a positive experience for some, those with pre-existing relationship problems had no respite from the difficulties. On the other hand, some experienced relationship improvement because lockdown forced them to confront their difficulties instead of sidestepping them.

The authors conclude that Isolation, job insecurity, relationship breakdown and bereavement are causing serious psychological problems for people with no history of mental ill health, while up to half a million people in the UK who weren’t treated during lockdown would need attention, leading to a potential ‘tsunami of mental illness’. Despite bullish words from NHS mental health spokesmen, it’s very doubtful the NHS will cope because (partly thanks to ill-advised changes in 2006 to the way primary care services are run) the services are already struggling with long waiting lists and poor choice of treatments.

Finally, it’s very cheering to hear about museums and galleries reopening and to hear people’s experiences of visiting them, often more positive because of being able to view the exhibits without being surrounded by hordes. It’s great that so many galleries are extending exhibitions we didn’t get the chance to see because of lockdown, such as the Tate’s Aubrey Beardsley and Forgotten Masters at the Wallace Collection, focusing on the little-known art of 18th century Hindu and Muslim art commissioned by the East India Company. Some of the best cited here are outside London, which will please those who weary of the often metropolitan focus prevalent in the arts and media worlds. Having seen some of Grayson Perry’s excellent Channel 4 lockdown series (Grayson’s Art Club) I have a penchant for a day trip to Bath to see his Grayson Perry: The Pre-therapy Years. ‘It’s easy to see that his eye for the absurd and grotesque was there from the start, along with his rage against a bourgeoisie who have since come to love him’.

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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