Sunday 9 August

As the UK death toll reaches 46,574, this week started with no-nonsense senior scientist Sir Paul Nurse lambasting the secrecy which has dominated pandemic management: ‘Decisions are too often shrouded in secrecy. They need challenge and we need processes to ensure that happens. If they are going to keep the trust of the nation, they need to make those discussions more public…They seemed not to want to admit that they weren’t prepared, that they were unable to do the testing properly, because that would have been an admission of failure from square one…’. This sounds like a good argument for more notice being taken of Independent SAGE, whose experts have long advocated policies which the government only adopts when forced to, eg more local involvement of public health experts. Independent SAGE also has webinars anyone can join so there’s a good deal more transparency. Official SAGE, on the other hand, meets in private and members are expected not to talk about its deliberations. Co-chairs Patrick Vallance and Chris Whitty, Chief Scientific Adviser and Chief Medical Officer, are government employees, giving them limited room for manoeuvre.

Besides secrecy Nurse effectively alludes to the need for nuanced policy rather than the current blunt instrument blanket approach:  ‘What worries me is that we have an increasingly technocratic and complex society and we are going to increasingly need complex discussions involving science and the use of science that will impact on policy.’

Meanwhile, as if care homes hadn’t seen enough suffering, we hear that the regular testing of residents and staff, intended to on 6 July (when this should have been much earlier), will now be delayed until 7 September for older people and those with dementia.

In his highly percipient and worrying article entitled ‘Boris Johnson’s rise to power taught him all the wrong skills for a Covid crisis’,  Rafael Behr suggests the PM has the wrong kind of personality and is without the right skills for his job, because ‘it consists of constant, agonising judgments – picking between imperfect options, each with undesirable side-effects…. Everyone who has reached any position of Westminster seniority, whether as a minister or civil servant, ends up awed by the relentless demand on a prime minister to make those calls. Everyone, that is, except Johnson…’. Behr sees the PM’s skill set (if it can be called that) as evasion, trade-offs and denial, his power base Brexit-dependent. ‘He struggles with the job itself and with the wound to his ego from the discovery that governing is beyond his capabilities’. The heavy reliance upon rallying cries of ‘we’ must do this or that (including staying alert, of course) is seen as a giveaway, a projection of responsibility onto the public which he doesn’t feel capable of carrying it himself.

Amid fears of a ‘second wave’ and more evidence that many don’t understand the ‘guidance’ and ‘rules’ (hardly surprising given the so-called ‘swift’ changes like the restrictions this week placed upon Preston and different arrangements in the other three nations), journalist Andrew Rawnsley used a word which captures so well the government’s desire for all this to go away. … ‘They dreamed of returning to that prelapsarian age in which you could eat out with your family, go drinking with your mates, commute to work, celebrate a religious festival or jet off to a holiday somewhere reliably sunny without having to worry about catching or spreading a deadly disease… The fear swirling around Number 10 is that the public will be much less tolerant of a resurgence, especially if it looks like the result of incompetence and recklessness’.

The frequent attribution of the rise of new cases in Greater Manchester with inter-generational mingling in BAME communities had to be questioned this week, with the news that 80% were in the white community Nine of the region’s 10 local authorities are in the top 20 areas with the highest infection rates in England, according to NHS data for the week to Friday 31 July.

https://bit.ly/3fJwfhE

As the Spain quarantine debate rumbles on, many are feeling anxious as to whether their destination could suddenly find itself on the list, several more countries this week having been taken off the ‘safe’ list and fears growing about France. But some sceptics at least won’t worry: due to the lack of procedures and enforcement, not to mention lack of a COVID-secure environment at airports, it seems that only 11 enforcement orders have been made. Apparently only one in four (and that’s the official figure) passengers destined for quarantine are followed up. A Radio 4 listener tweeted: ‘Pathetic and entirely predictable. Macho government talks up stringent measures but doesn’t deliver’.

Major weaknesses are thought to include ‘cakeism’ (having it and eating it), dismissal of  others’ legitimate concerns, muddled communication and to hide or go AWOL when it becomes too difficult or uncomfortable. His approach ‘is primed for the ruthless crushing of enemies’ but this is only useful in campaigns: for the day-to-day business of government this bludgeoning and adversarial style just doesn’t cut it. ‘There are no traitors to be hounded in the battle against Covid-19’.

Other big news items this week, such as the Beirut explosion and large increase in migrant landings, have put first world problems like holidays into perspective. We’ve heard about the corruption long dominating politics in Lebanon and have to feel for the people there having to cope with bereavement, homelessness and shortages on a massive scale. Once regarded as the ‘playground of the Middle East’, recent years have seen Beirut subjected to one war and rebuilding after another, against a backdrop of poverty and political stasis. No wonder those interviewed in the media sound exhausted.

A strange coincidence on Friday (and I wondered if anyone else had noticed so tweeted the Guardian just in case they were interested in this historical perspective): on leaving the National Gallery via route B, I just caught sight of a small painting by an Egbert van der Poel called A view of Delft after the explosion of 1654. The accompanying text states that Delft experienced ‘a momentous catastrophe as the municipal powder magazine exploded, destroying almost a third of the town and claiming many lives’. Information from the New Netherlands Institute tells us that the painting is ‘made more poignant when we know that the artist’s son was killed the explosion’. How many similar disasters have occurred which the waters somehow close over with the passage of time? I wonder how many tourists get to hear about this – I certainly didn’t when I went there and that was with a Dutch speaker.  

Journalist Jonathan Freedland dissects the speedy path to corruption he believes the government has taken, getting there even more quickly than the May administration. From the PPE and track and trace procurement debacles to the awarding of numerous contracts to private sector companies, usually with government connections, and the creation of yet more politically motivated peerages, it’s not taken long. The conflict of interest in many of these contracts is plain to see but only because investigative journalism and lawyer Jolyon Maugham’s Good Law Project have brought them to light, for example ‘the government’s £15bn supermarket sweep approach to PPE procurement’. The Project has initiated proceedings over several deals with suppliers with no evidence of experience or expertise in PPE, including a pest controller and a confectionery wholesaler. The government used the pandemic to dispense with normal contact tendering procedures – just when do they intend to reinstate them, we might ask? The path to corruption has also, of course, been additionally paved by the shaming and arrogant antics of Dominic Cummings, Robert Jenrick and others plus the two MPs in the frame for sexual misconduct.

Freedland nails the short-termism underlying this strategy – the government thinks, with an 80 seat majority, they can get away with anything and may have felt rather clever, but the longer term damage they will sustain will be seen in the likely lack of public compliance with any future general lockdown.

https://bit.ly/3kjF3OS

Another form of oversight, though, sadly, without real teeth, is the All Party Parliamentary Group chaired by Lib Dem MP Layla Moran, which is holding a ‘rapid inquiry’ into the government’s handling of the pandemic. It seems a very large group, over 50 politicians having joined, including former minister David Davis. Some members were moved to tears by the testimony of a group of relatives of the deceased, Covid-19 Bereaved Families for Justice, which is calling for a statutory, judge-led public enquiry. The PM has agreed to hold one, but seems to believe this can be kicked down the road with no timeframe (‘there will come a time….’) – meanwhile more are dying. Psychotherapist Kathryn de Prudhoe, who lost her father, is also calling for substantial government support to enable the provision of counselling for the bereaved – very much needed.  

There was bad news for the government from a different direction this week – not long after the conviction for sexual assault of former Tory MP Charlie Elphick, it emerged that another (so far unnamed) Tory MP and former minister had been arrested and bailed for alleged rape. Just days later, this seems to have gone very quiet, but it was notable that, when asked about this on the Today programme, business minister Nadhim Zahawi repeatedly refused to be drawn on why the whip had not been withdrawn from this individual. This could be another example of short-termism: the PM defending his man, seemingly unaware of the long-term damage such a stance will do his government. 

Further to the obesity strategy discussed in the last post, Channel 4 this week aired a controversial documentary, presented by Dr Michael Mosley, called Lose a stone in 21 days. It featured a number of people who’d put on weight during lockdown, who were first given a number of tests we wouldn’t normally get on the NHS. What I thought was interesting was the wake-up call potential, since many don’t recognise being overweight or the dangers associated with it, eg of being told they were metabolically 20 years older than their actual age and/or they were pre-diabetic. It could be argued that without such a wake-up call, which shocked these guinea pigs then subjected to an 800 calorie a day diet, many would fail to see their weight as a problem.

The Twitter reactions throughout were interesting, some commending the approach but quite a few, including eating disorder charities and people having experienced these difficulties angrily

complaining of triggering. 800 calories a day is regarded as far too low in the opinions of many, including some clinicians. I did wonder, though, if the idea was to enable quick results, which could then motivate them to continue at a higher calorie intake: too often a complaint of dieters is that it takes too long to achieve results and meanwhile they’re thinking of food all the time. But, as ever, there’s too much emphasis on calorie counting and not enough on the underlying psychological reasons people are overeating in the first place. A key question that needs asking is will the programme makers track these people 6 months or a year down the line to check if their weight loss has been sustained? Or will it be short-term because basic eating patterns and prompts for eating haven’t been addressed? A key aspect of the timing, of course, is the proven link between obesity and Covid19 susceptibility, but a rounded analysis of the problem necessitates exploration of the psychosocial issues, the need for exercise (not just dieting) and the need to permanently change eating habits. I found the smugness of the presenters slightly offputting and a key disconnect was some of the ad breaks featuring fast food, but I’ll reserve judgement until the end of the series. One reviewer at least challenged the reservations over ‘shaming’: ….’Covid-19 has changed all that. The data is clear. Our lives, I think we can all agree, are more important than our feelings’.

Finally, in The Week’s column ‘It must be true, I read it in the tabloids’ is news of the Satanic Temple in the US, which campaigns against ‘Christian privilege’, launching a Devil’s Advocate Scholarship to help students into higher education. To win a $500 grant, applicants have to describe a teacher who ‘made you hate every minute’ of school. The scheme’s founder said it offered ‘a rare opportunity to be critical of an institution that only rewards sycophantic adulation’.

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.

4 thoughts on “Sunday 9 August

  1. there’s too much emphasis on calorie counting and not enough on the underlying psychological reasons people are overeating in the first place Yes, (most) people aren’t fat because they lack the knowledge of what and how much to eat in order to be healthy.

    Liked by 1 person

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