Sunday 29 November

Weeks continue to be so eventful that it can be difficult not to let the latest onslaught eclipse important developments occurring at the start. All discussions and decisions have to be seen in the context of the latest sobering statistics: a further 696 coronavirus deaths were announced on Wednesday, the highest UK daily total since 5 May, but statistics are disputed because of the methodology for calculating them. One tweet asserted: ‘We should recognise that Covid-19 is linked to around 75,000 UK deaths since mid March, not the wholly fictitious government number of 52,147. The BBC and others should stop using that figure. The fact it is written down daily on a government website doesn’t make it true’.

The announcement earlier in the week that Christmas wasn’t ‘cancelled’ came as a relief to some and alarming to others, who don’t understand the obsession with Christmas and worry about the potential for a third wave in January. A wag tweeted: ‘Classic…. first the government admits it will break the law in a ‘limited and specific way’. Now we can celebrate Christmas in a ‘limited but cautious way’. Dr Julian Tang, clinical virologist at the University of Leicester, got it in one: “I do not think SAGE will have evidence to show that enhanced mixing is going to be beneficial in terms of stopping the virus from spreading, if anything it will increase the virus spread … The reason that the government and Sage are … giving this amnesty of five days is more of a psychosocial, emotional side of what Christmas means to people’. Meanwhile, widespread non-compliance with restrictions seems likely, with little policing to prevent it. A Radio 4 listener tweeted: ‘Yet again the government tries to have it both ways and give itself a get out clause: restrictions eased over Christmas to appease rebellious backbenchers but still cautioning people ‘to be very careful when making Christmas plans’. So it’s our fault if it goes wrong’.

The Christmas debate has revealed the stark divide between those desperate to see their families at Christmas, citing mental health and loneliness, etc and those who plead for patience and eschewing contact until it’s safe. It raises once again the old conundrum of instant versus delayed gratification.

The Guardian’s John Crace offered a witty analysis of the PM’s performance on Monday (‘Tiers of a clown as Boris Johnson’s video link falls down), an attempt, he suspects, to distract attention from the Priti Patel bullying fallout. Seizing on the illogicality of the ‘rules’, (‘Tier 3 would more or less be like the current national lockdown apart from the bits that wouldn’t’), it was felt to be ill-considered and smacking too much of unhealthy compromise: ‘It all felt pretty much like something that had been cobbled together on the back of a fag packet in cabinet to fit in with what the libertarian wing of the Tory party might accept, rather than something that was based on hard scientific evidence’. But our PM is forever optimistic, despite now citing Easter, rather than Christmas as originally suggested, as a time when all this might be over, relying heavily on the vaccine. ‘Though this had to kept hush-hush for now, because if the coronavirus got wind of any relaxations in measures it could seek to take advantage by working overtime and leaving many elderly relatives dead in January and February. There again, it’s been a long old year for Covid-19 as well, so maybe the virus could do with a four-day break too’.

Following the PM’s protracted IT problems, Matt Hancock was left to pick up the questions, until the PM reappeared, only to lapse into embarrassing nonsense that we must hope the foreign media weren’t observing. ‘Johnson happily went into a string of lazy metaphors – “the drumming hooves of the cavalry coming over the hill”, “Tis the season to be jolly, but also the season to be jolly careful” – before lapsing into rhyme with “squeeze the disease”. Not for the first time, it was left to the scientists to remind everyone to basically ignore the prime minister and to listen to them instead’.

The week has been a build-up to Thursday’s announcement of the new tier system to replace lockdown on 2 December, and it’s a shock to see the Metro’s map showing the country mostly allocated to Tiers 2 and 3, very few to Tier 1. Many southerners have been relieved to find themselves in 2 but those now in 2 who had been in 1 have reacted angrily at such a hike in restrictions. There’s been vociferous annoyance in some areas at what seems to them the unreasonable lumping together of areas with very different levels of infection, for example in Kent. Our PM, who has now developed a fine line in cringe worthy patter (‘squeeze the disease’), has now excelled himself with ‘your tier is not your destiny’, dangling the carrot that tiers may change when they’re reviewed.

He has frequently demonstrated his difficulty in facing up to challenging situations but is now stuck between a rock and a hard place – scientists advising caution and not supporting Christmas relaxation on one side and the Covid Recovery Group of MPs firmly opposed to lockdown and restrictions on the other. It will surely be embarrassing for him needing to rely on Labour to get these measures through, except typically, he is now trying to buy off the rebels by offering more reviews. The Times says: ‘…It is hard to see Mr Johnson making any substantive concessions to his MPs. The tiers will become law, even if it has to be with Labour votes, and it makes sense to take a political hit now in the expectation that it will all be forgiven in the spring once a vaccine arrives and the NHS has got safely through the winter’. It remains to be seen whether, given the anger engendered by this tier allocation, the Times’s prediction will prove accurate. ‘Ultimately, the public are still supportive of restrictions and astonishingly understanding about the curtailment of their freedoms. Only if this changes will Mr Johnson have real cause to worry’.

As usual, Matt Hancock didn’t escape John Crace’s attention this week, this time focusing on his performance at the Health and Social Care Select Committee, chairman one Jeremy Hunt (as erstwhile Health Secretary quite some conflict of interest there). ‘There must be many times when Matt Hancock wonders what he has done in a previous life to deserve his present one. Come to think of it, there are many times when most of us must wonder what we have done in a previous life to deserve him’. The interrogation was supposed to be about ‘lessons learned’, which the government seems to struggle with the very idea of: it seems that, despite the clear trajectory of errors and misjudgements since March, in the collective ministerial mind nearly everything has been done well.  

‘…..we never found out whether he had learned his lesson in hubris, and would never again allow his ambition to exceed his capabilities. Just when the country needed a really able Health Secretary, we’ve got someone whose enthusiasm and patter would have seen him rise to be the manager of an upmarket car showroom’. Crace describes the ‘decidedly tetchy’ exchanges between Hunt and Hancock (predictable bit of antler clashing) on the subject of ‘the science’. ‘Hunt asked Hancock if he had always followed the science. “I prefer to say that we were always guided by the science,” Matt said.

“But you did used to say you were following the science,” Hunt observed. “I was merely being colloquial on those occasions,” Hancock snapped. Now we were slipping down a semantic rabbit hole. One in which it was unclear if the government was following the science when it got things right and was guided by the science when it screwed up. Or vice versa’.

After the ‘jaw dropping’ statement ‘One of the lessons we’ve learned is that you must hit the disease hard and hit it early’, Hancock apparently began to demonstrate his confusion about the pros and cons of circuit breakers and lockdowns. ‘By now it was again unclear whether Matt was following the science or being guided by it. Or whether he was following the incompetence or being guided by it’.

Meanwhile, heavy media coverage of various vaccines has now revealed (you couldn’t make it up) that the government tried, unsuccessfully, to get the Oxford University/AstraZeneca coronavirus vaccine containers labelled with an image of the union jack in order to counter Scottish nationalism. Hospitals have been told to prepare for vaccine rollout in the first half of December. It’s surely a significant concern that in addition to its regular work, the NHS has been ‘tasked’ with the rollout, apparently without government help, enabling ministers again to abdicate responsibility if problems occur. Care home directors are up in arms that residents will not now be amongst the first to receive the Pfizer vaccine (as promised in September, along with NHS staff), ostensibly because of problems associated with transporting the vaccine, which loses efficacy if moved more than four times. This Pfizer vaccine, although it’s first off the starting blocks, does seem a somewhat delicate flower, including having to be kept consistently at low temperatures, not to mention being transported from Belgium post Brexit.

It looks more likely residents will get the Oxford/AstraZeneca one. ‘Unlike the Pfizer vaccine, it does not need to be frozen at -70C to -80C and can be stored in normal fridges and easily moved around by GPs, nurses and health visitors administering jabs in locations such as care homes’. And now our cup runneth over – top of the news is that Nadhim Zahawi (as well as retaining his business portfolio) will take responsibility for vaccine rollout, reporting to Matt Hancock. How long before we hear that some private sector crony, facilitated by the multitasking minister, has been commissioned to transport and distribute the vaccine?

As QC Jolyon Maugham and his Good Law Project continue to challenge the government in the courts on the award to cronies of pandemic-related contracts and inappropriate appointments like that of Dido Harding to head up Test and Trace, we have to wonder who will be awarded the contracts to run the 42 vaccination centres and to transport the vaccine. We can no longer, if we ever could, assume this will be carried out fairly or transparently. As if from a parallel universe, the government’s legal department told the Good Law Project that ‘they were not civil service roles so fell outside the requirements for full and open competition’. They then praised the administrative abilities and experience of those chosen, dismissed claims of indirect discrimination and declared that the case is ‘unnecessary and will soon be academic’. It’s a mistake for the government to assume, as they’ve done with the Dominic Cummings and Priti Patel rows, that the ‘matter is closed’ because to many, such examples are further nails in the coffin of trust in our leaders.

Chancellor Rishi Sunak’s Spending Review naturally generated keen interest but further anger in some quarters, freelancers again not benefiting, nothing for those with disabilities and the cut in the foreign aid budget. Fears of massive unemployment prompted a £4.3bn package of support to help the unemployed find work, including a £2.9bn Restart scheme designed to help with job hunting. But it also comes with a public sector pay freeze, which seems appalling when we consider how so many of these workers have kept going on the frontline throughout. Sunak said ‘The Covid economic emergency has only just begun’ and that the £280bn spent tackling the pandemic in the current financial year would be followed by a further £55bn of spending in 2021-22, to include substantial funds for testing, PPE equipment and vaccines; £3bn to help the NHS reduce its routine caseload backlog; and £2bn to subsidise the railways.

 ‘The shadow chancellor, Anneliese Dodds, accused the government of squandering public money on an industrial scale during the crisis and attacked the decision to freeze public sector pay. ‘Key workers who willingly took on so much responsibility during this crisis, are now being forced to tighten their belts. In contrast there’s been a bonanza for those who have won contracts from this government’. It prompts the question again about what jobs are actually available and which ones will become permanently ‘unviable’, increasing calls for a Universal Basic Income. Shocking that this lockdown and other restrictions have the economy on course for the worst contraction in three centuries and unprecedented peacetime borrowing, inducing a sense of helpless resignation in those not in a position to do anything about it and probably also those who do. Public anxiety will be ratcheted up every time we see evidence of our leaders out of their depth.

We hear more and more allusions to it, for example during radio interviews, and it seems people are beginning to grasp the extent to which their mental wellbeing has been undermined as a result of the profoundly unwelcome changes and uncertainty we’ve all had to confront since March, some much worse hit than others. The Guardian’s Marina Hyde drills down into some of the reasons for this – poor communication, unrealistic promises and inadequate management of expectations from the top. ‘From the very start of this pandemic, the Prime Minister has confirmed he is temperamentally unsuited to delivering bad news. Instead, he has opted to deliver bad news hopelessly belatedly, and good news self-defeatingly prematurely. The effect is to make people feel constantly cheated, even when the news is better than might have been expected had their expectations been managed more fairly or reasonably’.

On Tory disillusionment, she observes: ‘Naturally, there is a certain irony in seeing Tory MPs who voted for Johnson now outraged to discover that he won’t tell them the truth. Had you given a look to camera this morning every time an MP said something like “the prime minister needs to be straight with people”, you’d have had whiplash before breakfast….Much worse are the ones still quietly making excuses for his character failings, like he’s some special case….. Yet hope is hugely important, now more than at any time this past year, and a better leader – even an adequate one – should be able to inspire without misleading’.

Sir Norman Lamb, former coalition care minister, is one of the latest to call the government out on its lack of attention to mental health. Despite the government constantly saying it’s put ££ more into this area, it’s never enough and goes no way for compensating for the cuts made over the years during a time of rising demand. Lamb has joined a group of 18 former care ministers to call for more funding for social care, which naturally can’t be separated from health services. (While he welcomes the £500m expected for NHS mental health support in the Spending Review, he stresses it must be accompanied by extra funds for social care). A parliamentary select committee report estimated the social care shortfall in England alone was at least £7bn a year, to fund increasing needs of elderly and disabled people and, crucially, to improve pay and skills for care workers.

‘Lamb wants more acknowledgment of Covid’s lasting impact on people’s mental health and is campaigning with consultant clinical psychologist Warren Larkinfor the UK government to introduce a resilience taskforce. They have written an open letter to the health and social care minister, Matt Hancock, backed by a group of more than 80 experts, outlining why such a taskforce is vital to protect people’s mental health and social wellbeing…….On the issue of unfairness, Lamb is concerned that Covid is widening existing inequality: “There’s a sense of a growing divide. People who are financially secure are fine, and particularly young people from disadvantaged backgrounds are the most vulnerable as a result of this [pandemic], and that’s what worries me most…You can do so much to improve people’s lives and give people the chance of a happy life – and that is ultimately what government should be about.” This seems a very important statement, because we do hear ministers saying they’re about ‘improving people’s lives’ while pursuing numerous policies designed to do precisely the opposite.

Although the mental health impacts of domestic violence are now better understood, it’s clear there’s still quite some way to go. During the pandemic the situation has worsened because of lockdown and related stresses, ripples spreading out from victims, perpetrators, their families and the wider community, not to mention the costs involved. Now Nicole Jacobs, the first commissioner for domestic abuse for England and Wales, who will have significant powers once the domestic abuse bill becomes law early next year, has spoken out about the urgency needed to address femicide – the killing of women by men. The Femicide Census showed that over a 10-year period (2009-18), 1,425 women were killed by men. ‘One woman died, on average, every three days. Twenty men killed twice’. She criticises the ‘postcode lottery’ and lack of coordinated response of agencies. It’s also been found that when women speak out about their abuse, they’re often assumed to be liars. As Domestic Abuse Commissioner, her powers will allow her to obtain information from public bodies, make recommendations and to expect the authorities to respond within 56 days. It’s some indication of the scale of the problem that so far none of the leaders of the main political parties had commented on the census and the rate of femicide. We’re not told to what extent the new role will also cover male victims of abuse and if the powers extend to enforcing public bodies’ response to information requests – it’s hobbled if it’s toothless.

While some are rightly calling for some kind of public acknowledgement of and memorial for all those who have died from Covid, the Guardian profiles ‘an exclusive members’ club none of us wanted to join’. The closed Facebook group of 2,000 bereaved people is described as ‘a secret society… a place where the bereaved can drop the ‘just about OK face’ they manage in public and let the crumbling face of grief show’. Society as a whole still struggles with confronting the issues of death and dying, as shown by excellent documentaries like the series Dame Joan Bakewell presented for Radio 4 – ‘We need to talk about death’ – but Covid death is experienced differently by those bereaved by it. ‘They speak with a raw frankness about the reality of their loved ones’ deaths rarely heard in the national Covid conversation, for example, the anguish of sealed coffins and not being able to dress the deceased. And there is a powerful feeling they are out of step with the rest of the country as it obsesses over tiers and Christmas gatherings that seem to many “insane”. It is as if society, in a kind of collective fight-or-flight mode, remains in denial of the pain caused by Covid deaths’.

One member confided that she split from her boyfriend of 18 months because ‘he questioned my father’s death and said it couldn’t possibly be Covid as it didn’t exist’. Another spoke about her husband’s death in April. ‘Ten chairs were spaced out in the crematorium and it felt surreal and impersonal. There were no family hugs outside whilst I collapsed in grief … the darkness that swept over me, the shock that I would never hold my husband ever again’. Another captures the abject loneliness of this experience: ‘Sometimes it feels like you’re living in an alternate reality to others…To them it’s been disruptive and difficult but to us it’s been world-shattering’. The public facing Covid-19 Bereaved Families for Justice UK group is calling for a judge-led public inquiry into the government’s handling of the pandemic and for funding for bereavement counselling. Let’s see what happens as such measures seem the very least that can be done for these people.

Finally, on an artistic note, ‘important but divisive’ artist Maggi Hambling caused some controversy with her recently unveiled statue of feminist Mary Wollstonecraft on North London’s Newington Green. It took ten years to raise the required £143,000, and although the plaque says it’s ‘for’ Wollstonecraft, not ‘of’ her, feminists and other critics have lambasted the nude representation, described by Hambling as ‘everywoman’, (‘clothes would have restricted her’). It was felt that a man would not have been represented naked and apparently some feminists have been covering up the statue and ‘knitting her a tiny cardigan’. Having seen the recent documentary about Hambling on the BBC, I can well imagine the feisty and maverick Hambling would give critics as good as she got. At least it’s good that, whether or not we favour this memorial, it’s meant Mary Wollstonecraft has come much more to public attention than would possibly have been the case with a more conventional statue. At the end of the article below you can see a link to the short Facebook film made as a substitute for an official launch.

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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