Saturday 6 February

As we move into February the first week has seen plenty to occupy minds and media, from the Covid death totals, which remain very high (eg 1449 on Tuesday, 915 on Thursday, 1014 on Friday), to the sad death of Captain Sir Tom Moore, continuing debate about the vaccination programme and challenges regarding the slow progress being made in introducing quarantine hotels. Despite public sadness at the passing of ‘national treasure’ Sir Tom, many were annoyed by the Prime Minister’s cynical call for public clapping that evening, especially when the PM continues to be deaf to the intolerable strain and exhaustion NHS staff are experiencing. The tactic of praising people under severe strain when also denying them pay increases and underinvesting in their service just doesn’t cut it. We saw the same thing last week when the Prime Minister wrote to parents thanking them for their sterling efforts on home schooling. As one tweeter observed: ‘Perhaps you could properly honour the legacy of Captain Sir Tom Moore by properly funding the NHS in future so that centenarians don’t need to skip around the garden to raise 1% of the £30billion your government is underfunding it by.’

Referencing the effects of lockdown on mental health, the British Medical Journal drew attention to record alcohol-related deaths, with 5,460 in England and Wales attributed to this cause between January and September 2020, up 16% on the same period over 2019. This is the highest number since records began in 2001. The BMJ, considered one of the most respected medical journals, also attacked the government for corruption and misuse of science to suit its own ends. The Journal suggested that Covid-19 had ‘unleashed state corruption on a grand scale’, that politicians and industry were guilty of ‘opportunistic embezzlement’ and ‘the suppression of science’. The BMJ points to scientists being told not to speak to the media, and the suppression of key paragraphs from Public Health England (PHE) reports, besides accusing PHE of attempting to block the publication of a scientific report into the efficacy of antibody tests procured by the government. It’s surely an indicator of what dire straits we’re in when a prestigious organ like the BMJ feels the need to speak out like this.  

https://bit.ly/3cKrlmL

One of the most depressing news items, though not surprising, is the introduction of doorstep testing of around 80,000 people in specific ‘hotspots’ given the rapid rise in those areas of South African variant cases. Again, we see evidence of a process not properly thought out, as there will be household members missed and no procedure ensuring that those asked to isolate actually do. It’s thought that around 20,000 should be self-isolating but are not doing so. The reason this is so depressing is that, despite the government’s simplistic attempt to deflect from their mistakes and present the vaccine as a ‘cavalry’ coming to our rescue, a panacea which would enable us to ‘get back to normal’, it’s now manifestly not the case. More and more experts are saying that we will need other measures in place for some considerable time, some suggesting that we won’t be ‘out of the woods’ until the whole world is vaccinated because we can’t just operate as an island when we’re one part of a global economy. Health Secretary Matt Hancock’s declared goals to ‘stop the spread altogether of these new variants and bring this virus to heel’ aren’t likely to be met by doorstep testing while our borders remain open. It’s also a bit of joke describing this initiative as ‘a sprint’, when the government has been tardy in every measure it’s taken from the start of the pandemic.

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Sky News featured one public health expert who believes getting back to any kind of normality will take a couple of years, and the head of NHS Providers, Chris Hopson, forecast many more months. Hopson attributed this partly to the workforce being ‘exhausted and traumatised’ (still not acknowledged by the government), with many needing to go on long term sick leave and/or considering leaving the NHS. This is a serious issue the government needs to take seriously.

https://bit.ly/2YPv4Yj

These forecasts haven’t, of course, stopped vociferous anti-lockdown campaigners including Parliament’s inappropriately named Covid Recovery Group from expressing their views and putting pressure on the Prime Minister. He’s in between a rock and hard place trying to do what’s necessary, even ‘following the science’, at the same time as trying to placate these relentless backbenchers. But then being able to navigate such tricky territory is one of the many skills required in this role, not one demonstrated by the present incumbent, with his endless dithering and half measures.

A good example of half measures, like trying to fill a leaky kettle, is the delayed introduction of quarantine hotels for returning air passengers, not due to start until 15 February despite the South African variant being discovered here in December. But this is another half measure, planning to only quarantine UK passengers, as opposed to the thousands of others entering the UK. It’s strange that ministers don’t realise journalists and others will check out their statements – the head of the largest chain of airport hotels, Best Western Hotel group, said the government had not spoken to him and how frustrating it was not to have the opportunity to properly prepare. It’s not dissimilar to the government claim last March to have spoken to the supermarkets about supplies and stockpiling, when they had done no such thing.

These exemplify the imperious and top down attitude demonstrated by the government, failing to communicate well in advance with those expected to implement these plans and remaining unaware of the work and complexities involved. Shadow Home Secretary Nick Thomas-Symonds described the need for doorstep testing as ‘deeply worrying….. It shows the UK government’s quarantine system is not working, with the country being exposed to dangerous strains of the virus and new cases now appearing…while door-to-door testing is welcome … how can the Home Secretary justify keeping our borders open to Covid, allowing around 21,000 people to arrive every day?’ Nevertheless, one minister after another repeated during media appearances the standard disingenuous script, to the effect that this was an ‘additional’ measure because we already had ‘robust’ procedures in place, such as asking people to isolate when it’s known that there’s very little checking and a good number are not doing so.

Regarding the ending of lockdown, it’s fair to say many have been pressing ministers on this and their promised ‘roadmap’ (not expected until 22 February) not for simple answers to the when question but for the actual criteria that decision would be based on. So far there has been no clear response and this is yet another aspect of this situation to be increasing public anxiety.

Eviscerations of the Prime Minister came from several sources this week, including, as usual, the Guardian’s sketch writer John Crace and also the Scotsman. Crace’s article is titled ‘Prime minister’s questions for the prime minister who doesn’t do questions’, as it’s been highlighted many times how often Boris Johnson turns the questions into an attack on Keir Starmer, with no challenge from the Speaker. Several commentators have observed the lack of Speaker intervention and we can imagine such diversionary tactics wouldn’t have been tolerated by predecessor John Bercow. Crace started with Boris Johnson’s PMQs performance: Right now, PMQs feels increasingly redundant. Even as a piece of weekly political theatre it is failing. There was a time when Keir Starmer regularly managed to get under Boris Johnson’s skin, but Boris has long since worked out that he can get by quite easily without answering any questions, and the Labour leader has yet to find a strategy for forcing him to do so. He needs to do so quickly as we have reached a point of stalemate that suits Johnson just fine’. It sounded a very poor performance on questions relating to quarantine, dangerous cladding and the Northern Ireland protocol, resorting to waffle or tirades against the opposition leader and nor was Crace impressed with the PM’s performance at the Downing Street conference. ‘It started with Johnson again paying tribute to Moore. Almost as if the prime minister was trying to create an association between himself and the late soldier in people’s minds. Perhaps the prime minister has yet to learn the difference between selflessness and selfishness’. But later a change of approach showed itself, striking a more sombre tone. ‘What was most remarkable, though, was that – for almost the first time – Boris’s natural gung-ho optimism had given way to something rather more pragmatic. That he had discovered the hard way that the coronavirus couldn’t be pushed around and forced to fit with his government’s timetable…

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The Scotsman forensically dissects the Prime Minister’s behaviour. ‘The trick is to create low expectations for your conduct, in terms both of ethics and of political competence, and to do so boldly, with some degree of charm. Then thereafter, in true showbiz style, the trick is to live down to those expectations, in a spectacular way that keeps you in the news. You lie, you cheat, you fracture social norms and break treaties, you conduct a private life riddled with self-indulgence and betrayal; but always with the suggestion – false, but in the reactionary spirit of the times – that you are just saying and doing what every normal guy would do, given half a chance. Your political colleagues find your popular appeal seductive; your opponents are at a loss to know how to oppose you, because the more they point out the consequences of your actions, the more they boost your reputation as the bad boy who gets away with things’. Making the comparison with Donald Trump, the author suggests that this situation leads to the development of ‘Teflon’ politicians, whose supporters find them entertaining and whose detractors can’t touch them.

But this surely comes at huge cost, some supporters starting to understand that they’ve been taken in by the buffoonery which masks skulduggery. ‘…. if all political careers end in failure, the downfall of Teflon Boris, when it finally comes, may leave much more in ruins than his own vaulting ambition, and his childhood dream of becoming ‘king of the world’.

https://bit.ly/39QwUOO

While the PM and his colleagues repeatedly praise the NHS to the skies, taking their work for granted, The Independent raises the alarm about the government allegedly using the pandemic as a cover for taking more control of NHS England. We’re told the reforms would undo at least some of those undertaken by the Cameron government, by Health Secretary Andrew Lansley, in terms of NHS England no longer being an arm’s length body. There would be new powers to change the current structure, including new integrated care organisations and allowing some contracts to be awarded without the need to put them out to tender. You couldn’t make some of it up: ‘We are proposing to create a power of direction over NHS England that will provide clear lines of accountability by allowing the secretary of state for health and social care to direct NHS England in relation to relevant functions’. It’s long been known that Conservative health secretaries have been frustrated by not being able to enact the measures they wanted regarding the NHS so here’s Matt Hancock’s chance though some may argue this will result in less accountability, not more. But you will be relieved to hear there are some limits to the suggested new powers: ‘The health secretary will not be able to formally direct a local hospital nor will he have the power to intervene in clinical decisions’. At least you won’t have to imagine Matt standing over you at a critical juncture, saying they won’t be able to replace your hip after all.

Needless to say, it was former Health Secretary Jeremy Hunt who the Today programme invited to comment on the proposals, predictably saying that although they were big changes he reckons they’re the right ones. How about interviewing a health service expert? The Department of Health and Social Care, saying that it didn’t comment on ‘leaks’, said: ‘From tackling bureaucracy to driving forward the integration of health and care services, we are rightly considering where changes need to be made to help us build back better’. One listener tweeted: ‘Filtering proposals through Tory ideology, NHS becomes a charitable emergency service while private healthcare and insurance become mainstream; a status symbol. It’s what they’ve always wanted, and it’ll be sugar-coated for the election’. Another said: ‘It’s ‘bureaucracy’ when it gets in the way of crony contracting’ and, as we’ve seen throughout the pandemic, scores of companies linked to the government have benefited from contracts awarded without tender.

https://bit.ly/3cNLlFc

Vaccines and their rollout have also continued to dominate the news, especially regarding supply issues; efforts to prioritise certain occupations such as the police and teachers; clinicians’ efforts to put minds at rest given Belgian and German statements that the AstraZeneca vaccine wasn’t suitable for the over 60s; the capacity of vaccines to cope with dangerous new variants; and worrying suggestions that further departures might be made from approved use practice in terms of possibly switching to a different vaccine for the second dose. Concern is increasing over those who refuse the vaccine going into care homes, where the residents are effectively sitting ducks. It seems no one organisation has the power to enforce vaccination for care home workers and although employers could do so via employees’ contracts it could lead to litigation and would result in staffing problems since there’s a shortage of carers. At the same time discussion around vaccine passports is intensifying – the principles and practical issues such as preventing faking by criminal gangs. Typically, the government has said it has no plans to introduce them and new Tory peer Lord Hannan said on Radio 4’s Any Questions that ‘we’re not the kind of country that will enforce vaccine passports’. However, this stance is likely to prove short-sighted as some countries including Denmark already have them, they will be increasingly required for travel and potentially large numbers of venues will only admit those who can prove they’ve been vaccinated. So yet again the UK could be behind the curve and surely, in these times, public health has to trump accusations that such measures are discriminatory. 

Meanwhile, The Week reproduced an interesting letter to the Guardian, which sheds light on the disagreement over the changed use of the Pfizer vaccine. A Professor Paul Glendinning said the BMA, which had criticised the revised policy, has ‘a Kantian, (rule-based) moral philosophy, under which doctors have an obligation to do the best they can for each patient, and any action or inaction that causes potential harm to a patient is deemed to break this obligation’. He contrasts this with the stance of the Joint Committee on Vaccination and Immunisation (JCVI), which takes ‘a utilitarian view of moral philosophy, seeking the greater good for the greatest number, arguing that lives are likely to be saved by delaying the second dose to individuals, even if some of those individuals become vulnerable again’. The Professor suggests the two parties should stop arguing that they have the right interpretation of science and should recognise that this is a philosophical disagreement. Not everyone, though, will be cheered by his recommendation that it’s ‘the function of the government to decide which moral stance to support’, since ministers have clearly demonstrated a marked capacity to cherry pick ‘the science’ when it suits them.

Evidence continues to emerge of the second ‘pandemic’ affecting our society, the latest during Children’s Mental Health Week being the Mental Health Foundation’s findings on teenagers’ mental health. Researchers found, not surprisingly, that all those surveyed said their mental health had deteriorated during the pandemic and between 27% and 32% experienced marked anxiety, irritability, and trouble concentrating and sleeping. Those with unemployed parents were much more affected by anxiety and depression, as were those whose parents were in ‘social grades’ C2DE. Commenting on the findings, the Foundation’s Head of Research, Catherine Seymour, saidThese findings are a warning about how painful many young people’s lives have become during the pandemic. We gathered the findings before the recent school closures – and fear that when we next ask teenagers about their experiences, they will be feeling even worse’.

Professor Ann John, Professor of Public Health and Psychiatry at Swansea University (the academic partner in this research), pointed out how the pandemic had exposed ‘the deep inequalities in our society. Many studies have shown the greater impact and widening gaps in mental health difficulties, educational attainment and more severe financial consequences for the young and those in living in poverty…..More than this, the Government must address the factors that can contribute towards young people having problems with their mental health in the first place. This means delivering an equitable welfare system, guaranteeing housing safety and security and ensuring teenagers have the basics to live comfortably through the pandemic and beyond – including food and warmth’. Unfortunately, not only does the government fail to fund mental health services adequately, it also fails to recognise these fundamental inequalities which are aggravated by its own policies.

https://bit.ly/36QbEqB

We’ve long known how the French fiercely guard their language against foreign incursions, with some success, although some might argue that the Académie Française, described as ‘the pre-eminent French council for matters pertaining to the French language’ is fighting a losing battle, with phrases like ‘le weekend’ becoming commonplace years ago. Similar concerns are now being expressed in Spain, an article in Madrid’s El Pais newspaper suggesting that the ‘colonisation of the Spanish language by English is fast becoming a nightmare’. The complaint focuses on the growing habit of Spanish journalists to sprinkle anglicisms throughout articles, using phrases like ‘winner takes all’, ‘talent shows’, said to ‘infuriate’ Spaniards, who are thought to be mostly unfamiliar with them. The author says it’s fair enough if English terms are used when there’s no Spanish equivalent, but criticises use of the English ‘newsletter’, for example, when the Spanish ‘boletín’ is ‘perfectly good’. He attributes the habit to snobbery, laziness and perhaps a belief that using anglicisms is ‘cool’…. ‘But in a profession which prides itself on its economy with words, the proliferation of pointless synonyms is tantamount to abuse. It’s high time we put a stop to it’. It would be interesting to know if speakers of other languages have the same experience.

Consumer programmes have often featured the difficulty many customers have experienced getting refunds from airlines and holiday companies after so many flights and breaks had to be cancelled last year. The companies are supposed to refund customers’ money but all too often customers have not had a reply to their requests or they’ve been fobbed off with vouchers. In some cases customers couldn’t even contact the companies because they closed their phone lines and ignored other forms of communication. We have to wonder why they don’t realise that we will probably take our business elsewhere in the future, since we still can’t plan any travel with any degree of certainty so further cancellations are possible. A result recently, then, after many months of pestering (Twitter often works well as companies don’t like to be outed for poor customer service) to finally get more than £360 back from Travel Republic.

Finally, here’s a lovely little nature piece, with sounds of curlews and the River Tyne – a tonic to listen to after the maelstrom of news.

https://bbc.in/3ry2bw1

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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