Saturday 13 February

As the latest estimate of excess deaths since the start of the pandemic passes 120,000, four main issues have continued to dominate the news this week, none of them inspiring confidence in how they’re being managed. At the start of the week a number of newspapers and websites headlined fury with Michael Gove, amid plunging UK exports to the EU. Discussions have been taking place between Gove and his EU counterpart as to how the logjams in Northern Ireland can be eased, but it beggars belief that there’s any surprise given this was one of the consequences of the Prime Minister’s Brexit Deal. Having surveyed its membership, The Road Haulage Association informed the Observer that UK exports to the EU were down ‘a staggering 68%’ in January compared to the same period in 2020. RHA Chief Executive Richard Burnett said he was ‘very frustrated’ because his organisation had long warned about these problems ‘but the government did not listen sufficiently and is still failing to do so now’.

Many have been irritated by ministers’ suggestions that these difficulties are just ‘teething problems’. The post-Brexit border problems constitute a potentially incendiary mix of severely disrupted trade and supply of goods and political tensions. ‘Stephen Kelly, chief executive of Manufacturing NI, which represents all types of manufacturers in Northern Ireland, many of whom have been struggling with the new rules, says views on Brexit inevitably feed into wider historic divisions. Everything in Northern Ireland is viewed through an identity filter. Unionism is fundamentally opposed to the [Northern Ireland] protocol because it means that Northern Ireland is different to the rest of the UK whereas nationalism and the moderate middle ground is fundamentally opposed to Brexit and supportive of the protocol’.

The BBC has been accused of not fulfilling its educational role in news coverage, bandying terms around which not everyone understands, but this article on the Northern Ireland Protocol is well worth reading.

Amid accusations that mainstream media are obsessed with holidays and when we can have them again, pressure is building for some clues and clarification ahead of the government’s announcement on 22nd February of its ‘roadmap’ for the route out of lockdown. As we’ve seen before, the strategy seems to be to ‘leak’ proposals around a week before the planned publication date, allowing the government to backpeddle on those badly received. When interviewed ministers and policymakers have expressed some exasperation at continually being asked about the end of lockdown, but such questions are inevitable after such a long period of going in and out of lockdowns, this one evidently affecting people’s mental health more than the others. It seems one of the frustrations is not so much being kept in the dark as to when lockdown might be lifted, but what the criteria are for its easing and this is what the government doesn’t seem to be clear on, eg the R number, numbers of new cases, virulence of various strains of the virus, or numbers of deaths.

Those who aren’t normally engaged in equalities issues could start taking an interest since it’s been suggested that social inequality, the virus disproportionately affecting some areas, especially the South African variant ‘hotspots’, will hinder an early end to lockdown. Statistics showed marked differences between the numbers of Covid cases in less and more affluent areas. ‘Jonathan Ashworth, Labour’s shadow health secretary, said the government’s failure to offer financial support to help low-income people to self-isolate had caused a huge Covid divide to open up’. Ashworth said it’s vital these ‘transmission chains’ are broken but this won’t be possible without financial help for those needing funds to self-isolate. In his view this lack of funding is proof that the Prime Minister’s ‘promise to level up lies in tatters’. As Tory backbenchers and Covid Recovery Group members continue to exert their own pressure on the PM to ease lockdown, most scientists and policymakers are more guarded, no doubt partly informed by what happened last summer. Professor John Edmunds of the London School of Hygiene and Tropical Medicine believes that reopening schools alone will increase the R rate by as much as 0.5%, and advises proceeding ‘very cautiously’.

In my view it’s profoundly unhelpful, conveying the wrong messages and attempting to deflect attention from his mistakes over the last year, that Boris Johnson continues with his puerile idealisation of the vaccines: ‘I have no doubt that vaccines generally are going to offer a way out of the pandemic…with every day that goes by you can see that medicine is slowly getting the upper hand over the disease’. As of last week 147 people had been identified with the South African variant in Britain but scientists believe it’s actually many more because of rapid community transmission. Head of NHS Providers Chris Hopson goes to the heart of the matter, suggesting that the lockdown shouldn’t be lifted until the Test and Trace system had been improved. He wants it to be capable of spotting mutations within two or three days whereas at present genomic tests take eight days. Meanwhile, an interesting article in the Guardian suggests three different scenarios for how things could look by May: the optimist’s view, the middle ground and the worst case scenario. Unfortunately, the latter seems quite likely. ‘By far the greatest worry for most scientists is the creation and spread of new variants of the Covid-19 virus – in particular, mutations that could evade the protection provided by the current vaccines on offer’. Professor Martin Hibberd of the London School of Hygiene and Tropical Medicine thinks ‘a new strain of virus could overcome the protective effects of previous infections and vaccines, meaning that we will have to develop new vaccines and then re-vaccinate everybody again’. It anyone finds this unduly pessimistic, the middle ground section of the article isn’t that positive either.

More than 50 days after the South African variant was first discovered in the UK, the government has finally introduced a scheme of quarantine hotels for returning air passengers, but absurdly, only those from 33 ‘red list’ countries despite the variant being found elsewhere. Some scientists and policymakers say hotel quarantine should be imposed for all UK arrivals to prevent variants spreading, rather than an approach targeting only 11 of the 41 countries where the South Africa variant has been detected. The scheme has attracted anger, derision and disbelief in some quarters, many finding it ill thought out, sloppy compared with the Australian scheme, not even being enacted until Monday and leaving loopholes such as people travelling from one of the listed countries but transiting through another. And how will it be checked that people have had the requisite number of tests and what they’re doing when they go out, as they’re allowed to do? What about people due to return to the UK next week who won’t have factored this into their budgets and won’t be able to pay for these compulsory quarantine packages?

The threat of 10 year jail sentence for those breaking this law and lying has widely been found disproportionate. Tory MP Sir Charles Walker stunned Radio 4 World at One listeners yesterday by his intemperate outburst on this subject, during which the adjective ‘bloody’ was used and presenter Sarah Montague was called ‘Martha’. On Channel 4, interviewed by Krishnan Guru Murthy, Walker criticised ‘irresponsible’ ministers for implying, via the direction not to book summer holidays, that lockdown could continue into the summer. He said people were really struggling, needed human contact and alluded to ‘a very stressed out and exhausted nation’. Accusing the government of deliberately scaring people witless and ‘robbing people of hope’, he described the plan for 10 year prison sentences for those who try to evade quarantine rules as ‘utterly ridiculous’.

It’s not conducive to public confidence when one minister (Matt Hancock) lets us know he booked his summer holiday in Cornwall some time ago, at the same time as another (Grant Shapps) says it’s too early to book any holiday. Ministers not even being able to present a consistent policy across government will contribute further to public anxiety. One tweeter commented: ‘Rather ironic that liar Grant Shapps is introducing tough sentences for people who lie’, and Piers Morgan tweeted:  ‘If failing to quarantine properly is punishable by 10 years in prison, what is the punishment for failing to properly protect the country from a pandemic?’

We understand that these pricey hotel packages include transport, security and testing, and surely it won’t be too long before investigative journalists or curious individuals discover which companies with links to the government have been given the contracts to operate these services. Cronyism continues despite its exposure by the Good Law Project and others.

Guardian sketch writer once more turned his guns on Matt Hancock this week, focusing on his performance at Monday’s Downing Street press briefing. ‘Hancock tried to remain upbeat but he’s beginning to look frayed around the edges. A year of trying to hold it together, of being that glass-half-full guy, appears to have taken its toll. Outwardly he still looks like one of the first contestants to be thrown off The Apprentice, but his eyes are the giveaway. They are almost dead. Empty hollows. I’m not sure how much longer he can keep this up. Even Tiggers have their breaking point’. Yet again, the ineffective Test and Trace system was raised, as it’s clear, despite continuing idealisation of the vaccine, that this won’t prove the much vaunted ‘cavalry coming to the rescue’. ‘Door Matt also nearly came unstuck when asked how it was that Test and Trace was going along at a “blistering pace” when many staff were being made redundant. Ah, snapped Hancock. The fact that Test and Trace was able to lay off staff was a sign of just how efficiently it was now working. So once the organisation was down to double figures, it would be working perfectly. Presumably Hancock’s experience of test and trace is rather different from most other people’s’.

Radio 4 was criticised this morning for interviewing that famous epidemiologist, former Brexit negotiator David Davis, during which he pontificated about Covid,  suggesting it will become like flu, that we have ‘to live with it’ and we don’t lock down for flu.  His Brexit negotiating performance, which left his credibility hanging in shreds, hasn’t put the BBC off inviting him onto programmes, as if for balance with real scientists. When asked if flu/Covid comparison was a valid one, Professor Stephen Riley, professor of Infectious Disease Dynamics at London’s Imperial College, very politely dismissed this speculation and the idea that restrictions can just be lifted. A listener tweeted: ‘I can’t believe I’m *still* hearing David Davis cited as a counterbalance to a ‘Professor of Infectious Diseases’ on the subject of… infectious diseases. The continuing promotion of proven nincompoops is scandalous. Whatever the topic, Davis has all the expertise of a mackerel’.

Charities are now pressing for more clinically vulnerable people, such as those with ME and learning disabilities, to be moved up the vaccination queue and there’s still no clarity about those with asthma. A more nuanced approach to vaccination priorities is way overdue but, as we’ve seen so often, the government doesn’t ‘do’ nuance. ‘Professor Wei Shen Lim, the Covid chair for JCVI (Joint Committee on Vaccination and Immunisation), said: “The JCVI’s advice on Covid-19 vaccine prioritisation was developed with the aim of preventing as many deaths as possible. As the single greatest risk of death from Covid-19 is older age, prioritisation is primarily based on age. It is estimated that vaccinating everyone in the priority groups would prevent around 99% of deaths from Covid-19’.

Comedian and presenter Romesh Ranganathan is one of the latest to express concern about those who are entitled to the vaccine but who have eschewed it, such as some care home workers, who pose a massive risk to the residents they care for. Only 55% of Asian community members are said to be taking it. ‘I recently participated in a video organised by the actor Adil Ray, in which we tried to dispel some of the myths about the vaccine. But while the response was overwhelmingly positive, there were people who kicked back: they said it was patronising – how was a video made by a bunch of celebrities going to make people suddenly decide to have the vaccine? There were even suggestions that we had been paid to support a government agenda….I realise that people are distrustful of the government (and if you are from an ethnic or impoverished background, then it is understandable why); but the other option is to contract the virus, which is easily the worst one’. Yet the government has no plans to make vaccination compulsory in certain circumstances. Another factor is that there’s a shortage of carers so employers won’t easily be able to compel their employees to get vaccinated.

A hugely significant news item this week (now covered by the BBC since it’s no longer a leak) is the plan to reform the NHS, even during the pandemic. The proposals were presented to MPs on Thursday by Health Secretary Matt Hancock but there’s quite some discrepancy between what has been presented, what language the plans are couched in, and the reality. The plan is intended to ‘streamline’ services, especially removing barriers between health and social care, to remove ‘bureaucracy’, to increase accountability and give the Health Secretary much more direct control over the NHS. It’s long been known that the government has been frustrated that its power has been limited because of it resting with NHS England chief Simon Stevens, and now it’s likely he will stand down this year because he won’t favour the reduction of his own fiefdom. But it’s been suggested by clinicians that the worthy goals referred to could be achieved without a wholesale reorganisation at such a difficult time. It’s not convincing for the government to talk about ‘accountability’ and ‘taxpayers’ money’ when they’ve wasted millions on crony contracts which weren’t subjected to scrutiny, and the plan won’t see the end of private sector incursions into the NHS. Hancock said: ‘Medical matters are matters for ministers…NHS England will have a clinical and day-to-day operational independence, but the Secretary of State will be empowered to set direction for the NHS and intervene where necessary’.

The NHS White Paper is snappily titled Integration and Innovation: Working Together to Improve Health and Social Care for All. It’s been noted that it still kicked the social care can down the road despite improving social care being given as a major raison d’etre. Shadow Health Secretary Jon Ashworth commented: ‘We’re in the middle of the biggest public health crisis our NHS has ever faced, staff on the frontline are exhausted and underpaid. The Royal College of Nursing says the NHS is on its knees, and the Secretary of State thinks this is the right moment for a structural reorganisation of the NHS’. A Radio 4 listener tweeted: ‘NHS White Paper plans to sweep away ‘bureaucracy’? Aka proper checks to ensure decisions are made on clinical, not financial or ideological grounds’.

The undermining of proper scrutiny links to another news item this week. Newspaper editors have pressed for the protection of the Freedom of Information Act, as they have observed increasing difficulties experienced by those making inquiries in obtaining the information they seek. OpenDemocracy, set up in 2001 to ‘challenge power and encourage democratic debate across the world’, coordinated the letter to government from six different newspaper editors. The editors include those of the Guardian, the Mirror, the Daily Telegraph and the Financial Times. ‘Last November an openDemocracy report accused ministers of running an “Orwellian unit” at the heart of government that sought to control the release of potentially embarrassing information. It said Whitehall departments were rejecting requests at the highest rate since the introduction of the act 20 years ago’. Significantly, the budget of FOI regulator the Information Commissioner’s Office has been cut by 41% over the last ten years, during which time its caseload increased by 46%. This situation could make it even harder for those trying to find out more about crony contracting since the start of the pandemic.

Reflecting a trend reinforced by the pandemic and massive increase in working from home, news reaches us of a Swedish project seeking to improve urban living by reclaiming parking spaces. One microcosmic example is what happened recently in Gothenburg, Sweden’s second largest city, which involved the removal of several parking spaces and their replacement with outward facing benches outside a gourmet sausage shop. This led to people enjoying themselves, chatting, eating and drinking there despite the freezing temperatures. ‘This pop-up public space is part of a Swedish urban experiment known as the “one-minute city”. They’ve been appearing around the country as part of a government project called Street Moves, which aims to investigate what happens when cars are displaced, and how every street in Sweden could be healthy, sustainable and vibrant by 2030’.

In many areas motorists might object but it seems the locals have been broadly in favour. No doubt they can experience the benefit of the opportunities for social mixing, good for mental wellbeing rather than people driving around and sticking in their own silos. The approach links to the ’15 minute city’ idea, which is working well in Paris – that all key amenities should be within a 15 minute walk or bike ride. We could do with a bit more of this in the UK.

Finally, we’ve been hearing since the start of the pandemic about those who have lost their traditional jobs and who have since diversified and tried to find niches which wouldn’t have been workable pre-Covid. One of the most charming examples must be the Doorstep Puppet Theatre, developed by theatre professionals Benedict Hastings and Maddie Sidi. Since theatres closed, the pair came up with the idea of bringing performance art to the people, appealing to both children and adults. ‘We want to bring the magic of a live performance to people in these difficult times, so we’ve come up with a way of doing just that. Our portable puppet theatre allows us to come to your home and perform just for you and your family, outdoors and in a Covid-secure way’. 10% of the ticket price goes towards two theatres held dear by the performers, helping the theatres to keep going during these difficult times. Imagine (perhaps in better weather) a knock at the door turning out not to be a parcel delivery but a puppet theatre ready to entertain you on your doorstep. I think this would be marvellous for kids of all ages and I hope it does really well.

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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