Sunday 21 February

As numbers of Covid deaths and new cases continue to fall but remain high, this last week finally saw the introduction of hotel quarantining for UK passengers returning from the 33 ‘red list’ countries (in Scotland it’s sensibly all countries since dangerous variants have been found in many besides the 33). Ministers had quite a job in the media defending this delay, when the South African variant had been found here 50 days previously, yet despite this risky time lag hotel chains, airport and Border Force staff still said what little preparation and communication there had been. A number of passengers went public with their experiences of all passengers mingling freely within the airport, no segregation on planes and ‘red list’ passengers not being questioned about their departure points and countries they transited through, so only their honesty prevented them from just going on their way. A spokesman for the PCS union, which represents Border Force staff, said: “It is a disgrace our members in Border Force only received new guidelines on hotel quarantine late last night. It’s vital that Border Force are equipped to deal with helping the public stay Covid safe. However, many feel under prepared and under valued by a department that is not doing its job’. Unions also warned that security staff could refuse to continue working under these conditions unless they were issued with better quality facemasks.

One man, travelling from Brazil, via Madrid, said: ‘The system is ridiculous. It doesn’t make sense. I was on the flight from Madrid surrounded by other passengers who were not from red-list countries. How can that be safe and a good way to prevent coronavirus from spreading?’

Two issues getting scant coverage are the companies likely to have links to the government awarded the contracts for passenger transport, security and testing (we know about G4S and Mitie so far) and what about those to whom the £1750 quarantine charge would come as a big shock and may be unable to pay?

As if this muddled policy didn’t give the government enough to contend with, the Times tells us that one law firm, PGMBM, was preparing to launch a legal challenge, arguing that it could be breach of article 5 of the European Convention on Human Rights, the right to liberty and security. The company suggests that the enforced quarantine of people without knowing whether they have Covid and are therefore infectious could potentially constitute a breach and should be subject to judicial review.

At the same time, pressure on the Prime Minister to ease lockdown continues to increase, the most voluble proponent being Tory backbencher Steve Baker, who made numerous media appearances during the week. He says the UK ‘must never again be locked up without MPs having a say. We need a new Public Health Act, meaning: votes on restrictions in advance; amenable legislation; cost benefit analysis; and end of monopoly on advice of government scientists with red teams’. Baker and colleagues are asking for schools reopening by 8 March (already strongly hinted to be in the imminent ‘roadmap’ out of lockdown, the subject of heavy leaking), hospitality open by Easter and by 1 May ‘no more rules’.  The key factor he cites is the success of the vaccination programme, despite the fact that most people have only still received one dose and that the JCVI stance on vaccination criteria remains primarily age-based. Debate continues about other important groups, such as all those with learning disabilities and ‘frontline’ workers like the police and supermarket staff.

Others including scientists are urging extreme caution, as some lessons at least have been learned from last year and no one wants lockdown 4 within a few months. Although children obviously should be in school, reopening schools is a worry because of the risk of heightened transmission and now many more younger people are being hospitalised with Covid. But as mentioned in the last blog post, there’s another reason for caution: despite the much trumpeted reduction in cases and deaths in many areas, the situation is still dire in certain hotspots (as it’s emerged in a leaked government report), further highlighting social inequality. In some areas like Blackburn-with-Darwen, Bradford and Leicester, ‘interconnected factors such as deprivation, poor housing and work conditions, and delays in the test-and-trace system, were all likely to be significant contributors to the high coronavirus rates’.

Head of Test and Trace, Dido Harding, who seems to have been AWOL for months, has had the nerve to say that at least 20,000 people a day are not complying fully with isolation orders, ‘allowing the virus to spread’. An interesting statement when enforcing self-isolation is actually one of the key tasks of the organisation she heads. Many in deprived areas say they can’t afford to self-isolate but their going out and to work having tested positive is a clear public health failure. The report interestingly revealed that Scotland and Northern Ireland have guidance for how to self-isolate safely in high-density housing but England doesn’t.

Meanwhile, there seems to be no urgency about gearing up Test and Trace to carry out its isolation enforcement responsibilities and instituting an effective self-isolation payment system. This issue might compel those not interested in social equality to finally take an interest in it, albeit a cynical one, as the longer these hotspots keep emerging, the longer easing of restrictions will be delayed.

As usual, probably in a bid to catch the weekend papers, more details of the roadmap have emerged, such as the key one that an individual (using PPE) will soon be allowed to visit a care home resident and hold their hand but further closeness ‘will be discouraged’. This is great news for those residents and their families but what a pity that so many residents had to die, confused and lonely, before such a measure which could have been introduced earlier actually was.

Another measure is groups of people being allowed to meet outside by Easter, although the government has said easing this lockdown must be ‘cautious but irreversible’. We’ll have to see after Monday what the approach will be. ‘Will the Prime Minister hold fast to this new lower-key approach? Or will he be tempted to offer some concessions to the siren voices on his right?’ An anonymous Tory source said MPs and the country think they know what they are getting next week: schools to open on 8 March, non-essential retail in April and pubs and restaurants in May…The Party is largely onboard, but the problem is once you get detail, people will start finding things to complain about’. It doesn’t help that for weeks now the media has harped on about lockdown end and going on holiday – this week the Daily Mail’s front page shouted ‘Now take the brakes off, Boris’, its editorial titled ‘Set the nation free!’. A Radio 4 listener tweeted: ‘Tempting though it must be to leak a big news item like lockdown exit roadmap to catch the weekend papers, should this have happened ahead of parliamentary approval? Or is it partly to deflect attention from the Matt Hancock legal judgement debacle?’

Meanwhile, the hospitality and travel industries are understandably asking the government for ‘a plan’ out of lockdown, as they need time to prepare for reopening. But would the government recognise a plan if they fell over one, as what we usually see is a reactive muddle of the kind which happened with schools? In yet another example of the government not ‘levelling with’ the public and employers, we learn that this week pub chain chief executives left talks with the Department for Department for Business, Energy and Industrial Strategy (BEIS), complaining of a ‘lack of interest and respect’. Since the breakdown of talks, pub bosses said they were only hearing second-hand about proposals which would be problematic, such as being allowed to open without serving alcohol or only offering outside service. Last time pubs were open bosses apparently weren’t consulted in advance about policies like allowing a Scotch egg to count as ‘a substantial meal’ and the 10 pm curfew. In another example of parallel universe the BEIS insisted that they would ‘continue to engage relentlessly with the hospitality sector, as we have done throughout this pandemic, and our door remains firmly open’. Perhaps they were talking about gimmicks like Chancellor Rishi Sunak’s interview with TV chef Gordon Ramsay, which came in for some flak on social media for not representing the needs of most business owners.

The Observer gives it views on end of lockdown planning, pointing up the debate and disagreement between scientists and politicians regarding how accurately data can be used to decide dates of restriction easing. ‘Johnson cannot promise this is to be the last lockdown under the excuse that pre-announced dates are only indicative and will not trigger easing if the data suggests otherwise. The medical officers know Johnson is incapable of resisting pressure from the right of his party and pre-announcing dates invites a repeat of the mistakes that have led to Britain having among the highest Covid death rates in the world’. Instead of ‘switching targets as they suit political exigencies’, it’s suggested the PM must stick to the criterion of the R rate (but ministers won’t like the fact that the Blair Foundation has pressed so hard for this) ‘with the government agile enough to tighten pre-emptively, according to the data, or relax earlier if improvements are enduring’. So, the basic message is ‘data before dates and no changing the goalposts’: it will be interesting to see how it plays out.

Fewer people are likely to be able to enjoy the end of lockdown due to news this week that a further 1.7 million have been identified as possibly needing to shield. The decision has been made according to a model developed by New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) and Oxford University which uses additional criteria such as ethnicity, age, Body Mass Index and postcodes (indicating level of deprivation). The letters being sent out could be a shock for some but a key benefit is that they will be prioritised for vaccination. It’s understood they’ll be told they could benefit from shielding but this won’t be compulsory. ITV News reminded us that about 2.2 million people in England are currently on the shielding list, mostly identified for a single reason, such as specific cancers, being on immunosuppression drugs or having severe respiratory conditions. Those about to receive letters would bring the number to almost four million.

Given accusations that richer countries were hoarding vaccines, it’s significant that the PM chose the virtual G7 meeting on Friday to announce that the UK’s leftover vaccine would be donated to poorer countries, but typically, no details were given as to when and how much. During the meeting the PM said: ‘Science is finally getting the upper hand on Covid. Around the world [we need to] make sure everyone gets the vaccines that they need, so that the whole world can come through this pandemic together. There is no point in us vaccinating our individual populations – we’ve got to make sure the whole world is vaccinated because this is a global pandemic and it’s no use one country being far ahead of another, we’ve got to move together’. In another example of parallel universe, James Cleverly claimed on Radio 4’s Today programme that ‘we are a global force for good and that’s why we are leading the world in calls to ensure that the poorer countries in the world are also made safe’. He maintained that right from the start of the pandemic the government had borne in mind the needs of less developed countries but this does seem rather like a rewriting of history, the belated development of a global overview.

The most damning news item this week (and one of several the BBC has allowed to become the elephant in the room, not being covered in current affairs programmes) must be the court’s ruling that the government, in particular Health Secretary Matt Hancock, did break procurement law by failing to disclose the details of PPE contracts, many of which went to firms with links to the Conservatives. In a case brought by the doughty Good Law Project (and how shocking it had to be a private organisation which did so) the High Court judge said: ‘The Secretary of State spent vast quantities of public money on pandemic-related procurements during 2020. The public were entitled to see who this money was going to’. The judge added that DHSC could have avoided running up a £207,000 legal bill if the Department had “candidly” admitted that transparency rules had been broken. How shaming is this? But there’s no comeback or sanction, not helped by the silence in some quarters of the media, which prefer to focus on the royals and lockdown end fever.

In another example of parallel universe, the Department for Health and Social Care said the government had been “working tirelessly” to deliver what was needed to protect health and social care staff during the pandemic. ‘This has often meant having to award contracts at speed to secure the vital supplies required to protect NHS workers and the public’. Shadow Cabinet Office minister Rachel Reeves said the judgement was ‘troubling and unsurprising, and a perfect example of how this government believes it is one rule for them another for the rest of us…This government’s contracting has been plagued by a lack of transparency, cronyism and waste and they must take urgent steps to address this now – by winding down emergency procurement, urgently releasing details of the VIP fast lane, and publishing all outstanding contracts by the end of the month’.

It demonstrates how accountability at the heart of government has been severely undermined, and the original excuse of normal tendering being suspended due to having to move quickly during the pandemic simply doesn’t hold water. It’s interesting that the government has been notoriously slow to act at every stage of the pandemic, but shows itself capable of acting ‘at pace’ when it comes to issuing contracts to those connected with them, who are often markedly unqualified for the job. The Good Law Project pointed out that as the judge stated that the admission of breach by Government was ‘secured as a result of this litigation and at a late stage of it’ and ‘I have no doubt that this claim has speeded up compliance’. ‘It begs the question, if we hadn’t brought this legal challenge, what other contract details would have remained hidden from view?’ Quite. A Radio 4 listener tweeted: ‘Judging on past performance, can we expect Boris Johnson and Matt Hancock to treat this opprobrium as water off a duck’s back? There’s no longer any sense of shame in public life’.

Journalist Nick Cohen traces with concern how David Frost (now Lord Frost and just made a minister) and his ‘climb up the greasy pole’ have damaged Britain. Frost’s journey seems to convey the message that rapid progress with this government is possible by becoming an extreme Brexiteer and with a bit of cunning and planning. Could this prove a template for others similarly minded? His Oxford tutor apparently remembered ‘nothing at all about him’, but he entered the Foreign Office ‘where he became a figure familiar in many workplaces: the frustrated middle manager, whose resentment at an indifferent world that overlooks him gnaws at his pride. Do not underestimate the anger of the men no one remembers’. He was allegedly going nowhere, according to a former boss, describing Frost as being ‘very diligent and conscientious, good at carrying out instructions, not always as good at querying instructions’. A quality of intelligence surely crucial for these roles – being a yes man is the easy way out many take in the workplace and elsewhere but it doesn’t move things on.

But since then he seems to have become much more assertive, ‘aggressive’ in the eyes of some. ‘For years, liberals have warned about the danger of politicians corrupting the independence of the civil service. The inexorable rise of David Frost is a lesson to us. It shows there are civil servants who so want to be politicised that they yearn to become politicians, as long as they do not have to stand for election in the process. Perhaps all he sees is how well he has done. From Mr Frost to Frosty to Baron Frost to cabinet minister Frost is one hell of a rise. Not bad for a lad whose political career seemed over in 2013. Not great for anyone else’.

Radio 4’s File on 4 this week focused on the growing problem of self-harm in young people, taking as an example ‘Sarah’, who first started harming herself at the age of 11, then continued for 6 years. She often found the responses of parents, teachers and health services unhelpful and later describes what actually did help. Yet again such stories not only demonstrate how mental health difficulties are affecting younger and younger children and in worryingly rising numbers but also how inadequate the statutory services are at coping with them. It’s galling that time and time again, NHS spokesmen and policymakers are invited onto such programmes and wheel out the usual clichés like ‘speak up and ask for help…. help is out there’, when this amounts often to charity helplines and substantial help in the form of psychological therapy isn’t usually available without going on a long waiting list or accessing it privately. Again, this situation is attributable to rising demand (the pandemic is a contributory factor, of course) but primarily underfunding of NHS mental health services over years. The threshold to get help from NHS services is so high it can push people to do more and ‘Sarah’ did try to take her own life –  ‘it seemed like you had to be the sickest of the sick to get help’.

It’s concerning that there’s so much emphasis put on teachers first spotting the signs – although this is important teachers are already very busy and such emphasis deflects from the need, as stressed by organisations like BACP (British Association for Counselling and Psychotherapy) for years, for a qualified counsellor in every school. File on 4 features Kate Rufus of the NHS-funded Self Injury Pathways Project, who said she’d never been to a school where self-harm wasn’t an issue. Do government ministers even know this? She’s often asked why people self-harm. One reason is that it seems to afford a kind of release, almost a purging, from emotional pain and stress.  The project aims to train school staff about what to watch out for and how to talk to young people who may be self-harming. It’s also developing ‘online resources and information where teachers, volunteers and parents can learn to detect and address self-harming amongst school children’. Very worryingly, hospital admissions for those aged 13-17 have doubled in five years. It seems to me some want to blame social media for this but it’s only going to be one factor, which could obscure a failure to recognise the wider psychosocial and systemic problems.

Ahead of the start this week of the second series of Grayson Perry’s Art Club, which captured the hearts and imaginations of many during the first lockdown, a number of articles profile Perry and his psychotherapist wife Phillippa besides the Art Club’s themes and intentions. In a pre series programme in January, also on Channel 4, Grayson asked Phillippa what her advice would be to those wanting to have a go and it was interesting and refreshingly non-intellectual that she advised (paraphrasing) not trying to ‘do art’ but just allowing your life experience to communicate itself. In one article Grayson says: ‘We’re saying the finished thing doesn’t have to be good, but the process has to be genuine. And it has to be heartfelt and enjoyable. We’re not saying make art like a professional, we’re saying get stuck in and lose yourself a while in it…I am trying to democratise art, but I’m not saying it means a drop in quality. It just means upping the accessibility and entertainment. Entertainment and humour are often denigrated, but they take just as much skill as the so-called intellectual level of high culture’. I’m not artistic myself but nevertheless greatly enjoyed these programmes, illustrating different people’s art journeys, which afford a kind of mindfulness and wellbeing experience, and I hope to get to see the exhibition in Manchester when galleries reopen.

The Week reports on a Financial Times article about how publishing has boomed during the pandemic, Bloomsbury Publishing (of Harry Potter fame) citing just one example, expecting profits for 2020 to be well ahead of original expectations. Bestseller lists apparently show a marked appetite, not surprisingly, for wellbeing and ‘feel good’ choices, though a darker undercurrent is also discernable, for example in the continuing popularity of titles like George Orwell’s 1984. Statistics from Nielsen BookScan had UK book sales last year at 202 million, equating to £1.76 billion. Although it’s nowhere near the massive sales figures for Harry Potter titles, it’s suggested that the ‘upward trajectory’ is clear and suggests ‘a comforting truth’, that ‘the best shelter is to be found between the covers of a good book’.

Finally, it’s worth listening to psychoanalyst Susie Orbach’s reflections on the pandemic, lockdown and isolation. Suggesting that we are experiencing ‘social depression’, she says: ‘We are not simply able to breathe into a difficult situation, roll up our psychological sleeves or dig ourselves in without the emotional cost of feeling constrained, nervous, watchful, touchy’.

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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