Saturday 6 March

So much can happen in a week and when we come to look back over the trajectory of the pandemic, it could well seem as if a month’s worth has been packed into every single week. It’s interesting, then, that only on Monday there was extreme concern that our leaky border controls had enabled 6 cases of the Brazilian variant to be detected in the UK, one who’d not supplied proper contact details going AWOL, yet media interest had markedly declined towards the end of the week. The identity of the mystery 6th case was finally established on Friday, the delay of nearly a week being a great commendation for the chaotic Track and Trace system. But why didn’t this individual come forward of their own accord instead of compelling Track and Trace to visit 379 households in the South East of England?

In the latest example of parallel universe, Health Secretary Matt Hancock lauded this achievement, talking up the use of ‘the latest technology and dogged determination’ of   system staff to track down the individual. ‘The best evidence is that this person stayed at home and there is no evidence of onward transmission but as a precaution we are putting in more testing in Croydon where they live to minimise the possibility of spread’.

But on Monday’s Radio 4 Today programme Vaccines Minister Nadhim Zahawi was typically unable to answer key questions about this, instead talking up the UK’s world beating genome sequencing programme which had enabled the variant to be discovered in the first place. Professor Graham Medley, of the London School of Hygiene and Tropical Medicine and a member of the Scientific Advisory Group for Emergencies (SAGE), said the risk was that new variants could delay or even reverse the route out of lockdown. SAGE believes the return to school of ten million pupils could raise the R rate by between 10 and 50% – this represents a lot of mingling in mostly poor ventilated spaces, not to mention those children mixing with other household members, some potentially vulnerable, and the issue of parents at the school gates.

The reopening of schools all at once on Monday could prove risky, yet everywhere this seems to have become a bellwether for the approaching end of lockdown, prematurely implying that we’re out of the woods when this is anything but the case.

As the debate around vaccines and vaccine passport continues, it’s very encouraging to hear of successful NHS work (NB not the government’s despite their avowed intention to tackle misinformation) to tackle vaccine refusal and hesitancy. Professor Azhar Farooqi, a Leicester GP, says his practice has been contacting all in groups 1-4 who haven’t taken up a vaccine (about 25% in his area) and talks to them about their concerns, after which 60-70% of those contacted (mainly BAME/deprived groups) changed their minds. A key message here it is that it’s clearly about the personal contact, and the fact someone from their own community is talking to them about it, engendering trust, rather than relying on depersonalised websites and official ones at that which people may not trust.

Not surprisingly, it seems that more and more countries and UK venues will be requiring vaccine passports in order to allow people to travel and to take part in activities and events. There was a heated discussion about it on the BBC’s Moral Maze on Wednesday, some feeling that such a development attacks their civil liberties and others that public safety trumps libertarian arguments of some individuals.

Since Tuesday evening the news has been dominated by the Budget, which was made to sound very generous but which had several key omissions and evasions: the extension of the Universal Credit uplift for only six months; no investment in the NHS; a pay rise of only 1% for NHS staff; and critically, nothing on social care. Reform of social care has been promised then kicked down the road by successive governments for years, but its omission now seems especially shameful given the severe strain the pandemic has put the service under and the PM’s statement earlier this year that he had an ‘oven ready’ bill to bring forward. The fact that so many care home residents have died of Covid is partly attributable to the shocking policy of discharging Covid positive patients into care homes, representing another social care failure.  

Asked about his repeated praise for NHS workers over the course of the pandemic, Hancock insisted he could not be more generous: ‘We do have issues of the affordability because of the consequences of the pandemic on the public finances, which were set out in the budget this week’. It’s astonishing that he expects to be taken seriously on this. On Friday junior health minister Nadine Dorries, a former nurse, was interviewed on the Today Programme about the 1% pay rise, repeating that it’s what the government can afford. As a listener tweeted: ‘Did this government ever think that the ‘what we can afford’ schtick wouldn’t hold water further down the line because we’ve seen how much they wasted on crony contracts and malfunctioning Track and Trace?’ [The total for Track and Trace is now estimated to be a whopping £37bn]. NHS staff are now considering industrial action, which would cause the government far more trouble that giving them a decent pay rise in the first place. The shocking irony is that our Prime Minister is only here because of the 24/7 care he received from nurses during his ICU admission last year year, his survival hanging in the balance although he later attempted to deny it had been that bad. Meanwhile, Unison estimates there are 112,000 nursing vacancies and the largest NHS employer, NHS Providers, has come out in support of the pay claim, saying government had originally planned a 2% increase.

Palliative care doctor, author and broadcaster Rachel Clarke comments on the Prime Minister’s vacuous use of the word ‘love’, a descriptor he used of the NHS last April. ‘It is the best of this country. It is unconquerable. It is powered by love’, but the NHS has a very different experience of ‘love’ from his government’s mediated kind. She points out that the government’s hands aren’t (as they say) tied regarding the pay rise, it’s a political choice.

‘NHS love is kneeling on the floor to help a child into a mask and apron so she can say goodbye to Mummy, who is dying in intensive care. NHS love is nearly vomiting with anxiety by the side of the road – because there’s only so much dying one human being can take – before setting off again towards the patients you know still need you. NHS love is the doctors and nurses who even now, as I type, are suffering from PTSD, anxiety and depression in their droves: who feel they can’t go on, who are broken, who have even talked of suicide when their defences are down’.

Chancellor Rishi Sunak has allocated £700m to arts, culture and heritage bodies to help them keep going until they can reopen in May but there is concern that these funds could come with strings attached – adherence to government guidelines being developed on how British history should be portrayed. As discussed last week, ministers have long been concerned about institutions reflecting the bigger picture (one which includes the effects of colonialism and slavery), believing this amounts to ‘talking Britain down’. Although it receives no government funding, the National Trust, with a membership of over 5.6m, doesn’t get off lightly, some members and governors believing the ‘warts and all’ version of history needs telling (many of its properties having links to slave owners) and others complaining about a ‘woke agenda’ and saying this interferes with their aesthetic experience and plans for a nice day out.

A significant feature of Budget coverage has been criticism of the government and media for using a misleading household analogy to describe government finances, exemplified by allusions to ‘balancing the books’ and such like. The evidence is that many are taken in by such a ploy, seen to artificially justify austerity policies. We see it again now in the argument that the government ‘can’t’ afford an NHS pay rise (yet, oddly, it afforded billions for Track and Trace and the numerous contracts awarded to government contacts). In November leading economists wrote to the BBC about coverage of the Spending Review, complaining about key staff like political editor Laura Kuenssberg perpetuating what they see as myths about public fiscal policy.

‘….Specifically, when responding to the Office for Budget Responsibility’s public sector borrowing projections, BBC News political editor Ms Kuenssberg said that ‘this is the credit card, the national mortgage, everything absolutely maxed out’, and later went on to comment that ‘for next few years, there is really no money’. (This kind of spiel might sound ok on tv but it looks remarkably silly and superficial when seen in print). We argue that this commentary misrepresents the financial constraints facing the UK government and reproduces a number of misconceptions surrounding macroeconomics and the public finances.

To focus on the “credit card” analogy, we would argue that this is never an appropriate metaphor for public finances. Maxing out a credit card would imply that the government is approaching a hard limit on its ability to borrow. This is not the case. It is the consensus amongst economists that the government should at this point in time not focus on reducing the deficit, but rather on delivering the spending necessary to secure a recovery from Covid-19….. With informing and educating the British public at the very heart of the BBC’s mission, it is crucial economic issues are explained in an accurate way, and we ask that BBC journalists take care to avoid such analogies in the vital work they do’. It’s clear from Budget reporting that the media including the BBC have not taken these arguments on board.

Criticisms of the Budget itself came from the Institute for Fiscal Studies, the Resolution Foundation and others for lack of public sector investment, especially he NHS, and also by right-wing think tanks for the increase in corporation tax to 25%.

IFS Director Paul Johnson said the ‘spending plans in particular don’t look deliverable, at least not without considerable pain’ and that the government would have to spend more. ‘Are we really going to spend £16bn less on public services than we were planning pre-pandemic? Is the NHS really going to revert to its pre-Covid spending plans after April 2022? In reality, there will be pressures from all sorts of directions. The NHS is perhaps the most obvious. The chancellor’s medium-term spending plans simply look implausibly low’.

The Office for Budget Responsibility (charged with economic and borrowing forecasting) said the Budget didn’t give an ‘explicit commitment beyond the end of the 2021-22 financial year for the legacy of the pandemic for public services’. This despite the ‘need for an annual re-vaccination programme, an ongoing test and trace capacity, and catching up on operations that the NHS had been unable to do over the past year’.

It’s pretty clear that a long term view (something this government is allergic to) of NHS funding is needed and an Independent article by Mary Dejevsky, summarised in The Week, points out how other European countries like France and Germany have dealt much better with the pandemic in terms of lower death rates and have better health outcomes overall. ‘And one hard-to-admit reason is that a system funded out of general taxation is less able to respond to the challenges of an unexpected threat than Europe’s more flexible, insurance-based systems. For them there’s no sharp divide between public and private provision: patients, not doctors, decide what gradation of service they want’. The author says people often focus (perhaps unhelpfully) on the ‘appalling’ US system when insurance based systems are discussed but the European model is more helpful. ‘If Matt Hancock focused instead on systems across the Channel, he’d see that the insurance principle, not more political control, is the way forward’.

Meanwhile, the media continue to collude with the government, sheltering it from scrutiny over its own corruption while filling endless hours and pages with speculation about Meghan and Harry and the SNP debacle. It’s very worrying that economies with the truth come so easily to our Prime Minister but aren’t picked up by the Speaker. Only three days after the shaming court judgement last weekend on government contracts not being published within the appropriate time period, the PM misled Parliament by suggesting they were all on record, yet the judge later said this was untrue because 100 of the original 708 (!) contracts were absent from the public record. [The government is required by law to publish a ‘contract award notice’ within 30 days of the awarding any contracts for public goods or services worth more than £120,000].

The Good Law Project, which mounted the legal challenge, said: ‘Government has not only misled Parliament and placed inaccurate information before the Court, it has misled the country. Unless contract details are published they cannot be properly scrutinised – there’s no way of knowing where taxpayers’ money is going and why. Billions have been spent with those linked to the Conservative Party and vast sums wasted on PPE that isn’t fit for purpose. We have a Government, and a Prime Minister, contemptuous of transparency and apparently allergic to accountability. The very least that the public deserves now is the truth’.

On the same theme, concern has been expressed about the new UK science body being exempt from regular procurement rules, enabling ‘maximum flexibility’ as this could so easily lead to further cronyism. We’re told the Advanced Research and Invention Agency will have access to £800m during the life of this parliament and also be exempt from Freedom of Information legislation.

‘Although it will be audited by the National Audit Office and required to submit annual reports, there is concern be allowed to invest taxpayers’ money in financially risky projects’. Whenever ministers talk about removing ‘red tape’ you know that stands for removing due process. ‘Kwasi Kwarteng, the business secretary, said ARIA would be ‘equipped with all the tools and freedoms it needs to succeed’ including placing scientists at the heart of decision-making and ‘stripping back red tape’. You can bet that the Labour Party, Good Law Project and others will be keeping a close eye on ARIA, though their efforts will be hobbled by the lack of FOI.

In other major news we see yet another example of government short-termism. So desperate was our PM to ‘get Brexit done’ that he agreed to the Northern Ireland Protocol without apparently anticipating what problems this would cause him further down the line. Now the EU is threatening legal action because the UK has unilaterally put in place ‘temporary easements’ or ‘grace periods’ (as ministers call them, rather than the treaty breaches they actually are), there’s rising discontent in unionist communities in Northern Ireland and paramilitaries have written to Boris Johnson and Ireland’s taoiseach, Micheál Martin, warning of “permanent destruction” of the Good Friday Agreement without changes to post-Brexit arrangements for Northern Ireland.

Let’s not worry, though. Our ever optimistic PM has it all under control: ‘I’m sure with a bit of goodwill and common sense all these technical problems are eminently solvable’. It will now be interesting to see what the negotiating skills of ‘Lord’ Frost are really like.

Can anyone think of a less deserving charity than the one allegedly being set up to cover the costs of refurbishing the PM’s flat, an exercise his fiancée, Carrie Symonds, seems to be spearheading? ‘A No 10 spokesman would not deny reports in the Daily Mail that the prime minister is attempting to set up a charity where benefactors can contribute to the upkeep of Downing Street’. I wonder how well this idea will go down here, apparently modelled on the American White House one. ‘It was reported to be modelled on a similar scheme used by the White House to raise money for interior design and restyling the building, which is bankrolled by private donors. By tradition, incoming US presidents and their families are allowed to spend $100,000 on redecorating the White House, and the first lady takes an active part in the White House Endowment Trust, which maintains the fabric of the building’. Carrie apparently wants to get rid of the current John Lewis style, whatever that is, and replace it with a chintzy style one commentator thought resembled a Parisian brothel.

Several commentators reflect on lockdown, from both sides, focusing on the pain it’s involved for many but also on some of the upsides we’re likely to take into the ‘new normal’. One article tracks the last year for those who’ve been separated from family members because of travel restrictions, etc, and they’ve obviously stuck to those rules, unlike some. One had lost her grandparents and captured the experience of many unable to attend the funerals in person, an important and publicly witnessed aspect of the grieving process, which in some cases has been halted or cannot begin. ‘I still don’t have closure with my grief because I don’t have a physical memory of saying goodbye’ (she had to watch who had to watch the joint funeral via a live stream)…. . ‘There’s definitely a detachment to the reality of what has happened’. The situation is particularly acute for those living outside the UK, having missed so much contact and not knowing when they will be able to meet again.

Despite the huge increase in holiday and flight bookings since the roadmap was announced and talking up an anticipated spending spree as the economy recovers, at least one commentator thinks ‘there may well be an initial splurge, followed by a slightly anxious retrenching’. Instead of a sudden switch back to our erstwhile lifestyle choices, a hybrid pattern is predicted, for example working both from home and office and accessing cultural content online besides attending live events. ‘We could use tricks learned of Covid necessity to add new layers of possibilities to old lives, rather than as wretchedly thin substitutes for them. Everyday life may not change radically, but could still evolve more incrementally for the better’.

For a year now, fitness guru Joe Wicks, aka the Body Coach and ‘the nation’s PE teacher’, has been live streaming workouts, so it was a poignant moment yesterday when he bid us farewell (for the timebeing – ‘I’ll be back’) as children are returning to school on Monday. But these and many other workouts are available on his YouTube channel for free. Many have been grateful for his engaging and encouraging manner, his upbeat patter and being so open about his life and mental health issues during media interviews. He ended yesterday’s session with a repetition of his recipe for life – work hard, have fun and be nice, that’s all you need to remember’ – not bad advice. Perhaps a few politicians could think about following suit.

Finally, The Week focused recently on Edvard Munch for its ‘Artist of the week’ feature, based on a Guardian article by Kate Connolly. The lugubrious Norwegian artist has been the flavour of the year, exemplified by the major Royal Academy exhibition featuring his work besides that of Tracey Emin, two of his works expected to fetch millions at auction soon and a major museum devoted to his work opening in Norway this summer. But it’s also thought he has somehow captured the zeitgeist of this pandemic year, his famous 1893 painting The Scream expressing the pain and despair of the human condition. Munch experienced both physical and mental illness, was ‘prone to alcoholism and nervous exhaustion’, also finding relationships difficult. He never married or had children. Connolly believes his true achievement was to ‘turn his own angst into symbols of universal malaise…which acts on us subliminally, its underlying source remaining hidden…‘Munch distilled the anxieties and uncertainties of modern life onto canvas with an originality and urgency that has made his work a byword for alienation and inner turmoil: rarely has it felt more contemporary than now’.

Let’s hope it won’t be too long before we can view these works in person, but with one of the benefits of the pandemic – social distancing measures in place so you can actually see the exhibits rather than being jostled by the hordes of pre-pandemic times!

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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