Sunday 28 March

As we pass the anniversary of the first lockdown, the British Academy, the UK’s national academy for the humanities and the social sciences, issued a major report, warning of a post-pandemic decade of ‘social and cultural upheaval’ featuring significant inequality and deprivation. Set up last year, initiated by the Chief Scientific Adviser Sir Patrick Vallance, the report has contributions from over 200 academic social science and humanities experts and hundreds of research projects.

Although recent months have seen much talk about how things have to change, it sounds as if the Academy has some doubts about this happening. ‘The British Academy warned that failure to understand the scale of the challenge ahead and deliver changes would result in a rapid slide towards poorer societal health, more extreme patterns of inequality and fragmenting national unity’. One of the main interventions needed is a major investment in public services, such as education and health, especially mental health. The report recognises the plummeting of public trust in the government, which we know contributes to the anxiety many have been experiencing. In the observations about ‘returning to normal’ not being enough there’s perhaps a hint that public services need reconfiguring as well as reinvestment, but this is a government ideologically opposed to public services. It’s likely the warnings against over-optimism are directed at our Prime Minister.

The Academy identifies three key areas for action: addressing declining public trust, deepening inequalities and worsening mental health. BA Chief Executive Hetan Shah  said: ‘A year from the start of the first lockdown, we all want this to be over. However, in truth, we are at the beginning of a Covid decade. Policymakers must look beyond the immediate health crisis to repair the profound social damage wrought by the pandemic’.

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Meanwhile, especially during Tuesday’s National Day of Reflection, Boris Johnson was all over the airwaves, expressing regret for the 126,000 who lost their lives (some have estimated the numbers much higher, eg 130,000) and seeming to only imply there are things he should have done differently. He repeatedly stonewalled on the need for a public inquiry now (not kicked down the road for years), resorting to the ‘the time will come, now isn’t the time’ argument and clearly hadn’t rehearsed a response to BBC Political Editor Laura Kuenssberg’s question as what he should have done differently. A rather stumbling and bumbling Boris Johnson waffled for a while, then said it had been unfortunate they hadn’t known about asymptomatic transmission. This is to entirely sidestep the major mistakes he made, which are well-known. Labour’s shadow Health Secretary Jon Ashworth said many of the errors had been the PM’s and urged him again to order an inquiry. ‘The tragic reality is we’ve seen a litany of errors from Boris Johnson’.

‘Public health should have been central to our response from the start, the failure to sufficiently financially support people to isolate has been a monstrous failure, the lack of protection for care homes was negligent, contact tracing should have been community led. And years of underfunding and cutbacks left our NHS vulnerable and exposed when the virus hit. Given future pandemic risk lessons must be learned – meaning a public inquiry is vital’.

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The Guardian’s John Crace didn’t hold back on the PM’s omissions, noting that none of these errors and oversights had featured in Tuesday’s press briefing. ‘Boris Johnson hadn’t bothered to attend five Cobra meetings; he had insisted on ignoring the scientific evidence by boasting about shaking hands; he had allowed the Cheltenham Festival to go ahead. And there would have been all hell to pay if he had tried to cancel Carrie Symonds’s baby shower at Chequers. Then there was the abject failure of test and trace in its early months. The care home scandal. The over-optimistic relaxation of the rules over the summer. The refusal to adopt a circuit breaker in autumn. The complacent messaging around Christmas. The delay in bringing in a third national lockdown.So arguably what the country was also pausing to remember was the many thousands of people who had lost their lives through Johnson’s incompetence and negligence’.

It seems especially tasteless that rather than admit fault when he must have realised at least some of the thousands of bereaved would be watching, he resorted to praising the British spirit of endurance during restrictions and talking up the vaccination programme, as if these cancel out the catastrophic effects of his foolhardiness. ‘Johnson probably couldn’t do his job without a high level of denial about the mistakes he has made. If he were to seriously think of the consequences of some of his decisions, then he wouldn’t be able to sleep at night’.

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The Guardian reported on how the bereaved and Long Covid survivors experienced the National Day of Reflection. ‘For the families and friends bereaved by Covid-19, it is a day to quietly contemplate those they have lost. For long Covid survivors, it is a reminder the vaccine-enabled relaxing of restrictions will not do much for the bodies they are trapped in that do not work like they used to. For everyone else, it is a day to take stock. So many taken before their time. The nation grieves’. The losses have been made even more painful because of limitations on physical contact and on numbers allowed to attend funerals and wakes. This has deprived the bereaved of the necessary ritual of public acknowledgement of their loss. Covid-19 Bereaved Families for Justice UK has repeatedly called for a public inquiry and for therapeutic support for the bereaved, to no avail.

The article cites some distressing examples of the effects of Long Covid, much overlooked during the early stages. Claire Hastie used to cycle 13 miles a day to her full-time job but is now a wheelchair user on long-term sick leave. It’s shocking that the support group she formed for Long Covid sufferers has over 37,000 members but 74%  of the 268 who tried to access the patchy NHS treatment and support for this condition were unsuccessful, for reasons like lack of provision in their area or the fact they hadn’t been hospitalised. Many Long Covid sufferers feel ignored or left behind as the country moves out of lockdown. ‘……for some bereaved, this sense that society does not want to look their suffering square in the face can compound feelings of estrangement and alienation’. Let’s hope that despite the understandable wish to return to something approaching ‘normality’ (though this needs redefining) we don’t, as a society, forget those bereaved, disabled and cut off by the aftermath of this punishing virus.

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Meanwhile, The Conversation details six lessons the UK should have learned by now. They are: act quickly (not delaying lockdowns and circuit breakers by weeks despite evidence of mounting cases); act decisively (instead of going for half measures and unworkable steps presented as solutions, eg policy on arrivals at airports); trust people to follow the rules (lack of trust contributed to delayed lockdowns); communicate clearly (what we’ve seen is inconsistent messages throughout and the government only ‘levelling with the British public when it wants to raise taxes); tackle inequality (crucial in its own right but also as deprived communities have seen the highest number of infections); be prepared (for example not ignoring the results of major exercises like Cygnus, the 2016 three-day pandemic preparedness simulation.

One of the main points of the communicate clearly section is the damage caused by faulty messaging on restrictions, leading to absurd examples like the Barnard Castle fiasco. Many will also remember the circulation of videos and memes featuring a Boris Johnson lookalike (one being courtesy of Matt Lucas) conveying the farcically contradictory messages: you must work from home if you can, but if you can’t do go to work, don’t go to work, and so on.

‘Over the course of the past year, people in the UK have been in lockdown at least as long as they have been out of it. Even when people have officially been free from full lockdown, they have been living under some form of restrictions. It is absolutely vital that this third and longest lockdown is also the last’.

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These ‘lessons’ are even more vital given fears over the Third Wave sweeping through Europe now, compounded by the poor vaccination record in many of these countries and concerns over vaccine shortages. ‘If a slow down in vaccine rollout is not countered by slower relaxation, we can expect more hospitalisations and deaths. Imperial College modelling suggests the UK can expect a further 30,000 coronavirus deaths by next June’. Alarming stuff, yet people still rushed to book flights and summer holidays the minute the lockdown exit ‘roadmap’ was issued despite government advice to the contrary, and the UK’s leaky border policy never prevented the influx of potential cases. It’s a salutary reminder that we can’t just think about what the UK does – we have to take full account of what’s going on in mainland Europe and elsewhere, including the rise of new variants.

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As ever, the UK is behind the curve, this time on limiting travel, but is now considering extending the  list of ‘red zone’ countries, currently just 35 though many more have been in the frame including the no brainer – France. ‘Official data published by the UK government on Thursday showed 412 cases of the variant first identified in South Africa had been found in the UK so far. This is the variant causing most anxiety among ministers because some studies have suggested it may be partially resistant to vaccines’. Labour’s Yvette Cooper gave Boris Johnson a challenging time on this during the week and our PM, sounding very hesitant, said they would have to ‘look at’ this (including testing haulage drivers coming from France) but that it would be difficult. ‘Looking at’ always sounds to me like sending something to the bottom of the priority list or kicking it down the road altogether.

This is so typical of the government: if something’s difficult that’s an excuse not to try it but this is not good enough. One of the problems is that ministers aren’t all on the same page regarding the level of caution to be exercised. Some commentators have been struck by the leeway suddenly given to those with second homes, where travel wouldn’t normally be allowed but now it’s permissible to travel to them if the owner’s purpose is to prepare those homes for rental. This has widely been seen as a get-out clause for the Prime Minister’s lawbreaking father, Stanley Johnson, long known for his disregard for rules. A wag tweeted: ‘Surprised Stan hasn’t been given his own show: Great Lockdown Journeys’.

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As if critics didn’t have enough to lambast Boris Johnson about, he came in for more stick last week due to his habit of making throwaway remarks, which the press and others then seize upon as policy but which clearly haven’t been subjected to intelligent thought or scrutiny. More cautious colleagues and policymakers then have to scrabble around trying to tone down these shootings from the PM’s hip. One was the suggestion that pub landlords would themselves be able to decide about vaccine passports (surely a recipe for confusion and inconsistency).

He was also branded irresponsible (not to mention tactless) for suggesting that people had had ‘enough days off’ and should go back to work, when many workers have been struggling to keep going, often several workers in the same property and home schooling children at the same time. This also clashes with an emerging consensus that the future of work is more likely to be a hybrid model, working from home some days and going into the office on others. His suggestion was also out of turn because the policy is subject to an ongoing government review, so it’s likely the people working on this could feel his intervention was unhelpful, to say the least.

Another example of ‘misspeaking’ tin ear was telling the 1922 Committee of Conservative backbenchers that ‘greed’ was the reason for the success of Britain’s vaccine rollout. (‘Capitalism’ and ‘giant corporations’ had enabled Britain to secure such large vaccine supplies before other countries). Not the most sensible of remarks to make given heightened tensions across Europe regarding vaccine availability. One tweeter observed: ‘No, Boris Johnson, the success of the vaccination programme was down to the quality of our NHS with its public health service ethos.  “Capitalism and greed” helped you waste £37bn on a private industry track and trace system that doesn’t work’.

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As ever with our Prime Minister, though, all criticism seems to be water off a duck’s back. We have to wonder if he reads any critiques or if his ‘people’ don’t tell him about them. The most striking expression of opprobrium could well have been John Crace’s account of Boris Johnson’s Prime Minister’s Questions performance. ‘How much longer can this go on? Previous prime ministers have at least been on nodding terms with the truth, but Boris Johnson is completely without shame. Without conscience. A sociopath for whom no lie is off limits, either in his public or his private life. What counts is reality as he would like it to be’.

That he’s allowed to get away with so much economy with the truth must have something to do with the apparent weakness of the current Speaker: you can imagine John Bercow would have challenged the PM much more on his fibs and evasions, not to mention failure to answer questions. This week one example was on the reduction of troops a part of the defence review. ‘The thing that was going to happen was not the thing that was going to happen. Reducing the number of troops was not actually reducing the number of troops because fewer soldiers would actually be more effective than having more. No wonder the Labour leader looked thoroughly confused by the time he had finished his six questions. Everyone was’. This despite the Tory manifesto promise not to cut the number of troops, although these days manifesto promises seem made to be broken.

‘How much longer can this go on? Just keep delaying the public inquiry into the coronavirus pandemic indefinitely and he could remain “world king” for many more years’.

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The government continues to dance on the head of a proverbial pin over compulsory vaccination for care home workers, a no brainer in the eyes of many considering the residents are sitting ducks. The libertarian ethos undermines the need to do the right thing, despite the gall of talking about having a ‘duty of care’ to residents and staff.  Remember the undertaking to ‘throw a protective ring around our care homes’?

‘The Telegraph reported that the sub-committee paper had warned that a “large” number of social care workers could quit if the change is made, while there could be successful lawsuits on human rights grounds’. This is very difficult for care home managers, wanting to protect their residents and staff but at the same time clearly up against the shortage of social care workers.

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Meanwhile, there’s growing awareness of the massive falls in numbers of referrals for cancer treatment and urgent surgery. ‘Now an analysis of NHS England data by Cancer Research UK has found that the number of people urgently referred for suspected lung cancer fell by 34% between March 2020 and January 2021 compared with the same time period in 2019/2020 – adjusted for working days. That, they say, equates to about 20,300 fewer people being urgently referred’. Other cancers were affected to a lesser but still significant extent and there’s also a big backlog of knee and hip operations.

In a Cancer Research UK survey of 1000 GPs, 91% said a key factor was patients’ reluctance to attend hospitals for tests, with more than three-quarters citing patients not seeking primary care. And another worrying factor in the way primary care is increasingly run is the use of remote consultations making it much harder to spot potential cancer symptoms. The big question now is how will the NHS be supported to tackle these backlogs?  

https://bit.ly/3rqn4IR

As the debate over violence towards women continues, the Guardian discussed one of the overlooked costs of violence, that is, suicides of the women involved. These deaths have resulted from violence but aren’t counted in the usual statistics because the women have taken their own lives. Although the figures are unclear, it seems they are significant. One study suggests that of the female suicides in England and Wales, one third were victims of domestic violence. The impossibility of estimating statistics were spelt out by activist Karen Blatchford, who tweets them at Female Suicide @we_are_nina). ‘I’m dependent on local press reports of inquests and only one in 10 [of all inquests] are reported. Families are often unrepresented. The abuse might not be raised’.

In such situations it’s common to hear people ask ‘Why don’t they just leave?’ But it’s much more complicated than that and will often involve a longstanding belief on the victim’s part that they don’t deserve better. But a another major factor is the expectation or otherwise of getting help. ‘The fear of not being believed or properly supported can play a huge part in driving a suicide, says Dr Jane Monckton-Smith, a forensic criminologist who specialises in homicide, stalking and coercive control. Domestic abuse has a higher rate of repeat victimisation than any other crime, says Monckton-Smith, who has written a book about coercive control. ‘If you’re not believed, then you can’t get safety’. It means the police can’t help you, the court can’t help you – and the abuser can act with impunity. It means there’s no way out’. Critics of the current legal system feel that it should be possible to criminalise abusive conduct, holding perpetrators responsible for another’s suicide.

https://bit.ly/3dbVr1j

Related to last week’s piece about ‘re-entry anxiety’, public toilets and benches are cited in a report about loneliness and the difficulties emerging from the lack of these facilities in public spaces, proving a disincentive for people to meet up. But for a number of reasons, a survey by Opinium of 2,000 UK adults found that 32% worried that they may not be able to connect with people in the same way as before. In a British Red Cross survey, it was found that (35%) of Britons feel less connected to their community than they did before Covid-19 and 39% don’t expect their loneliness to disappear once restrictions are lifted.

‘The All-Party Parliamentary Group on Loneliness wants Boris Johnson and his government to ensure that the country has a “connected recovery”. They also want ministers to do more to close the digital divide, plan new housing developments so that residents can spend time together and fund charities and voluntary organisations that help “the lonely and cut-off”. The pandemic has shown how much we need connections of all kinds, but what faith can we have in the government addressing such a need when they’ve been blind to such socioeconomic issues in the past?

A government statement was quick to mention the sums invested in work to address the problems but it’s not just a matter of investment – it has to be effectively targeted and followed through. ‘Since the beginning of the pandemic we have invested over £31.5m in organisations supporting people who experience loneliness and a further £44m to organisations supporting people with their mental health. We recognise that the easing of lockdown restrictions will not mean the end of loneliness for many people, which is why this will remain a priority for the government’.

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During the pandemic many of us have become so familiar with Zoom that it’s hard to imagine life without it now. It seems fairly likely to assume that its use will continue after restrictions end, in the key contexts of work, learning and social life. Now research has shown that complaints of ‘Zoom fatigue’, feeling ‘zoomed out’, are very real. Researchers at California’s Stanford University have identified four reasons for this fatigue, a major one being the effect of seeing yourself so prominently all the time on screen, ‘like being followed around by someone holding a mirror’. The second is the amount of eye contact involved, whereas normally people would be shifting their gaze from one person to another, looking at notes and so on. The third is the lack of the usual cues in this kind of interaction and the fourth is the need to remain in the same spot to ensure they’re on camera. Something not mentioned is the disconcerting time lag in the audio so people often end up speaking at once because they’ve not realised someone is already speaking. It also rather undermines spontaneity when someone wanting to speak has to raise their hand each time, one problem being that, depending on numbers present, the host can’t see all the participants at the same time and has to toggle between ‘pages’.

Perhaps the most interesting finding, though, is that last year the British Association of Aesthetic Plastic Surgeons saw a 70% uplift in requests for consultations, a significant number from men.

Finally, another form of communication, letter writing, seems to have taken on a new lease of life during the last year. Long neglected during an era of email and social media, personal letters have creatively filled time for some during lockdowns and given solace to others participating in pen pal schemes. ‘…..letters are good for us – humans thrive on activity and connectivity, and feel thwarted in the absence of those things. Letters offer a reprieve from the sameyness of lockdown, which made us simultaneously time rich and connection poor’.

An academic points out how letters are also ‘first-person accounts of history as it unfolds…..Letter-writing puts you into a speculative mode….some of the best essays in literature start as letters.” The writer of this article explained how writing letters helped her cope with the loss of her mother, a point which conveys the therapeutic nature of this activity for both writer and recipient. It’s so delightful to receive a handwritten letter through the post, given that the bulk of stuff coming through our letterboxes smacks of obligation and tedium, whether it’s the Census form or the Council Tax bill. So let’s hope this very positive development continues after the last difficult year: who will you write to next?

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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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