Sunday 19 September

As the working week ended with our climate-aware Prime Minister jetting off to the States and 178 Covid deaths, it started with ‘acceleration’ of the vaccination programme and continuing debate over autumn and winter strategy – with much in between. It’s been quite some week, which will have been unsettling for many, from the reshuffle to changing ‘traffic light’ system rules and from social care reform proposals to autumn/winter Covid planning. If what we’ve heard can be called a plan. On Wednesday 30,597 new cases (8,000 Covid patients in hospital) and 201 deaths were recorded, but some individuals and organisations seem impervious to this worrying news, firmly attaching themselves to the ‘things are opening up again’ narrative. This is probably due to wishful thinking and lack of awareness but also faulty government messaging.

In the LA Times a respiratory therapist’s account of the 7 stages of severe Covid makes salutary reading, especially the chilling Stage 7: ‘….We extubate you, turning off the breathing machinery. We set up a final FaceTime call with your loved ones. As we work in your room, we hear crying and loving goodbyes. We cry, too, and we hold your hand until your last natural breath. I’ve been at this for 17 months now. It doesn’t get easier. My pandemic stories rarely end well’. I wonder how many Covid deniers and antivaxxers would stick to their guns after reading such an article.

Although re-introduction of restrictions hasn’t been ruled out (the government has at least learned that lesson from last year) the autumn/winter plan seems fairly feeble despite its 30 page length – still, despite evidence to the contrary, treating vaccination as a silver bullet on which they’re relying far too heavily. The imminent easing of travel arrangements, welcome though it is to holidaymakers and the travel industry, surely poses quite some risk, particularly reduction of the red list. As a piece reported on the huge drop in mask wearing (it now seems normalised and unchallenged on public transport, around here in north-east London at least) and predictions of 1000 deaths a week, a sceptic tweeted: ‘We are going to have to watch Boris Johnson dither, delay and obfuscate before announcing a new lockdown under a new catchy three-word title. The delay is going to cost lives. And this government will be responsible’. Another said: ‘How can we rely on people to do the right thing while refusing to tell people what the right thing is? Johnson loves mixed message chaos – it means his opponents have a hell of a job pinning him down’. At least Chris Whitty was the voice of caution, warning against presumptuousness because we haven’t faced a winter with the Delta variant before: ‘Those who say they know how it could pan out have not understood the situation’. Unfortunately, this didn’t stop a deluded and hyperbolic Sajid Javid on Wednesday talking up the ‘amazing’ treatments and ‘fantastic’ vaccination programme. Anyone would think he was trying to deflect from the need for more nuanced thinking.

Meanwhile, the BBC paints a depressing portrait of what this coming winter could look like, flagging up a likely massive rise in hospital admissions, higher food prices driving up inflation, avoiding a ‘lockdown lite’ and a likely rise in school absences because of Covid fears, to name just a few. Others would include the imminent ending of the Universal Credit uplift and of furlough. There’s no substantial evidence that the government is taking these issues sufficiently seriously, which will contribute to public anxiety.

The doctors’ union, the BMA (British Medical Association) weighed into the fray, its chairman suggesting that the so-called Freedom Day on July 19, when many restriction were eased, was a ‘gamble’ that has since then contributed to almost 40,000 hospital admissions and more than 4,000 deaths. Besides criticising ministers for dismissing calls for a rapid inquiry into the crisis before the second wave of infections struck last year, meaning that crucial lessons from the previous six months were not learned, he faulted the ministerial mantra of ‘living with Covid’, which belies the reality that thousands of people continue to need hospital care for Covid, with hundreds dying each week (around 6m people are still unvaccinated, too).

Regarding mask wearing, there have been comments about their lack in the House of Commons and can we have faith in a Health Secretary who thinks you can only get Covid from strangers? Sajid Javid said that Boris Johnson and his ministers didn’t need to wear masks at cabinet meetings because they were not ‘strangers’, yet this is how the PM and others contracted and spread Covid last year, through close contact with colleagues. What’s even more telling is the confirmation that vaccine passports would not be required at the Conservative Party conference next month after senior Tories had threatened to attend a rival event if people had to show their vaccine status to get in. So much government policy seems to be unhealthily driven by the desire to appease certain vociferous groups, whether it’s Tory backbenchers or the travel industry.

A contributory factor in faulty messaging has been seen by some scientists as partly attributable to the sidelining of behavioural experts, who were told their input to SAGE (Scientific Advisory Group for Emergencies) is no longer required. ‘They also warned of an absence of independent advice at a time when the virus’s spread depends largely on individual behaviour and social norms rather than laws. The intervention comes as ministers face criticism for mixed public health messaging on face coverings – including the new cabinet meeting maskless in a packed room on Friday – and a U-turn on vaccine passports in England, while Scotland and Wales press ahead. Professor Stephen Reicher said: ‘I very much welcome the expansion of in-house behavioural science advice but … you want people who can speak uncomfortable truths and it’s very difficult to do that when your job depends on it’. His understandable concern as well is the timing, as individual behaviours are a key factor in the spread or suppression of the virus. Yet another transparent government attempt to control the advice they get to hear?

Not for the first time, Work and Pensions Minister Therese Coffey didn’t cover herself in glory when responding to questions on Radio 4’s Today programme about the Universal Credit uplift issue. Besides suggesting measures which are unworkable, such as working extra hours when many employers have cut down employees’ hours, there was very much a ‘let them eat cake’ attitude on display. There will be a lot of anxiety around about this, as the temporary uplift comes to an end on 6 October, meaning a cut in income to almost six million people. Almost two in five people on Universal Credit have jobs. It’s clearly a difficult issue to resolve, as the Chancellor has said he definitely won’t extend this UC uplift, yet statistics of those on UC have almost doubled during the pandemic, from three million in March 2020 to 5.9 million at the end of July. At least one tweeter wants to alert the government to the reality of this situation: ‘If PR phrases could cure poverty the government of Boris Johnson would be world-beaters. However, ‘levelling up’ and ‘build back better’ are merely words while the £20 cut to Universal Credit is real’.

But perhaps there will be yet another government U-turn as Boris Johnson is facing a backbench rebellion because the cut is thought likely to risk poverty for more than 800,000 people.

On a not dissimilar theme, Labour MPs outed an elephant in the room – the lack of a wealth tax – to fund social care reform, asking for the inclusion of such a clause in the forthcoming legislation. ‘The health and social care levy will become payable only after the Chancellor of the Exchequer has laid before the House of Commons an assessment of the merits of raising at least the same amount of revenue for health and social care as would be raised by the levy by introducing instead a wealth tax on individuals with assets totalling over £5,000,000’.

Meanwhile, the government continues to ignore another elephant in the room (unpaid tax), which could help fund social care reform and the Universal Credit uplift. The amount of tax lost in Britain through non-payment, avoidance and fraud has increased to £35bn, according to official figures but some years ago the number of HMRC investigators was reduced (another piece of ignorant short-termism). And a good number of the avoiders and evaders will be supporters of this government, so there’s little incentive to upset them. As George Turner, the Executive Director of the TaxWatch campaign group, said that fraud was a much bigger problem than had been acknowledged, the timing is terrible because public finances have been so strained by the pandemic. We have to wonder whether any ministers how regret the shortsighted strategy to hobble HMRC in their investigative efforts. From a parallel universe, Jim Harra, HMRC’s Chief Executive, said: ‘It is encouraging to see such a large proportion of businesses and individuals meeting their tax obligations. We want to help everyone get their tax right, which will help fund our vital public services like the NHS and emergency services’. Except he doesn’t seem to recognise that many will be evading any HMRC overtures which would enable or force them ‘to get their tax right’!

In the Guardian parliamentary sketch writer John Crace lampooned the Autumn/Winter Covid plan press conference. ‘For the last few weeks in Westminster, it’s almost been as if Tory backbenchers – and many frontbenchers for that matter – would rather do anything than be reminded that Covid still remains the country’s main public health problem. Despite the many posters pinned up around the parliamentary estate urging people to ‘wear a face covering’, almost everyone on the government benches is snuggling up to one another, defiantly mask free. It’s as though the coronavirus was yesterday’s problem. Or the guidelines are only for the little people’.

If Plan A is thin, Plan B seemed even thinner, Javid even venturing the astonishingly clever advice that if people feel unwell they should stay at home. ‘This involved making face masks compulsory in certain circumstances – cue loud boos from Desmond Swayne and others on the Tory benches – asking people to work from home, though definitely not during the party conference as the Conservatives didn’t want to be out of pocket, and the introduction of vaccine passports. The same vaccine passports that Javid had said only days earlier the government definitely wouldn’t be introducing. More like a case of definitely maybe’.

Several commentators have observed the difference in the stance adopted by Vallance and Whitty at these press conferences – whereas last year they were muted and perhaps even slightly cowed by the unaccustomed attention, they are now openly more aware of this government’s and Prime Minister’s deficits. ‘He (Vallance) looked at Boris with something approaching disdain. He seemed to be thinking that the UK could get similar results (as other countries with far fewer cases) if we didn’t have such a deadbeat for prime minister, who couldn’t even get his own MPs to wear a mask’.

Perhaps one of the most striking things this week was the Cabinet reshuffle – rearranging the deckchairs on the Titanic comes to mind. While it was clear that some would definitely be ‘out’, like Dominic Raab and Gavin Williamson, who nevertheless deludedly tweeted about his ‘transformative reforms’, it was less obvious in the case of others like Roberts Jenrick and Buckland (housing and justice), who hadn’t appeared (beyond the usual Tory low bar) to have done anything wrong. It emerged that what the PM wanted was people who were upfront (tweeted a lot?) about promoting their ‘work’. We heard that Michael Gove, replacing Jenrick, was already getting into his brief so perhaps that clubbing the other weekend gave him a shot in the arm. But appointing Liz Truss as Foreign Secretary and Nadine Dorries as Culture Minister does beggar belief, the main criterion obviously being the candidates’ degree of loyalty to Boris Johnson. Liz Truss has bragged about not being diplomatic, but seriously, a self-confessed non-diplomat as Foreign Secretary? A complete nonsense but presented by the BBC’s Laura Kuenssberg as a good thing, a sign of strength.

A tweeter got it in one (‘PM prizes uselessness above all with new jobs for the likes of Truss, Gove and Dorries’) but the prize for the most classic comment must go to journalist and broadcaster Matthew Parris, who said: ‘He’s a complete charlatan and this is a charlatan’s Cabinet’. But Parris also said the reshuffle was done ‘elegantly’, when we know it had been a very tense meeting between Johnson and Raab.

As for repetitive and waffling Nadhim Zahawi, he’s seen to have done so well as Vaccines Minister that he gets the plum education gig. The move which personally strikes me the most is that of Nadine Dorries to Culture (a former star of I’m a celebrity – get me out of here), given her lamentable performance in the mental health role. Various arts and culture organisations have already expressed dismay, besides noting the government’s lack of interest in this area, as manifested by regular changes of incumbent (ten in as many years). Broadcaster James O’Brien tweeted: ‘It’s appalling, obviously, and conclusive evidence that Johnson holds the Culture department in complete contempt, but Nadine Dorries becoming Secretary of State is straight up hilarious’. The media have made much of her being the author of many books and how many words she commits to writing a day but we have to wonder in such cases about the level of commitment to the day job they’re so well remunerated for. Dorries tweeted: ‘From Breck Road in Liverpool to the Cabinet Room in No 10. Surreal experience but excited to get stuck into the hard work’, which attracted the response: ‘Having once been poor does not qualify you for government’.

Meanwhile, Defence Minister Ben Wallace demonstrated the intellectual heft of those retaining their posts by seeming to suggest that ‘levelling up’ is about government departments moving oop north. The retained postholders may not have felt that comfortable, though, as the reshuffle continued for three days and it wasn’t till day 3 that Lord Bethell (junior health minister found to have used private email for official communications and who ‘lost’ his phone during the crony procurement investigation) was sacked. He had also sponsored a parliamentary pass for the former health secretary’s lover, Gina Coladangelo.

As usual the Guardian’s John Crace goes for the jugular on the reshuffle which ‘reveals the shallowness of the Tory gene pool of talent – the PM prizes uselessness above all with new jobs for the likes of Truss, Gove and Dorries’. It will be interesting to see how they get on, especially those who’ve already bullishly tweeted about getting into their new jobs. We’re told that Johnson gathered his new cabinet together for the first time on Friday morning (minus masks) and gave them what he called a “half-time pep talk”, stressing the need to deliver on their promises and “level up” the country. What a joke.

Sky News produced a useful listing of who’s in, who’s out, who’s moved and who remains.

As reflections and recriminations continue to emerge from the Afghanistan takeover, the key question many of us have been asking (can the Taliban govern as well as conquer) has come even more to the fore. It’s crucial for world leaders that they know who to engage with in the new regime but within a fortnight of the takeover, those said to occupy the top positions had changed. Now it’s emerged, perhaps not surprisingly, that there has indeed been conflict within the leadership, some claiming to have contributed more to the takeover than others. Now there’s been an interview with an individual new to at least some of us: Mawlawi Mohammad Shebani, officially in charge of policing morals throughout Kandahar, the Taliban heartland of southern Afghanistan. ‘He is newly appointed head of the provincial office for the promotion of virtue and prevention of vice, a title which strikes fear into many Afghans old enough to remember its previous incarnation under Taliban rule in the 1990s. Its officers served as the brutal enforcers of the group’s extreme interpretation of Islam, whipping men into mosques to pray, policing beard length, smashing radios and televisions and attacking or detaining women who tried to work, went out without a male guardian or showed their faces in public’.

But Shebani says his officers will now focus on ‘persuasion, not violence’, describing the 1990s approach as ‘the mujahideen without a written code’. But how different is it? Within a four-step process of dealing with perceived recalcitrants, the fourth step does allow for ‘stopping him with your hands’. ‘Some people think we are extremist, but we are not like that. Islam is a religion of moderation, not too much and not too little, everything just right. Media channels are publishing negative things about us, please spread the reality to the world’. This statement will result in some raised eyebrows. ‘The leadership is apparently aware of how the organisation is perceived internationally; when they handed out an English language list of new cabinet appointments earlier this month, the vice and virtue ministry was the only one not translated’. Time will tell, as long as Western journalists are allowed free access.

Another question many will be pondering is just how long Prince Andrew can keep on running from the long arm of US law. Having tried to evade the serving of legal papers, his legal team using a technicality to justify avoidance, the Mail Online reports that Andrew, currently at Balmoral, is likely to emerge from hiding in order to visit his pregnant daughter, Beatrice, in hospital. ‘However, royal aides fear the duke’s ‘wall of silence’ strategy towards the sex abuse lawsuit is increasingly damaging the monarchy, with insiders admitting the prince is ‘stressed’ and ‘worried’ as the pressure to respond to the bombshell allegations mounts. It comes as the High Court last week gave Andrew’s legal team seven days to challenge its decision to begin notifying him about the civil sex case in New York against him. As these legal shenanigans continue, a source suggested the Prince’s mood has changed over the past few days and he has become ‘worried’ and is ‘not his usual blasé self’. Not a moment too soon.

In an initiative which reminds me slightly of social prescribing, some Belgian medics are involved in a three month trial to see how museum visits could help patients deal with Covid stress. ‘Patients being treated for stress at Brugmann hospital, one of the largest in the Belgian capital, will be offered free visits to five public museums in the city, covering subjects from fashion to sewage. The results of the pilot will be published next year with the intention that the initiative can be rolled out further if successful in alleviating symptoms of burnout and other forms of psychiatric distress’. Although this shouldn’t be treated as a substitute for treatment such as talking therapy, there’s no doubt that for many cultural activities like this enhance mental wellbeing. One of the obvious benefits is that the visits will be free of charge, which many UK museums already are, but perhaps this is an initiative Nadine Dorries might take an interest in, especially as it reflects her ministerial segue from mental health to culture.

Finally, in a long-running series involving readers responding to others’ questions, some interesting suggestions come up about when and why men stopped wearing hats. Although this would have gone for both sexes, it’s interesting to reflect that the very tall wardrobes one sees in stately homes, for example, were constructed to accommodate an upper shelf for top hats and the like. The questioner cited a photograph of the 1923 Cup Final, which showed almost every man wearing a cap. Respondents’ offerings include the following: ‘It used to be something of a class signifier (flat cap for the working class, bowler hat for civil service types etc), and related to jobs with uniforms. As dress became less formal, and hair fashion became more widespread, the hat lost its cultural significance’; ‘the rise of private car ownership meant that more and more men weren’t standing around waiting for buses getting cold and wet. Plus, when you had a car – what did you do with your hat? You’d have the ludicrous situation where you’d put on your hat to go to the car – take it off, drive to work, put it on again to walk into the office, and then take it off again. So car owners gave up hats as too much faff’; ‘The Hat Research Foundation (HRF), which was apparently a real thing, found that 19% of men in 1947 who didn’t wear hats said it was because they triggered the trauma of war associated with their uniforms. Maybe that’s when the decline began’.

Here’s one that definitely shouldn’t be overlooked: ‘As a bald old man who lives in a very cold climate and walks to run most of his errands – I think the comments are missing some of the more practical roots of hats. Hats are very effective at keeping you warm. My wife with her luxurious mane will occasionally mock my hat while we are for a walk. She simply doesn’t understand how much heat my bold pate releases’. Let’s just hope it’s not a baseball cap – a most unattractive piece of apparel, in my view!

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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