Friday 24 April

A big news day – 19,506 deaths so far, moving up to the 20k thought shocking several weeks ago, but also the testing website closing within hours and the revelations about the alleged independence of the government’s scientific advice source.

Amid continuing talk about ‘ramping up capacity’ for COVID19 testing, it was reported that the much trumpeted new website for key workers to book tests had temporarily closed – hours after being opened by the government. You could not make this up!

The Today programme (about 08.50 am) featured playwright David Hare’s searing verdict on the government’s COVID19 performance, criticising the lack of transparency we are owed in return for such massive disruption to our lives in the form of lockdown. Hare had and recovered from the virus and makes clear where he thinks the inadequacies lie.

https://bbc.co.uk/sounds/play/m0

Guardian parliamentary sketch writer John Crace has experienced mental ill-health for some years and has now produced this podcast – what is the covid19 crisis doing to our mental health? The ‘biggest health crisis in a generation and the enforced isolation of lockdowns is taking not just a physical toll on people but also affecting mental health’.  Of course we feel for those who can’t see their families but the position of those living on their own, without partners or families, gets mentioned only halfway through, eg the effect of going so long without physical touch and not knowing when this will end. When asked what helps, most of the advice is obvious but repeating it is helpful as things could easily be missed or overlooked: the public health expert said how important ‘keeping the basics gong’ (eg for some even getting dressed), accessing online sources of help, keeping in touch with friends and family, staying connected, ‘physical distancing but not social distancing’, being part of a community, helping others and exercise, which releases ‘feel good’ endorphins. John ‘eases off on news consumption’ towards the end of the day and recognises the powerlessness we’re experiencing with COVID19, that of just not knowing when this will end and what society will look like afterwards.

https://bit.ly/3cIuAIe

This evening the Guardian broke the shocking news that Dominic Cummings, the PM’s Chief Political Adviser, is on SAGE, the committee of scientists advising the government on its COVID19 strategy, and whose membership and minutes have been kept secret. Of course this will lead to further doubts about the quality and independence of that advice. Green MP Caroline Lucas tweeted: ‘So much for “independent” scientific advice … No wonder the Government wanted to keep the membership of SAGE secret Not only that, but the group clearly needs much stronger voice for Public Health experts on the committee too’.

Again, today’s events are likely to add further to public anxiety.

Thursday 23 April

A big day today – it’s World Book Day, St George’s Day, Shakespeare’s birthday and Ramadan starts. I wonder how much these days mean to people. Obviously, none of these celebrations can take place in the usual way. For World Book Day, the custom of giving out free books will happen later and readers are recommended to read for an hour today before the 8 pm clapping. The good news is that people are reading more during lockdown, great for language and vocabulary development and also affording some escape. I’m always interested to hear what people are reading.

St George’s Day won’t see Morris dancers or big pub gatherings and flag waving. The Hits Locker on Twitter recommended listening to Dylan’s Desolation Row on Shakespeare’s birthday – have to confess I hadn’t heard of it (1965) but enjoyed it.

As for Ramadan, there are concerns about older Muslims still trying to get out to the mosque and about their fasting all day when this could endanger their health at a time treatment is harder to get.

More sobering news is that the virus death count is now 18,738, although it’s said the ‘curve is flattening’. Now it’s clearer, despite ongoing talk of ‘going back to normal’, that the virus and measures to counteract it will continue for quite some time yet. And we won’t be returning to how things were: instead society will evolve to take account of losses, necessary changes.  These changes will be far-reaching, eg societal, financial, global, environmental and so on. Physical distancing will have to continue so this threatens to severely undermine if not kill off the no-frills airlines, restaurants, bars, cinemas, sports and arts venues which we used so heavily before.

What are you doing/achieving/learning during lockdown? A question which seems to be gaining attention and this tweet attracted opprobrium earlier:

‘If you don’t come out of this quarantine with 1) a new skill, 2) your side hustle started 3) more knowledge — you never lacked time. You lacked discipline.’

It evidences the superiority and judgementalism in some quarters but raises interesting questions because lockdown does afford an opportunity to do things differently and many do have additional time (not all, obviously). But apart from an antipathy to the ‘side hustle’ phrase, which smacks of criminality to me, some are up to their ears with work, trying to keep households together, childcare and perhaps care for someone with dementia or learning difficulty. So some respondents said if they came through lockdown in one piece they’d done well enough and how their lives already demonstrated a great deal of discipline. Some have quite inspiring stories to tell, exercising for the first time, re-learning a language, getting into handicrafts and so on but there are different routes to personal growth.  

Wednesday 22 April

Besides the daily death toll, another depressing piece of news is Chief Medical Officer Chris Whitty’s view that the UK will have to live with some social distancing measures for the rest of the year.

Today’s Guardian editorial paints a reactive rather than proactive picture of the government’s COVID19 strategy, presenting an analysis of what’s wrong and what’s needed. This is in the context of the much-hyped vaccine announcement yesterday, itself looking like a government attempt to claw back some dignity from the flak being flung at it.

‘While no expense should be spared to find a vaccine, the UK government must also display the wherewithal to design an administrative system to support and enable the public to live with this threat. That means getting the basics right. So far the signs have not been good. In Britain, everywhere you look you see a state overstretched and driven by politicians’ panic rather than careful planning.’

The article shows that other countries did not make unrealistic claims about tackling the virus but the UK did, eg saying said we’d have 100,000 tests a day by the end of the month. ‘There do not seem to be coordinated, sustained efforts by the government….’ The operative word here is coordinated, with ministers like Simon Clarke saying x or y isn’t in their portfolio. Level is another operative word, because they have ‘levelled’ about the likely cost to the taxpayer post-pandemic but not about other important areas: ‘Ministers need to level with the public over the PPE shortfalls and blockages.’

The article suggests that two things need dispensing with PDQ – ‘They must shed ideas of British exceptionalism that saw them waste chances to purchase kit and protective equipment on the global market, as well as delusions that “herd immunity” was a way out of the pandemic. Again, increasing doubts about the government’s approach will increase anxiety in the population. At least, though, the government finally has some effective opposition and it sounds as if Keir Starmer gave Dominic Raab a good run for his money at PMQs today, the first of this new virtual parliament.

Although not surprising, it’s depressing to hear of the rise of scams, taking advantage of people’s insecurity and anxiety during the crisis. They range from the more predictable finance scams to the more insidious ones, eg the sale of expensive ‘vitamin infusions’, allegedly helping to protect people from the virus. Those purveying such things aren’t prevented from doing so despite NICE (National Institute for Health and Care Excellence) pointing out the lack of evidence base and asking them to desist. Of course, those with health anxiety will be especially vulnerable to this kind of exploitation. Not for nothing is there a hashtag on Twitter: #nutribollox.

Meanwhile, there are some cheering lockdown stories, people doing and making new things and those unable to do their old jobs adapting to the situation eg the tailor turned food picker featured on Radio 4 You and Yours.

We’re used to hearing about NHS staff at risk but the difficulties facing the psychiatric sector have largely been overlooked. Mental health units are hugely at risk because only half the psychiatrists surveyed said they’d been able to get tested (despite assurances that any NHS staff could get tested), and units can’t get PPE. A very real concern is that people living with mental illness might experience worsening symptoms and others might develop new mental health problems, especially depression, anxiety and post-traumatic stress, while loss of employment and financial worries may lead to a sense of hopelessness.

Sir Simon Wessely (Professor of Psychological Medicine at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London) has usefully drawn attention to this interesting blog, also written up in The Telegraph, about how we resume our lives after lockdown. Rather than everyone going mad celebrating when lockdown ends, it looks at why people may be more reluctant to resume their previous lives, preferring safety to freedom.

Author Professor Bill Durodie (University of Bath) suggests that ‘as a slogan, “Stay Home, Save Lives” encourages what, at the time of the Second World War would have been recognised to be a paralysing “deep shelter mentality”. It fails to engage people actively in the collective effort to restore normality.” He argues that this ‘prolonged period of social isolation, fear and dependence….could lead to a culture of suspicion, avoidance and intolerance towards others, an unwillingness to embrace life’s uncertainties..’, – sounds more like existing than fully living. [For some reason the blog URL will not post but it’s University of Bath IPR blog – Getting on with life is the real battle now]

At 8 pm on Radio 4 (or catch up on BBC Sounds) Mary Ann Sieghart presents the last episode of Fallout, looking at the kind of society likely to emerge post-pandemic, focusing tonight on the environment. Key questions discussed include ‘How will COVID-19 affect how we think about risk? If we can change our behaviour to fight this emergency, could we also do it to avert a climate emergency? Or will we be even less willing to do so, as we’ll be more concerned about putting food on the table? Will governments also be less interested in tackling climate change when climbing out of a recession is a higher priority? Will we see more global co-operation to tackle global problems or the opposite: a more nationalist and divided world?’

https://www.bbc.co.uk/programmes/m000hfs7

Tuesday 21 April

This morning housing minister Simon Clarke was the latest junior minister to be found wanting by interviewers, including Piers Morgan – ‘savaged’ in the words of one source. On the PPE saga and the latest news that the Turkish supply still had not been released, Clarke made on the Today Programme what must be the understatement of the week: ‘’This is not a situation where we’re beyond criticism’.

The emergence of another scientist giving advice contrary to that of SAGE will be cause for further disquiet about the basis on which the government is basing its policy. Carl Heneghan, director of the Centre for Evidence-based Medicine at Oxford University, said that the impact of the lockdown was “going to outweigh the damaging effect of coronavirus”.

The crisis has sparked necessary focus on a still taboo topic in some quarters: death and dying and how we anticipate and plan for them. Many are not yet doing it. You may remember We Need to Talk about Death, an excellent Radio 4 series a while back presented by the inimitable Dame Joan Bakewell. But it’s not only death and dying we’re up against in this situation: it’s death taking place where (despite the change in government policy) it’s not easy to see the deceased at the end and there’s no public ritualistic recognition (eg funeral and wake) of the customary kind. This is going to lead to numerous experiences of complicated grief, adding to the general mental health burden.

Today’s BBC Woman’s Hour led on this issue, featuring the impressive a palliative care expert Dr Rachel Clarke, who smashed it on Question Time last week. This discussion is so worthwhile and overdue as it’s common to encounter people who refuse any consideration of death even when in the older age group. It can be mistakenly seen as anti-life when philosophers have said we can’t live fully without having first reflecting on own endings.

https://www.bbc.co.uk/sounds/play/m000hfxy

One of the side-effects of lockdown has been people being unable to get to hairdressers, nail bars and beauty salons and the likely collapse of those businesses. Weekend Woman’s Hour got some flak for covering the challenge of how we manage without these services, featuring a beauty editor who spent some time telling listeners, for example, how to wax and how to remove their gel nail polish (apparently has to be acetone, not with regular remover). I wonder what people think about this. On the one hand it could feel like first world problems and some emailed in to say how trivial it was and how there would be many who’d never got nails or waxing done. On the other hand we know how important the state of our appearance can be to our sense of wellbeing, and while it can perhaps be taken too far, a kind of dependency and over-emphasis on appearance, the fact is that it does make a difference to our sense of wellbeing.  

Just before today’s Downing Street briefing yet more sobering death statistics were announced: another 828 today, making a total of 17,300 COVID19 deaths.

On a lighter note, you might be interested to know that today is both World Curlew Day (shame no opportunities to get to nature reserves at the moment) and National Tea Day. So you can only see these beautiful birds online but you can make a cuppa!

Finally, you might enjoy this example of slow radio (examples of slow radio are regularly featured on Radio 4 Broadcasting House on Sunday mornings) was this piece last night at 11 pm on Radio 4 – an aid to mindfulness.

https://www.bbc.co.uk/programmes/m000hdkw

Monday 20 April

As we enter the 5th week of lockdown, the government issued two rebuttals to the searing Sunday Times article, one saying the article ‘contained a series of falsehoods and errors’, the second concerning a Financial Times story on efforts to source privately designed ventilators. On another rebuttal, Shadow Health Secretary Jonathan Ashworth told the Sophy Ridge Show that Gove had given “possibly the weakest rebuttal of a detailed exposé in British political history” about the PM skipping the February COBRA meetings.  

Conservative MPs are barred from talking to the media about the pandemic without No 10 clearance, but some are known to be worried about the apparent lack of preparation, the continued significant daily rises in deaths, and the lack of a publicly discussed lockdown exit strategy.

The Times reported on the decision to keep secret until the crisis is over the advice and advisers to government. Neither the minutes nor the membership of the Scientific Advisory Group on Emergencies (SAGE), the government’s most senior team of expert advisers, are being made public. As SAGE is ‘the most senior team of expert advisers’, this lack of transparency will cause even more public disquiet because it’s been clear for a while that the use of ‘evidence’ and ‘science’ is variable and inconsistent. Scientist Dame Anne Glover said: ‘Openness supports trust and trust is really needed at the moment. It also opens up the possibility of very valuable challenge and input from ‘not the usual suspects’ which could be very helpful.” (my italics). This begs the question does the government want ‘valuable challenge’?

Added together, these various sources of opacity could result in even more anxiety for the public. But at least it’s good that more and more media sources are discussing the mental health implications of this crisis.

Meanwhile, the PPE and gowns saga rumbles on: the supply flight from Turkey expected before the weekend has still not reached the UK and even then the equipment would first need to be tested and distributed. Meanwhile, politicians repeat that this is global issue and clinicians continue to put their lives at risk. The suggestion of a minute’s silence to pay tribute to health care workers who have died seemed another diversionary tactic, not unlike the care badge, a cynical kind of virtue signalling that doesn’t address the problem.

The quality of ministers leading the 5 pm Downing Street briefings seems increasingly variable. Earlier a wag tweeted ‘Updated list for the next rota for the Downing Street Briefing: Priti Patel; Gavin Williamson; Stanley Johnson; Tim Martin; Guy Martin; Guy Fawkes; Ben Fogel; Foghorn Leghorn; Leggy Mountbatten; Jim Davidson; Oliver Dowden; Oliver’s Army and Chris Grayling (but only if absolutely necessary)’.

Finally, I know we’re being inundated with zillions of suggestions for stuff to read/watch/listen to, but if you’re looking for something really compelling to listen to, you might enjoy Tunnel 29, the story about the building of the escape tunnel under the Berlin Wall. This kind of gripping listening has the ability to take us out of ourselves, something very much needed at the moment.

https://www.bbc.co.uk/programmes/m0009kyn

Sunday 19 April

The government’s COVID19 performance and the PM’s in particular were blasted this morning from a source unexpected (to me, because of the normally pro-Tory Murdoch ), the Sunday Times, which detailed the trajectory of missed opportunities and delayed actions. In Coronavirus: 38 days when Britain walked into disaster, the authors show how the PM missing 5 COBRA meetings, the failure to order PPE and the ignoring of scientists’ warnings (or perhaps listening to too many inconsistent ‘experts’) formed the foundations of the domino effect outcome over the months which followed.

‘But it took just an hour that January 24 lunchtime to brush aside the coronavirus threat. Matt Hancock bounced out of Whitehall after chairing the meeting and breezily told reporters the risk to the UK public was “low”.’

Nevertheless, the PM still has a 66% approval rating for his handling of the crisis. A business leader tweeted: ‘Sadly there will be those that still think “they’re doing their best in tough circumstances”. We live in a country full of sycophants.’

If you want to hear some truly rigorous discussion about these issues, tune into Stephen Nolan on BBC Five Live at 11 pm on Saturdays, when Stephen is joined by former Tory minister Edwina Currie and broadcaster Mohammed Shafique.

Meanwhile, a new phrase has entered the English language – ‘lockdown shaming’. Police have been inundated with reports of alleged lockdown breaches, thought mostly to be mistakes or attempts to settle ‘vendettas’. West Midlands police, the UK’s second largest force, revealed it had been receiving up to 2,000 Covid-19-related calls a day – up to half of its daily total. The Guardian reports how some areas have ‘enthusiastically embraced “corona shaming’, eg Norfolk over the Easter weekend. This phenomenon suggests the surreal situation we’re living through is leading to the emergence of our more primitive sides beneath the veneer of civilisation.

At today’s press briefing, Education Secretary Gavin Williamson announced another 596 coronavirus deaths in hospitals, taking the total to over 16,000 and the number of cases to over 120k. At least 86 health and social care workers have died of COVID19, many of whom simply did not have adequate PPE, making it especially shocking that the gowns promised by the weekend will not arrive till tomorrow at the earliest. And yet Jenny Harries, the Deputy Chief Medical Officer, says “the U.K….has been an international exemplar in preparedness.” It seems very unfortunate, then, that the gowns promised by the weekend will not arrive tomorrow at the earliest.

All this news contributes further to the feeling that we are not being psychologically ‘held’ by a team of authentic, competent or consistent politicians and policymakers, with the potential for exacerbating anxiety and uncertainty.

On a cheerful note, ICYMI, you might like to catch up with the inspiring and chirpy fitness guru Joe Wicks, interviewed at 11 am on BBC Radio Five Live, where he talks so engagingly about the importance of exercise and diet at this time. This is especially helpful because so many were deterred from exercise years ago, having felt humiliated by early experiences of bossy or bullying games teachers at school. A key part was when he clarified the mental health benefits of exercise. As the presenter said, ‘his positivity is contagious’. There are great workouts on his YouTube channel (The Body Coach) at 9 am each weekday morning and if that feels too tough, there are others on offer eg several 10 minute ones for seniors. And no, I’m not getting paid to promote it, lol !

https://www.bbc.co.uk/programmes/m000hgz3

Saturday 18 April

Today the UK death toll from COVID19 increased by 888, taking the total number of fatalities to 15,464 and we’re told there could be 40,000 in this first wave of the outbreak – terrible news all round.

As the debate on PPE shortages continues, specifically focused on the likely shortage of gowns this weekend, Matt Hancock’s statement at yesterday’s Health and Social Care Committee was widely found galling, that he “would love to be able to wave a magic wand” to increase supply of PPE, when it’s now well known that the government turned down several opportunities to obtain supplies earlier this year.

An irony about the much-criticised care badge was reported by the Guardian: the website soon ran into difficulties, leaving visitors with the news that there was now a shortage. ‘Until production is “ramped up”, it’s hard not to conclude that the chief success of the care badge was to form a psychic shield around the health secretary. It will, however, take more than a badge if he doesn’t hit his 100,000 tests a day target for the end of April, having already missed the 25,000-a-day target for the middle of the month.’ What a marvellous phrase that is: ‘ a psychic shield around the Health Secretary’ – surely to become one of the most memorable of this period and one likely to be applicable in many other situations. Some equivalence to Emperor’s Clothes!

It seems shocking that these trumpeted care badges aren’t being distributed free of charge. A care worker was asked by BBC Newsbeat whether she will be buying one of the new CARE badges, she said “No, they are being sold for £8.99 and my wage is only £8.75 an hour.”

It’s to be expected that relationships will come under strain in such challenging and uncertain times, and although it’s long been an overlooked problem, it’s shocking to see how lockdown has caused domestic abuse to rocket or rise to the surface. The UK’s largest domestic abuse charity, Refuge, reported a 700% increase in calls to its helpline in a single day. After the first week of lockdown, domestic abuse charity Refuge said there had been a 25% increase in calls to the National Abuse Helpline and online requests. Within the national context, about An 1.6 million women and 786,000 men experienced domestic abuse in England and Wales in the year ending March 2019,statistics now out of date.

Priti Patel recently launched a campaign under the hashtag #YouAreNotAlone to support victims of abuse after a rise in cases during the coronavirus lockdown. The UK’s largest domestic abuse charity, Refuge, reported a 700% increase in calls to its helpline in a single day. This phenomenon carries with it a significant mental health burden for the abused and their children. What public sector help will be available to them when this is over?

Sarah Coulthard-Evans, a mental health service user who spent 10 years on a psychiatric ward, wrote movingly in the Guardian about her experience of finally being discharged from hospital, only for the lockdown to severely curtail her freedom. She captures very well the mental health challenge many will be hit with, an experience she has gained insight into during her long hospital spell.

‘My fear is that during this pandemic we could see a significant spike in suicide or self-harm rates as vital support is stripped away, and those living with mental health problems are left with nothing but their own thoughts. Depression and anxiety thrive on social isolation, a lack of routine, and sudden changes of plans.

The lockdown will mean that a lot of people can no longer access mental health services, attend face-to-face therapy, or simply see their friends – things that offer people a lifeline in a mental health crisis. It’s not surprising that a recent survey by Young Minds found that 80% of young people with a history of mental ill health found their conditions have worsened since the coronavirus crisis began in the UK.

When this is over I expect we will see a surge in the demand for mental health services, and I worry how the overstretched system will cope. The lack of money, too few beds and the shortage of home support meant it was already in crisis long before this pandemic hit.’

This is exactly what the government must develop a strategy for – how the ‘overstretched system will cope’ when it’s already been creaking at the joints for so long. As a mental health professional tweeted about lockdown: “The worst part of living in isolation is that fundamental elements of your life are exposed for what they are. You can no longer hide from the hard truths.”

Friday 17 April

In case anyone thought the lockdown extension was to be three weeks only, Dominic Raab has warned that the measures could last into June as ministers came under increasing pressure to set out a detailed plan to ease the stringent restrictions. I wonder how much of this is a delaying tactic because there’s still no plan for an exit strategy, which other European countries mostly have.

Matt Hancock was expected to come under pressure to commit to a coordinated testing and contact tracing regime when he appears before a ‘blockbuster’ Health and Social Care Select Committee hearing this morning, led by former health secretary Jeremy Hunt and attended by several other committee chairs as guests. Given his former role, it must have been gratifying for Jeremy Hunt to take charge of this grilling. During the virtual meeting, Hancock outlined a 6-stage ‘battleplan’ (note that bellicose language again) and said the first step for beating the pandemic is social distancing, with the UK currently remaining in lockdown for at least another three weeks. The next 5 steps are boosting NHS capacity; supply (eg correct equipment), described as ‘challenging’; testing, tracking and tracing; treatment; and shielding (protecting society’s most vulnerable people from the virus to make the UK safer overall).

It could be argued that putting social distancing first, important though it is, is a distraction from severe delay and underperformance in what the main interventions should be, ie testing, tracking and tracing, attributing too much responsibility to the public and not enough to policymakers.  As if we hadn’t already heard enough about PPE shortages and should be able to assume the supply problems are resolved, Hancock was unable to promise MPs that some hospitals would not run out of gowns this weekend. It’s also quite late in the day, given what’s been happening in care homes, to talk about ‘protecting society’s most vulnerable people’.

Palliative care doctor Rachel Clarke put in an impressive performance last night on Question Time, repeatedly challenging minister Robert Buckland on why, for example, Germany was doing so much better than the UK: not just because it has a stronger pharmaceutical industry but because it took precautionary measures sooner and has invested far more in health care than the UK. It’s worth catching up on Iplayer if you missed it.

Social distancing is just not being taken seriously in some quarters, eg scenes of a packed Westminster Bridge as people clustered closely to applaud NHS workers. As one observer tweeted: ‘Well, I give up. Four bloody weeks into lockdown – what’s the point if clowns congregate on Westminster Bridge clapping the very people that will be detrimentally affected by their behaviour!!’

After all these weeks there are indications the population is becoming impatient with all the delays, muddle and lack of transparency. As one sceptic tweeted: ‘The people have given this Government their full support during this crisis, but I feel there is a well of anger building up about a lack of competency and mistakes that are still being made’.

Several readers have suggested I write about self-care, so here goes. It’s an important and often overlooked topic, embedded as a key principle in the ethical codes of counselling and psychotherapy professional bodies and no doubt others, besides being applicable to all of us. I think there are some misunderstandings about it, eg content you see on the internet is often a thinly-disguised sales pitch for some product or other, and it’s often assumed self-care is just about things like candles and bubble baths. Self-care is about looking after our physical and mental health and besides things we enjoy and find relaxing, it also involves things we may not always feel like doing, eg exercise and keeping up with domestic tasks.

A few weeks back you may have seen an article in the form of a letter to the UK population from an Italian writer, who said what happened in Italy will happen here and ‘you will eat more and put on weight’. That doesn’t have to be an inevitability. Although boredom has made some resort to lots more wine, chocolate and pizza while bingewatching tv and this might initially feel comforting, it’s best not to do too much if we don’t to emerge from this crisis with mushy brains and having put on a stone in weight.

I think a key step is creating a structure for your day and filling it (but not all of it as it’s important to have unscheduled time) with a variety of activities which are necessary (eg shopping and housework), which are enjoyable and which confer health benefits. These could include exercise (lots of online resources available on YouTube and elsewhere and the Joe Wicks daily workouts are to be recommended as he’s such an engaging guy); getting out in the Spring weather for a daily run, walk or run (as proximity to nature is a bonus); pursuits like gardening, handicrafts or playing a musical instrument (enjoyable in themselves but also for their mindfulness qualities because when you’re focusing on the plants, the stitch or getting the right note ruminating over problems has to take a back seat); communicating with friends and family via phone, email, WhatsApp, Skype or letters; clearing out cupboards and drawers (very therapeutic and who doesn’t have a long neglected glory hole somewhere?); mindfulness or meditation (again with mental health benefits); and reading (many of us have books we’ve been intending to read or finish but haven’t yet managed to). There are many others, of course: there’s something you might have wanted to do for years but not quite got round to so now might be a good opportunity. More and more friends and groups are meeting via Zoom, which helps tackle isolation and ensures we are physically distancing but not socially.

If you don’t enjoy having the usual parks so busy and joggers pounding past every two minutes, it could be worth seeking out less obvious places. I’ve taken to walking along a local waterway, blissfully free of hordes, and visiting several pairs of nesting coots. It’s a lovely sight seeing the hen bird sitting on the eggs while the other continually fetches twigs and weeds to reinforce their nest.

Besides this there’s all the usual stuff everyone will be familiar with such as the importance of healthy diet, limiting or eliminating smoking, watching alcohol intake, getting decent sleep and so on. This can perhaps sound a bit crass and feel easier said than done because so many (IPSOS Mori statistics) are experiencing anxiety, depression and sleep difficulties as we  struggle to come to terms with uncertainty and how the world has changed. Embracing the mindful approach towards anxiety and depression can be helpful:  rather than trying to fight it or ‘get rid of it’, we accept what we’re feeling. Acceptance can reduce the anxiety but it’s also important to give ourselves a break and understand that such feelings are inevitable at such challenging times.

Finally, at the daily press briefing the very sobering virus death total was reported – 14,576,with a total of 40,000 UK deaths forecast. There’s increasing concern about how the oft quoted mantra ‘we’re being guided by the science’ can be trusted, when all the relevant scientists outside of government say that they have been getting it wrong.

Thursday 16 April

As we approach the end of the 4th week of lockdown, with a three week extension likely, there are more and more voices calling for an ending on the grounds that it’s causing as much damage (to the economy and mental health) as the virus itself. But ‘multiple government sources’ say ministers and their advisers don’t yet have a plan for an exit strategy despite the Chief Medical Officer saying the country is “probably reaching the peak” of the epidemic. The risk is that without a transparent strategy people will take the law into their own hands: it’s one thing complying for four weeks and this is hard enough, but quite another if it continues indefinitely. The Guardian reported one source as saying “People are looking at the evidence but there is nothing central and cross-government that has been produced. It’s lots of shadow-boxing at the moment.” This is just what we need: lack of coordination and jockeying for position in the PM’s absence. This will add further to the experience of lack of containment described in the first blog post.

We hear that a further 861 people have died with Covid-19 in the UK, bringing the total number of deaths of those in hospitals with the virus to 13,729. 103,093 people have tested positive for coronavirus. It seems the government remains in denial about testing. Former chief scientific adviser, Prof Sir David King, also criticised the government’s response and called on it to “massively step up measures”, including mass testing, which current scientific and medical advisers had suggested until recent days was not practical.

At least the government has recognised the need for leeway around dealing with loss: on the new right to say goodbye, a psychiatrist tweeted: ‘Sudden bereavement of a loved one in a fearful setting is a cause of trauma so this move may help some people cope and even prevent some PTSD and depression’. Let’s hope so, but doubt this measure will be enough to prevent it and we also need to consider those who have lost loved ones and weren’t able to say goodbye. A huge backlog of complicated grief is likely to emerge over the months and years, without the NHS support available to help the bereaved work though it.

It’s been interesting to note over recent weeks that Piers Morgan, who often gets a lot of flak, has been lauded for his tough interviewing of ministers and his social media presence. About the social care badge, he tweeted: ‘WTF? Care workers are chronically short of PPE as thousands of residents are dying of coronavirus and Matt Hancock says he’s giving them all a bloody BADGE? This is not the Thick Of It, Health Secretary, this is real life and death. Stop patronising these heroes and get them PPE.’ The strain of maintaining the government’s inadequate position is clearly telling on the Health Secretary, becoming noticeably irascible during an interview with Nick Robinson on the Today programme, and losing his temper with Piers Morgan on GMB.

So now it’s definite: lockdown will continue another three weeks and commentators are saying the government won’t be able to delay for much longer discussion about an exit strategy and transparency about communicating it. One suggests that the route out of this will be ‘staggered, gradual and cautious’. So again we need to buckle up – three weeks feels a long way off, given that it seems 100 years since lockdown first started.

You might be interested to listen tonight on Radio 4 at 8 to the Briefing Room, about the psychological impact of the coronavirus pandemic or catch up later on BBC Sounds. Not before time as I think mental health has been largely overlooked by this government and policymakers. Please feel free to leave comments and views if you listen to this or about the blog content!

Just a point about following this blog: when you first enter the site a follow message pops up, enabling you to do that. You can also click the second box after the post (‘notify me of new posts’) but I’m told this could be missed as you have to scroll past comments to see it. So if you want to follow, scroll down to the end of the page past any comments to click the right box. Many thanks!

Wednesday 15 April

Late last night came the announcement that President Trump was withdrawing US funding from the World Health Organisation. How helpful is that at a time like this, as global deaths pass 125,000? The US is the largest contributor to WHO, so this begs the question of how that funding gap be closed when, arguably, WHO advice is more important than ever? We have to wonder if this is a muscle-flexing response to individual states asserting their rights to end lockdown when Trump asserts that he alone has that power. A CNN reporter tweeted:  ‘Ha. Trump says he will be “authorizing” each governor to reopen their state at the time of their choosing. This isn’t his call; he doesn’t get to authorize. The power is already theirs’.

Issues about care homes and vulnerable residents continue to dominate the airwaves, some shocked to be told by homes that their relative wouldn’t be taken to hospital if they got COVID and it’s not only care home staff and residents who feel so vulnerable. An anonymous psychiatric ward clinician writing in the Guardian says they are ‘sitting ducks’ because ‘physical distancing is impossible, we have no PPE, patients aren’t allowed to go out, and violence and anxiety are on the rise. Lockdown has ended patients’ leave and visits. This affects their stability, and to many feels punitive. If self-harm increases, our patients will not be a priority on general wards. We worry for them’.

It’s not surprising the writer chose anonymity, as the Guardian also reports on the widespread gagging of NHS staff by their employers, forbidding staff from speaking to the media. As if they didn’t already have a hard enough job. One mental health professional said: “When it comes to the day-to-day clinical issues and challenges we face, there is a definite power dynamic at play, and [we] are generally petrified to speak out”.

Today Labour is pressing firmly for a transparent strategy on ending lockdown. Staying at home and self-isolating are the very opposites of what’s important for optimum mental wellbeing, yet this could continue for many more weeks and some will become disillusioned and may breach the lockdown. The Guardian reports on scientists’ warnings that physical distancing measures may need to be in place intermittently until 2022, in an analysis that suggests there could be resurgences of Covid-19 for years to come. The paper, published in the journal Science, concludes that a one-time lockdown will be insufficient to bring the pandemic under control and that without continuing restrictions secondary peaks could be larger than the current one.

Will we ever again feel safe to hug and kiss friends and loved ones? What will this lack of physical contact do to our psyches? It’s well known (and currently there’s a large research project underway about it) that touch is essential to wellbeing and yet we are all having to mostly avoid it. You can check out the Radio4/Wellcome Collection/Goldsmiths University research here. https://www.gold.ac.uk/news/the-touch-test/

BBC Economics editor Faisal Islam broke the news that a draft document from Public Health England discussed “last resort arrangements” for “acute supply shortages” of PPE because of “stock & reduced ability to resupply”. The ‘arrangements’ include using “sportswear” and reusing normally single use masks and will have to be reviewed by HSE.

This afternoon we heard that another 761 COVID19 patients with have died in UK hospitals, bringing the total to 12,868, but it’s suggested figures are far higher because of the exclusion of care home and community death stats. At the daily press briefing (painful to listen to) a key part of the social care announcement turned out to be the plan to introduce a badge of honour for workers, enabling them to be more easily identified and recognised, no mention of decent pay. You couldn’t make it up. As someone tweeted:

‘Badges for social care staff sounds like a lovely idea, but feels more like yet another costly PR stunt by this Tory administration that is essentially an empty gesture following years of underfunding’.

Don’t forget to tune into Fallout tonight if you can: 8 pm on BBC Radio4 with Mary Ann Sieghart on what kind of society and changes we’ll see post COVID2019. The third in the series focuses on health and although there’s no mental health expert on the panel Ms Sieghart assured me on Twitter that the topic will be covered.

https://www.bbc.co.uk/programmes/m000h7y8