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

Tuesday 14 April

Pensions and later life expert Baroness Ros Altmann is the latest public figure to highlight the plight of elderly people, ‘abandoned’ in care homes without the necessary level of care and care for the carers. It’s not surprising these residents could feel disturbed: those with dementia could struggle to understand why their loved ones are no longer visiting them; many are seen by carers who reportedly aren’t adhering to the required hygiene standards; doctors are reluctant to visit these homes; and a high number of care home residents are already on anti-depressants when many would prefer talking therapy. All these factors will exacerbate pre-existing mental health difficulties and create yet more.  

Care home death statistics are only updated weekly and now numerous voices are pressing for the longstanding artificial divide between NHS and social care to be erased. It sounds promising that amid the rising clamour for daily and accurate recording of COVID deaths in care homes and the community, the Care Quality Commission has stepped up to take the lead on this important work. A related, delicate and under-recognised issue has been how the cause of death is represented on a death certificate. It’s long been known but goes under the radar that doctors (and now they don’t even have to see the patient) often put the surface presenting ‘cause’ eg pneumonia, when the underlying cause is actually neglect or a combination of problems. So it follows that the COVID death toll could be much higher if older people’s deaths weren’t attributed to these other ‘causes’.

The Guardian reveals how Britain missed three opportunities to be part of an EU scheme to bulk-buy masks, gowns and gloves and has been absent from key talks about future purchases,  as pressure grows on ministers to protect NHS medics and care workers on the coronavirus frontline. A survey by the Doctors’ Association UK found that only 52% of clinicians carrying out the highest-risk procedures said they had access to the correct full-sleeve gowns. Refusing to cooperate with the EU on this is an example of doctrinaire adherence to Brexit policy, leading to damaging delay in obtaining vital supplies.

Two million more unemployed and a 35% drop in economic performance are predicted by June as a result of this crisis. A regular listener to BBC World at One tweeted: ‘It’s quite possible that lockdown is causing additional deaths. If your business is in free fall, you’re in financial meltdown, and/or whole range of mental illnesses. e.g. our Trust has seen a collapse in eating order referrals. That is storing up trouble’. It certainly is. So many facets of this COVID crisis are bringing about a mental health domino action.

Choice of language is important in every field, conveying powerful messages about the beliefs of the speaker or speakers. COVID has thrown up some good examples, eg criticism levelled at politicians and the media for using bellicose terms (‘it’s war’, ‘it’s a battle’ or about the PM ‘he’s a fighter’) and drawing comparisons with WW2 and the alleged Churchill/PM likeness.

No-one wants to hear it, but we’re going to have to make uncomfortable choices about how we pay for this.”

Psychotherapist Mark Vernon tweeted: ‘I’m wondering about the gendered nature of language around COVID. For example, military metaphors seem spontaneous, “fighting the virus” etc, plus the objection that they imply “defeat”. It sounds masculine, echoing science’s “control” of (mother) nature etc. Make any sense?’

And have you noticed how many politicians and public figures, when being grilled (or being given an easy ride) by the media use obfuscatory and diversionary phraseology like ‘What’s important now is….’ (implying the big mistake they’re being asked about is trivial) or ‘What we want to see is/what we’d very much like is….’ when wanting is just that – not actually getting something done or rectified?

Tonight’s Downing Street press briefing had several main points including the Chancellor saying   he will “have to right the ship” when we’re through this, implying cuts and some are already predicting austerity Mark 2. At tomorrow’s conference we’re promised a statement on social care – way overdue. Let’s hope it has some substance.

Monday 13 April

It’s much cooler today so police forces shouldn’t have so much trouble monitoring the lockdown. As the death toll reached 10,600, the Government is again lambasted over the lack of PPE and tests, not to mention the absence of reliable stats on deaths in care homes and the community. To Matt Hancock’s assertion that it’s ‘impossible’ to get personal protective equipment to everyone that needs it ‘because the quest is to get the right PPE to the right people on the frontline at the right time to many millions of people across the NHS’, a doctor tweeted simply ‘It isn’t impossible.’

While deaths in UK hospitals rose to 11,329 today, Hancock also couldn’t give an update on the number of care home and community residents and NHS staff who have died. We’re told the Office for National Statistics is giving some information on the former (over 1,000 in England), stats only updated weekly, and statements from hospitals and workers’ families show the NHS staff figure is more than 30.). The Radio 4 PM programme featured a heartrending interview with care home manager, struggling with the admissions they are forced to accept from the public sector, maintaining staffing and lack of PPE. This situation draws further attention to the social care crisis in this country.

The Guardian reports that snapshot data from varying official sources shows that in Italy, Spain, France, Ireland and Belgium between 42% and 57% of virus deaths have been in homes, according to the report by academics based at the London School of Economics (LSE).

The government is under fire on another front, having admitted that only 1.4% of businesses enquiring about its corona virus business interruption loan scheme (CBILS) have so far been successful. Heaven knows what those business owners must be going through. This is the trouble with trumpeting great-sounding schemes without necessarily thinking through and implementing the infrastructure to effectively roll them out.

A decision about extending the lockdown has to be made by Thursday because that’s when the regulations covering England need to be reviewed. It’s thought inevitable that the lockdown will be extended – necessary but with severe effects on the economy and people’s mental health. Polling organisation IPSOS Mori is reporting increased anxiety, depression and sleep difficulties in half the UK population.

The Guardian reported that over this holiday weekend, when highways would usually be busy with holidaymakers, traffic on some major roads fell by as much as 86%. But this drop has encouraged some to drive at ‘extreme speeds’, like the one doing 151 mph on the M1. Elsewhere, a scuba diver and a family drove more than 200 miles for a fishing trip and people visiting second homes in Wales are reportedly sending luggage via couriers to prevent detection, prompting police to wonder about ‘that level of cunning’.

On the European front, we learn that France is continuing the lockdown for several more weeks and Spain is allowing some people back to work.

Meanwhile, in other news, broadcaster Chris Packham said he will continue his fight against the construction of HS2, which environmentalists say is leading to irreversible destruction of ancient habitats and woodlands. The High Court dismissed his application last week for an urgent injunction to halt construction work, arguing for a judicial review of the government’s decision-making process in relation to the £106bn high-speed railway. Such pieces raise the interesting issue of what’s not being reported due to wall-to-call corona coverage.

Sunday 12 April

Last night the Guardian tweeted: ‘The Queen has given an Easter message to reassure the people of the UK that this pandemic can be beaten. The monarch’s speech is said to be her contribution to those marking the occasion at home’. Interestingly, the Queen didn’t appear in the 2 minute video, which mostly featured a lit candle. She spoke about the importance of hope and light overcoming darkness, referencing the lighting of candles during the vigil preceding the Resurrection. I wonder how much impact these messages are having: as with the Queen’s Christmas broadcast, there are those who never watch and would prefer not to have a monarchy here, and those who watch religiously, regarding any avoidance almost as heresy. These messages are clearly very sincerely meant, but I wonder how comforting people are finding them.

The government faced a chorus of cross-party calls on Sunday for the urgent recall of parliament (closed down on 25 March) in “virtual” form as MPs and peers demanded the right to hold ministers to account over the escalating coronavirus crisis.

At 3 pm, having been discharged from hospital, the PM issued a 5 minute video message, praising the NHS to the skies and thanking the population for observing the lockdown. Within minutes it had received thousands of views and retweets on Twitter. It will be interesting to see, over the forthcoming week, what emerges from him now he’s recovering at Chequers.