Sunday 3 May

It was good news that at the Downing Street briefing last night, Communities Secretary Robert Jenrick announced key measures to address domestic violence, modern slavery and homelessness, although some critics are saying they aren’t enough. A task force led by former homelessness Tsar Dame Louise Casey will work on ways of helping rough sleepers and £76m will be given to DV and modern slavery charities. Two concerns about this: it’s not being implemented quickly enough to prevent more DV incidents and fatalities, and putting the voluntary sector in charge is unfair pressure and doesn’t facilitate an overview of the work.

More attention is now being directed to health inequalities as a factor in COVID risk. Marked reductions in council budgets during austerity led to cuts in vital public health spending, affecting mental health work as well as other areas. The damaging thing about this is that public health work is preventative, so its lack will result in worse problems further down the line. Public health expert Professor Kevin Fenton (leading a government review into BAME risk factors) draws attention to ‘sobering findings from a new Institute of Fiscal Studies report (The Deaton Review – Are some ethnic groups more vulnerable to COVID-19 than others?), showing that Black African COVID deaths are 3 times higher than those in white Britons, saying that ‘we must also look beyond the data to understand and address the life experiences, social, economic and structural factors driving these differences.’

https://bit.ly/2Ytp5cE

Are some ethnic groups more vulnerable to COVID-19 than others?

Views on the lockdown are becoming increasingly polarised. An Opinium survey for The Observer found at the end of last week that 17% of people think the conditions have been met to consider reopening schools, against 67% who say they have not been, and that they should stay closed. Nevertheless, there’s a groundswell of protest against lumping together of all over 70s into a further period of lockdown (‘indiscriminate targeting’), when it’s clear that many over 70s are fitter than some in their 40s and 50s. This damaging conflation of age with incapacity needs to be addressed urgently otherwise people will start to make their own decisions, further breaching the already fragile lockdown. The conformity associated with the older generation has limits. Max Hastings in The Guardian said: ‘Britain has not been exceptional in much, except in its refusal to inform and debate with the public over lockdown. It has behaved like an old-fashioned centralist bureaucracy, with ministers and officials mouthing slogans and giving orders. ” Such an approach can add further to general anxiety, because of the feelings of powerlessness it gives rise to, a very clear undermining of autonomy.

Meanwhile, it’s interesting that Spain, allowing people outside for the first time in weeks, is age-segregating these exercise times. This might be a good idea, to help prevent people being mown down by large numbers of cyclists and pavement pounders.

A lockdown exit strategy is expected to be announced on Thursday but some say it’s already broken down and there’s plenty of evidence in some areas to confirm that – busy roads, little or no distancing in shops, people congregating and many more around in streets and on buses than weeks ago. Better understanding of the rise in mental health difficulties during lockdown, including a significant rise in problem drinking, means behavioural scientists could be forced to conclude that 5-6 weeks is the limit of people’s tolerance of such unprecedented restrictions.

Robert Jenrick said ‘the second phase’ of their ‘battle plan’ will be addressed ‘with the same energy, determination and commitment to this effort as the first’, a statement which might not inspire confidence in all quarters. The Guardian yesterday cast a cynical eye over the entire Downing Street Briefing strategy, down to the repetition of the same soundbites including the now classic ‘straining every sinew’. https://bit.ly/3df2AfH

Another programme on COVID19 fallout should be worth tuning into tonight at 8 pm – ‘The decisions being made now by our politicians, our doctors, our scientists and business leaders will affect us all for years to come. Tom Chivers (science writer) meets with leading experts and asks whether the cure is always worth the cost’.

https://www.bbc.co.uk/programmes/m000htrs

Ending on another nature note, it was pleasing on visiting the nesting coots this morning to see both sets of eggs have now hatched. Interesting that the food I threw in was gobbled up immediately by the male bird. Despite managing to get some near or close to the first nest the female didn’t budge, obviously reluctant to expose the chicks for even a moment. I’m looking forward to seeing them on the water, hoping they survive until then.

Saturday 2 May

As the death toll now passes 28,000, I’m still appalled by Matt Hancock’s disingenuous and self-congratulatory spiel at yesterday’s Downing Street Briefing. Having made the arbitrary 100,000 tests a day target a key goal, ‘a massive achievement’ based on massaged statistics, there’s apparently still no understanding that this is only one aspect of an uncoordinated approach. Experts are saying it’s meaningless without contact tracing and an overarching approach focusing on local public health teams rather than being directed solely from Westminster. Despite much criticism, it doesn’t seem that the Health Secretary has yet been seriously challenged by the media on this misrepresentation. Another major claim, that we’re now ‘past the peak’, has been challenged by experts, on the basis that we don’t yet have the full set of figures from the Office of National Statistics which would lead to that conclusion.

You’d probably have to be of a certain age to fully appreciate this tweet. Some might even remember the advert’s tune!

‘Welcome to the #DowningStreetBriefing sponsored by Fudge, a finger of Fudge is just enough to fudge Covid19 the test figures’.

Meanwhile, the lockdown exit issue is attracting mixed opinions, sections of the population and businesses understandably champing at the bit to get going again, but many others appreciating the extra time and peace to not rush around, to enjoy reading, listening to music, meditation and the natural world around us. Research has shown that proximity to nature is good for our mental wellbeing, enabling calmness and tranquillity. This time of year especially lends itself to such experiences, as so many trees and plants are coming into bud and blossoming. It’s very pleasing to see three white and scented irises unfurling in my little garden, surviving yesterday’s downpours and hailstorms. For the past month, I’ve been visiting two pairs of nesting coots on a local waterway and it was marvellous today to see one lot had finally hatched, the tiny hatchlings peeping out from beneath the hen bird’s enfolding wings. Apparently, very few survive more than a few weeks because of various predators so I hope at least some of these do. It seems fitting, then, that tomorrow is International Dawn Chorus Day, ‘which celebrates nature’s greatest symphony around the world’, and BBC PM treated us to snatches of birdsong earlier – blackbird, robin and blue tit.

One of the things I like so much about Joe Wicks, the ‘nation’s PE teacher’ who hosts a daily workout during the week on his YouTube channel, is that he emphasises the mental health benefits of exercise as much as the physical ones, in an engaging and compelling way. I’ve come across so many people who’ve never exercised as adults because they were so put off by harsh and humiliating games teachers at school. Perhaps these live workouts (‘attended’ by so many all over the world’) might attract some of these people, as they were initially aimed at kids and now people of all ages are joining in, whole families doing it together. As Joe doesn’t do them at weekends, I’ve been catching up with the earlier ones I missed. There’s a surprisingly challenging exercise in the 24 March one I’ve never done at the gym – manageable but not easy. It involves alternately kneeling and standing at a reasonable speed, without using your hands. Harder than it may sound!

For a bit of light relief and if you’re not addicted to the Scandi noir on BBC4, you might like to catch up with this lovely film on BBC2 tonight, if you missed it when it was first released: The Guernsey Literary and Potato Pie Society. ‘In 1946 a London-based writer begins exchanging letters with residents on the island of Guernsey, which was German-occupied during WWII. Feeling compelled to visit the island, she starts to get a picture of what it was like during the occupation’.

https://www.radiotimes.com/film/fzn5k2/the-guernsey-literary-and-potato-peel-pie-society/

Friday 1 May

As the 6th week in lockdown draws to a close, it seems that daily revelations of delay and incompetence in handling this crisis are adding to general anxiety. This is because we need to trust and believe in our leaders, authority figures who act as proxies for the early parental figures whose job it was to take care of us. When this psychological ‘holding’ is missing, anxiety can increase.

This obsession with the macho and arbitrary target of test numbers (which experts tell us this is meaningless without a broader approach including contact tracing) detracts from energy which could be better expended on other things. Further complications are that people can be carriers but without symptoms, meaning they would have no reason to seek a test, and ‘false negatives’, eg the unreliability of tests, all of which means we need a coordinated and nuanced approach, not the simplistic and uncoordinated one which has characterised strategy so far.

Reaching the 100,000 a day (with a bit of statistical massaging, which doesn’t equate to tests actually done) is being presented as a great success despite the terrible death toll. ‘By hook or by crook we will get it to 100,000 tests per day. But mainly by crook’, tweeted a BBCPM listener. Top bioscientist Sir Paul Nurse was impressive on Question Time last night re the government’s response to Covid-19, cutting very smoothly through the obfuscation of Transport Minister Grant Shapps:  “We could be doing better”, “We were totally underprepared for it”, “We should’ve prepared for it” “we’re “playing catch up”.

A Today Programme listener tweeted: ‘Continuous long-standing lack of transparency with govt actions/policies has led to lack of trust in what they tell us. So with testing … Is 100K tests carried out, or simply tests booked online + ordered home test kits? It probably doesn’t really matter, but trust does’.

One of the most daunting aspects of this crisis has to be the extensive collateral damage already being inflicted: business failures, mental health crises, struggling councils, closure of yet more care homes, and so on. There was already a social care crisis and now we learn that more care homes will be forced to close, due to COVID-related costs (eg the hugely increased cost of nursing care). It always seemed wrong to me and a risky business model for social care to be largely in the private sector. If you can overlook the irony, ADASS (Association of Directors of Adult Social Services in England) did capture a key realisation earlier, tweeting: ‘Important to hear Jeremy Hunt at the Commons Health & Social Care Committee, saying ‘If there is one thing we have learnt from this crisis it’s the importance of social care to our society. The challenge now and post Covid-19 is to prioritise, protect and re-imagine social care for the future.’

Local government isn’t in a position to make much headway, having had its central government grant severely cut for years, yet today housing and local government minister Robert Jenrick told journalists ‘’I’ve been very clear to local government that we will be standing behind them’. This coincided with the news that Liverpool City Council declared it was on the brink of bankruptcy and looking to file a Section 114 notice. [Part of the 1988 Local Government Finance Act, a 114 order bans all new expenditure, with the exception of safeguarding vulnerable people and statutory services. It is only issued ‘in the gravest of circumstances’]. There are so many services communities rely on their council for that they cannot be allowed to collapse – lack of trust in national government could then be coupled with a similar lack in local government.

Rob Whiteman, CEO of CIPFA (Chartered Institute of Public Finance and Accountancy) said: ‘This may require a temporary or new set of rules for local government finance. Councils may need to borrow in order to fund services – government should be underwriting what is needed to keep councils solvent as it is already doing for businesses and the NHS’.

Worsening mental health has manifested in the number of people seeking help, suicides and charity Rethink’s survey of more than 800 people living with mental illness showing that 80% felt their mental health was worse due to the impact of the coronavirus, 28% saying it was ‘much worse’. In a letter to the Guardian (30 April), pleading the case for sustained mental health investment, Danielle Hamm (Associate director of campaigns and policy) pointed out:

‘While necessary to prevent the spread of this highly contagious virus, lockdown is depriving people of the things that they need to stay well, from peer support groups to the routine of work and social engagements. We’re hearing from people who are not just feeling a lack of motivation or purpose but experiencing an increase in suicidal thoughts, or deterioration in their health to the point they require urgent intervention to manage paranoid delusions or psychosis’. This reinforces the debate as to whether lockdown could be as damaging to people’s health as the risk of the virus.

One of the most interesting COVID news items must be Cambridge statistician David Spiegelhalter’s, effectively about the rise in risk aversion. He suggests people are over-anxious, as 60 % of those surveyed by IPSOS Mori said they’d feel ‘uncomfortable’ about going to bars, restaurants and on public transport and two thirds would about attending a large public event like a concert or sports fixture. The academic said Britain will need a public information campaign to persuade people to ‘start living again’ because the government’s stay-at-home message has been “slightly too successful”. There’s an interesting debate to be had about personal risk management: some risk aversion is obviously sensible but too much (and there is often too much) curtails the capacity to grow and develop. 

Thursday 30 April

As the PM prepared to pick up the reins once more at the Cabinet meetings and daily press briefings, it’s become increasingly clear that the much-trumpeted 100,000 tests a day target is nowhere near being met by the end of April deadline. The latest figure was just 52,429 tests, for Tuesday. As this morning’s government interviewee on the Today programme,  Justice Minister Robert Buckland may have introduced a new entrant to the soundbite lexicon (alongside ‘ramping up’, ‘straining every sinew’, ‘flattening the curve’ and many others) – ‘working hand in glove’, somewhat ironic given the recent spotlight on PPE and single gloves being counted separately.

Labour’s Shadow Chancellor of the Duchy of Lancaster, Rachel Reeves, said the government has been “too slow” on testing, which is why “we are still way off that goal” of 100,000 tests a day. The whole of government need to take responsibility for this and start to get things right…Tests are not being carried out at anything like the scale the government promised and the government need to get a grip and get their act together.” It still seems surprising that part of this ‘getting a grip’ hasn’t taken the form of stopping flights or at least testing and quarantining disembarking passengers, as South Korea did at the start.

Professor Allyson Pollock, public health expert and director of the Newcastle University Centre for Excellence in Regulatory Science, smashed it on BBC World at One, clarifying that the government doesn’t actually have ‘a strategy’: testing doesn’t make sense without contact tracing and there should be local public health teams coordinating all this rather than the unhelpfully centralised approach directed by Westminster. No coordination = no strategy (shades of the Emperor’s new clothes syndrome). One tweeter suggested Professor Pollock for SAGE – great idea.

It was revealing hearing World about At One presenter Sarah Montague’s COVID19 test, which she recorded on her phone. The whole procedure sounded clunky and how absurd that she had to go in a private car and so far from her home. This effectively restricts mass testing and surely the kind of thing journalists could ask at the Downing Street Briefing and the public could raise during BBC Question Time tonight.

Not before time, politicians and experts have called for urgent action to create more space for walking and cycling during lockdown in the UK, and ‘to avoid a nightmare rise in traffic as restrictions on movement are lifted’. Although most councils haven’t acted yet, there’s increasing concern at the lack of time left to ensure viable alternatives to car use are available. It can already feel a struggle trying to do a decent walk or run because of the numbers of people doing the same thing and lack of etiquette (eg people walking two or more abreast, dominating a narrow path or pavement), forcing others onto the road and into the way of passing traffic. As exercise is so important for our mental health as well as physical, it’s imperative thought is given to these space creation measures.

BBC PM has just had an interesting piece about the British Library’s COVID Chronicles project, an electronic archive of COVID-related content people are invited to contribute to, so I’m going to let them know about this humble blog!

As the death toll was announced as 26,711 this evening, it seemed to me (and others) that the PM put in a poor and blustering performance at the Downing Street Briefing, starting with alluding to the UK’s ‘success’, based on the strange criterion of the NHS ‘not being overwhelmed’, never mind the shocking death toll. The response to the mental health question was especially lacking, eg ‘There are lines you can call’. For the zillionth time, services need properly funding and many of these won’t be staffed by qualified counsellors. The PM responded to Robert Peston’s question on strategy with ‘Broadly speaking, I think we did do the right things at the right times’. One indignant listener tweeted: ‘The families of 40,000 dead people would like to take issue with Boris Johnson’s “disaster having been avoided”. Also with the upbeat “Tigger” mood of the PM when briefing about mass deaths. He might have recovered from COVID19, thousands didn’t’.

Palliative care doctor Rachel Clarke summed it up:

“We have succeeded in avoiding the tragedy we saw in other parts of the world.” Did

Boris Johnson *seriously* just say this? 26k deaths. One of the world’s worst death rates. I care for these patients. They’re human beings, Mr Johnson. This is the definition of tragic.’

It’s very timely that tonight’s The Briefing Room on Radio 4 focuses on social care – 4,500 providers in a fragmented sector. Successive governments have kicked the social care can down the road for years – now COVID19 and the shocking number of deaths in care homes (one third of the death toll) means this cannot continue. Let’s hope the government is held to account on when we can expect that long promised Green Paper!

https://www.bbc.co.uk/sounds/play/m000hpdx

Wednesday 29 April

A big news day today – for the first time the death toll figures will include those in care homes, giving a more complete picture, and the PM has become a father again. While it’s a relief that he won’t be taking paternity leave so soon after returning to ‘run the country’, media fawning over the birth could lead to the risk of the PM being held less to account than he should be. At PMQs, Keir Starmer said we were on track ‘to have one of the worst death rates in Europe’.  

A wag tweeted: ‘Get divorced, get elected to lead party, win landslide election, get engaged, get Covid-19, almost die from Covid-19, have a baby. Quite a year for Boris. I finally put up some shelves after deliberating for 12 months… ‘

Another pleaded: ‘Please, media, stop being so seduced by #Borisbaby that you’re turning even more of a blind eye to the PM’s failings’.

Following concerns that SAGE (Scientific Advisory Group for Emergencies) membership was too narrow, it’s positive although rather late in the day that the government has urgently approached researchers at universities to help them expand the pool of scientific experts, specifically in the fields of public health epidemiology, emergency response and logistics. Public health has long been neglected too long, partly as responsibility for it moved to local authorities from the NHS in 2013 but councils have been too cash-strapped and perhaps without the right expertise to rise fully to that challenge. We’re told SAGE members will be named, so details won’t have to be rooted out by investigative journalists.

An interesting Guardian article examines why, given the delays and errors in the handling of COVID19, the PM’s ratings remain so high (60%). The answer, it’s suggested, lies in having lowered our expectations so that even a trip to a newly reopened council tip seems a bonus and that we’re broadly divided between lockdown accepters and resisters. Whereas accepters (the biggest category) tend to be middle-class, comfortably off and coping moderately well so far, resisters are more likely to be in insecure employment, living in cramped spaces with no garden and chafing at the restrictions. ‘The happiest people in lockdown are those most capable of finding solace in small things, and it’s this dramatic lowering of expectations under pressure that might help explain the baffling paradox in politics right now’. The accepters are also thought to be more natural conformists, which could be problematic. ‘Their positivity helps them cope, but also makes them slow to question authority. They’ll be dangerously open to the defence Johnson is now apparently trying to build ahead of any public inquiry…’ There does seem to be a worrying reluctance in some quarters to challenge and criticise authority, when this is precisely what we should be doing in a mature democracy, holding our elected representatives to account when the media are not always doing it.

Amid evidence that alcohol service referrals have dropped (and many services have been cut over the years) there is concern that people are drinking more during lockdown – a fifth of those already drinking alcohol admit to drinking more since lockdown began and sales have risen by a third. It’s probably not surprising that isolation, anxiety and having to deal with massive changes overnight are leading to this. We are all having to adapt very quickly to what Martin Blakebrough, CEO at addiction charity Kaleidoscope, has called ‘a new and strange reality’.

BBC4’s The Rules of Drinking series (tonight at 9 pm) examines the history of what it calls ‘our complicated relationship with drinking’, governed by unwritten and unspoken rules, such as going to a bar being a rite of passage for young men in the 1940s and 1950s. I see there are 12 episodes in this series and it would be interesting to check if any of them cover the UK phenomenon of binge drinking, which doesn’t characterise other European countries.

Given the confusing verbiage of the daily Downing Street Briefings, it was useful to get via Sky News that crucial number: coronavirus deaths in the UK have risen sharply to 26,097 (hospitals, care homes and community). There are almost no words for this. This means the UK has now overtaken both France and Spain for the total number of confirmed coronavirus deaths and is not far behind Italy. There seems to be a notion underpinning these briefings that if the NHS is praised to the skies and sadness expressed at the death toll it somehow reduces its impact and distracts attention from those responsible. Another characteristic of these briefings seems to be an even more pronounced use of a soundbite lexicon, designed for obfuscation or avoidance of difficult questions, ranging from ‘That’s a very good question’ to ‘working round the clock’, ‘straining every sinew’ and ‘ramping up’ this, that and the other.

Tuesday 28 April

Sections of the media came under fire this morning for failing to cover or covering very superficially the scandal revealed by Panorama last night. This centred on the discovery that the government was counting each single glove as an item of PPE in order to misrepresent the figures and imply they were meeting demand when this has manifestly not been the case. Surely one of the most surprising things about this, given these days of investigative journalism and social media, is the apparent assumption that it wouldn’t come to light. Minister Victoria Atkins, who responded not by answering the question but with ‘we’re following the science’, got a much easier ride on Today than on Piers Morgan’s GMB. A Today programme listener tweeted: ‘Victoria Atkins safeguarding minister? What does that mean? Safeguarding this government’s rapidly deteriorating reputation because they’re certainly not safeguarding anyone else at the moment?’

Social media and personal stories enable us to know what’s going on ‘at the coalface’ rather than solely at the level of official narrative. A GP tweeted: ‘The PPE scandal: far too little too late. Staff don’t need sympathy. Last night’s Panorama should be watched by everyone. In my visit to my breathless elderly patient yesterday, I wore a visor made by a local school, gloves, a surgical mask & a flimsy apron from Amazon’.

A third of COVID deaths are now said to be in care homes, where there is no or insufficient PPE. Again, we need regular and accurate statistics on the total numbers of deaths (ie including care homes and community), not just daily hospital figures in order to get the complete picture. Given the importance of testing, it’s worrying that efforts to increase it are being led by a hereditary peer and former corporate lobbyist, Lord Bethell, who gave money to Matt Hancock’s failed Conservative party leadership campaign. This smacks of cronyism and conflict of interest.

At 11 am there was the minute’s silence to mark the deaths of NHS and frontline workers, an event organised by unions and, we were told, ‘observed by the PM and senior politicians’. This observation was found hypocritical in some quarters, one tweeting: ‘Boris Johnson tweeting his minute’s silence makes my blood boil. It was his dither and delay, his libertarianism, he resisted lockdown. It cost 40,000 unnecessary lives and killed the economy! Johnson’ dither compounded govt failure to prepare!’

Meanwhile, the lockdown exit debate rumbles on and there was a rather good analogy earlier from a garden centre business representative, lamenting the lack of level playing field regarding business closures: ‘we’re locked in the changing room with no referee’.

Increasingly, the over-generalised advice for over-70s to ‘stay at home’ is being criticised by Lord Blunkett and many others for its arbitrariness, not treating them like grown ups, discriminating against them and so on. As has been widely acknowledged, some over 70s are far fitter than some in their 50s, so it doesn’t make sense to lump them all together. This tendency to conflate age with incapacity does also convey quite a powerful message about policymakers’ attitudes towards the older generation.  Older people, especially those living alone, are more likely to experience damage to their mental health through loneliness and enforced isolation.

Tonight’s Downing Street Briefing was striking for a number of reasons: it was headed by Matt Hancock rather than the PM; there were two (!) questions from ‘the public’ (one yesterday); and Hancock refused to apologise for the care home deaths on his watch. During a session which saw a number of obfuscatory and delaying tactics, eg ‘that’s a very good question’ and ploys to artificially identify with and disarm the questioner (‘as a father of three young children myself’), he said ‘That’s unreasonable as a question’ when invited to apologise to the relatives of those having died in care homes. That journalist was not given a chance to challenge that response.

We are now hearing much more in the media, not before time, about mental health difficulties due to or worsening during lockdown. Over 800 people responded to charity Rethink’s survey, the results highlighting the importance of sustained investment in mental health services when this area has experienced long-term funding deficits. ‘We’re calling for mental health to be a government priority during COVID19.’ Sceptics could be forgiven for wondering how close to a reality this could be, since ten years and more of similar pleas have fallen on deaf ears. If mental health difficulties were more visible it might be a different story!

Monday 27 April

As the PM returned to work today, interestingly promising to be transparent and to involve opposition parties in lockdown exit planning, the Guardian suggested 6 urgent tasks lay in his already challenging in-tray. Besides the obvious lockdown strategy (about which ministers are said to disagree), the other 5 concern testing (claim of reaching 100,000 a day and to what extent to continue standing behind Matt Hancock); revisiting the decision-making process (currently somewhat scattered between ministers and committees) and whether Dominic Cummings should continue attending SAGE; assessing his own handling of the crisis; what to do about the Brexit talks and how to deal with the report of the investigation into the Priti Patel bullying allegations. Well timed was Dr Xand van Tulleken’s comment on the Channel 4 ending lockdown programme last night:  ‘Scientists can give advice but we do need clear leadership from government’.

Meanwhile, palliative care doctor Rachel Clarke (who smashed it on Question Time recently) tweeted: ‘Dear Boris Johnson, 1. The UK has one of the worst #COVID19 death rates in the world 2. 20k people have died already – probably double that 3. Lockdown was delayed 4. PPE & testing are inadequate 5. Frontline staff are dying. How can you possibly spin this is a success?’

One of the shocking things about the crisis has been the massive rise in domestic violence and the news that during the first three weeks of lockdown 14 women and three children were killed. The Met had been arresting around 100 people a day for domestic abuse in the period just prior to lockdown.  Although relationships could understandably come under some strain during this very strange time, it’s disturbing to find that so many, which may look fine from the outside, only survived on the basis of partners spending less time together, a very fragile basis indeed. Yvette Cooper, chair of the Home Affairs Select Committee, said: “Staying at home is an important part of the strategy to prevent coronavirus from spreading and save lives, but for some people home isn’t safe. Urgent action is needed to protect victims and prevent perpetrators from exploiting the lockdown to increase abuse. Our cross-party committee is calling for an urgent action plan from government setting out practical measures to tackle domestic abuse as an integrated part of the fight against Covid-19’. These would include guaranteed safe housing for the women and children at risk of abuse.

She rightly alluded to the significant mental health burden domestic abuse leaves in its wake. ‘The emotional, physical and social scars from domestic abuse can last a lifetime. If we don’t act to tackle it now, we will feel the consequences of rising abuse during the coronavirus crisis for many years to come.’ The operative word is surely ‘urgent’ action: too often such measures are slow to be implemented, leading to the risk of more unnecessary deaths.

Ahead of his new Channel 4 show tonight, Grayson’s Art Club, about inspiring people to be creative and ‘using the creative process as a kind of therapy’, Grayson Perry attracted some criticism for saying ‘there’s no excuse for people not doing art’ (during this time). This lockdown period has apparently led to some division of opinion on whether we should regard simply getting through the day as enough, or whether we should be using the time productively to get stuff done, declutter our homes, achieve something, learn a language or write a book. Some are feeling shamed (as the Listening Project showed yesterday) by exhortations to achieve (in capital letters) when they don’t feel like attempting these things and don’t appreciate being put under pressure to do so. A Facebook post suggested that such achievements are associated with the pinnacle of Maslow’s hierarchy of needs (self-fulfilment), whereas we are actually towards the bottom of that pyramid, ie safety needs. I’m not sure about that: while it’s clear that some are indeed in this category and others may be run off their feet trying to earn money, look after children and/or elderly relatives, etc, many of us aren’t and do have additional time. While we all need some downtime and comfort zone, of course, it’s not conducive to our personal growth and mental wellbeing to spend too much time there eg on the sofa for hours bingeing on tv. Whatever we think of Grayson Perry, though, he did come out with a compelling definition of art: ‘Art is one person’s unconscious to another’s’.

I’ve long felt appreciating nature to be an important ingredient of mental wellbeing so it was good to hear journalist Isabel Hardman interviewed on the Today programme about her new book – (The Natural Health Service – what the great outdoors can do for your mind). Diagnosed with PTSD in 2016, she used exercise and tuning into nature alongside traditional treatment as part of her recovery from anxiety and depression. The importance of nature is so underrated and perhaps more so at this time it’s therapeutic to be reminded of its permanence in a sea of uncertainty: each season follows a pattern, birds are singing, plants and trees are coming into bud, their leaves unfurling and the candle-like flowers of chestnut trees are dominating parks and open spaces. Hardman stressed that nature isn’t a cure-all but it can help prevent mental illness taking hold and help those already experiencing mental ill-health. She stressed the need to re-focus as people can be so caught up in their heads and their devices they simply don’t notice the natural world around them. ‘The world is a lot richer than they would have imagined’. If you want to listen to that interview it’s about 1 hour 40 minutes into the Today programme.

https://www.bbc.co.uk/sounds/play/m000hmm8

Finally, it’s interesting that (part of the new transparent and consultative approach?) tonight’s Downing Street briefing included a question from the public for the first time. I’d be interested to know how YouGov selected the question(s),which was:

If the 5 steps are met, is being able to hug closest family one of the first steps out of lockdown?

One regular listener at least wasn’t convinced by this innovation, tweeting: ‘it’s another gesture. Gesture politics, slogans, headline-grabbing mini-initiatives. All to replace having a proper well-implemented strategy for the past 2 months.’

Sunday 26 April

Continuing the theme for a moment of one of the hidden costs of the pandemic (worsening symptoms and deaths due to the postponement or cancellation of urgent treatment for life threatening conditions, mental health crises etc), Independent health correspondent Shaun Lintern challenged the BBC this morning, tweeting: ‘BBC News this morning saying NHS intensive care units have coped. That is not true. NHS has coped because tens of thousands of operations have been cancelled and those areas turned into makeshift ICUs with stretched staffing ratios and machines. We need to be honest about this.’  He was supported by London GP and health campaigner Louise Irvine:

‘You are right. The lack of honesty is breathtaking. The NHS is not coping – or only “coping” because so many others are being denied care. My friend, with prostate cancer, has had his treatment delayed for six months, for example.’

Broadcaster Dr Phil Hammond added:

‘One of the lessons of this pandemic is that staff well-being is not a priority in health and care services. It needs to be, & fast. In addition to the lack of PPE, there could be huge volumes of burnout & post-traumatic stress amongst frontline staff. Help them soon or lose them.’ Staff are supposed to be eligible for counselling, paid for in part by the money raised by Captain Tom Moore and others for NHS charities, but it’s unclear how this is working ‘on the ground’. Let’s hope it gets resolved soon.

On mental health specifically, the crisis has highlighted longstanding problems with resourcing and service provision and many service users are saying they aren’t getting the support they need, which would be frightening for them. Alex Thomson, liaison psychiatrist, tweeted earlier what sounds like a recipe for root and branch reform:

‘The mental health response to COVID19 must include – Provision for people who have, and who develop, severe mental illnesses -Recognition that mental health care is for ALL, not just people already ill -Consistent standards of quality -Evidence-based treatment, not just ‘support’ -Mainstreaming of services to avoid two-tier staff/non-staff or COVID/non-COVID quality gap -Permanent increase in resources, staffing, skills, therapies -Strong public mental health, community and structural approaches.’

All very important, especially provision of all NICE-approved talking therapies (not just CBT) but perhaps the most pressing, because it supports the secondary service and starts at the beginning in primary care is ‘Strong public mental health, community and structural approaches.’ Unfortunately, the current primary care model, IAPT (Increasing Access to Psychological Therapies) is based largely upon the non-relational model of CBT and has long waiting lists, meaning that many patients go without help or the kind of help they need.

Despite the (temporary, we hope) disappearance from the radio schedules of regular programmes such as Saturday Review and the Archers, there’s still much worthwhile to listen to. The Listening Project is a Radio 4 initiative offering a snapshot of contemporary Britain, in which people across the UK volunteer to have a conversation. These conversations are collated and archived by the British Library, in order to capture the essence of life in the early 21st century. Sounds a bit like the mass observation project of the 1930s. Today’s focused on personal experience of lockdown and it was interesting to hear presenter Fi Glover say ‘we’re all having those days when we can’t face the world’ (surprising because I suspect many would not want to admit this although it’s helpful to share experience). One interviewee said this manifested in not getting out of bed all day and feeling shamed by exhortations to use the time productively, eg learning a language.

Despite all the good stuff going on, said another, ‘there’s still an undercurrent of fear’. He referenced The Waning of the Middle Ages by Johan Huizinga (1919), which took me back to undergraduate days, learning about the concept of courtly love, and which reminded him how intensely life was lived in the Middle Ages.

Wikipedia explains: ‘In the book, Huizinga presents the idea that the exaggerated formality and romanticism of late medieval court society was a defence mechanism against the constantly increasing violence and brutality of general society. He saw the period as one of pessimism, cultural exhaustion, and nostalgia, rather than of rebirth and optimism.’

https://www.bbc.co.uk/programmes/m000hfqz

For some light relief and perhaps a mindful experience, there’s an interesting example this afternoon of ‘slow radio’, which developed from the original slow movement focusing on food. It traces the flooding of the Kielder Valley in Northumberland, its natural world soundtrack including running water, birdsong, folk music and so on. Apart from anything else, I love those local accents.

https://www.bbc.co.uk/programmes/m000hmxn

Two interesting if sobering programmes feature in the tv schedules tonight: at 8 pm on Channel 4, Dr Xand van Tulleken, one of those televisual twins, explores what the end of lockdown could look like, talking to ministers, scientists and other experts. It includes the crucial question of how long restrictions will last and what form might they take. It will be good to see how he tackles this subject, compared with the recent Radio 4 series Fallout.

In the bonnets slot on BBC2 at 9 pm, ‘Stacey Dooley talks to police, dealers and smugglers to learn about the drug supply chain and how it operates, as well as meeting a Colombian drug boss to find out why Southern Spain sees so much cocaine. It’s a shock to hear how much of it will end up in Britain’, says the Radio Times.

Finally, many will be wondering what the PM’s return to work tomorrow will bring and perhaps could be forgiven if they don’t find the prospect reassuring.

Saturday 25 April

While people are still processing the news about Dominic Cummings’s attendance at SAGE meetings, it emerged via a confidential Cabinet Office briefing leaked to the Guardian that Ministers were warned last year the UK must have a robust plan to deal with a pandemic virus and its potentially catastrophic social and economic consequences. This leak comes as the UK’s hospital death toll from coronavirus exceeded the 20,000, which seemed unreal weeks ago and which reinforces the failure to act upon the 2016 Cygnus Report.

There have been frequent complaints about lack of up to date statistics on care home and community deaths but I think another statistic we need is the number of deaths attributed to people afraid to attend hospital with other life threatening complaints, cancelled surgery, halted treatment and mental health crises. It’s not just their own fear of COVID stopping them going to hospital but government messages of ‘don’t overwhelm the NHS. Another public health communications fail.

(Pause for a triumphant shriek as my tweet about this was read out on Any Answers!). But we have to think about the amount of stress and anxiety for each and every individual waiting for treatment and surgery or worried about their mental health. They could be feeling very disempowered at this time.

It must be challenging for the government when one of ‘their own’, former Chancellor Philip Hammond in this case, joins in the clamour for a lockdown exit plan for the sake of the economy. He warned that the country could not afford to wait until a vaccine had become available before resuming more normal economic activity. 

There are two interesting programmes today on Radio 4: one about emerging from lockdown and what we will emerge to (https://www.bbc.co.uk/programmes/m000hmzl) and a profile of the Health Secretary Matt Hancock (https://www.bbc.co.uk/programmes/m000hmxq). These Profile programmes are only 15 minutes but pack in a surprising amount of useful information about key public figures. Very revealing it was, too, eg around age 10 he said he wanted to be PM, remarkably similar to his boss, who wanted to be ‘king of the world’. Such ambition didn’t seem to be justified by his former headmaster’s comments, though, who said that he wasn’t head boy material.

The lockdown programme looked at strategies in different countries. The Korean Dr Kim says COVID19 won’t just disappear – there will be further outbreaks. Meanwhile, a British pandemic expert was clear that when this is over we will not ‘go back to normal’ eg physical distancing will remain. She stressed the need for policymakers to ‘be transparent, keep the message to the public clear and keep it simple’ – the opposite of what has actually been done. 

You may have heard how important exercise is for mental health and a key advocate for this message is ‘Body Coach’ Joe Wicks, who volunteered at lockdown to be ‘the nation’s PE teacher’. During the week he does a live workout (on his YouTube channel) and is so engaging and positive it would be hard to think of anyone who wouldn’t be motivated by it. People tune in from all over the world, as far afield as Nigeria, Dubai and Moscow. Having done these for several weeks, I’ve decided at weekends I’ll catch up with the earlier ones I missed. This is his first, for 23 March, where he explains what his aims are, including getting people to feel much better and says it always makes him feel happier. He also offers others eg a ten minutes one for seniors.

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.