From David Vincent in Shrewsbury, UK: Hitler, Shipman, Satan and Mengele

February 9. The sense of optimism as the vaccines are rolled out is colliding with the battle weariness of medical staff.

Rachel Clarke published the first book-length account from inside an intensive care unit.* Its anger with the government and anguish at the bleak and lonely deaths suffered by covid victims was balanced by a joyful account of the sense of community that the pandemic had created. Writing about the first wave last Spring she discovered something new:

“Not once in my lifetime have I seen anything like this grassroots eruption of improvised altruism. Communities coming together, the young and healthy offering to shop for those shielding, restaurants delivering mountains of takeaways to overworked hospital staff, everywhere the desire to be useful, to do something, to make it better, to help out. It startles and thrills me. There is no such thing as society. We do have more in common than divides us.” (159-60)

Nine months later she has written a newspaper article clearly exhausted by her continuing labours on wards that are still operating at peak capacity, and overwhelmed by the hostility of covid deniers and anti-vax campaigners. “I’ve been called Hitler, Shipman, Satan and Mengele for insisting on Twitter that our hospitals aren’t empty,” she writes. Inside the hospital, all is joint endeavour :

“Outside, on the other hand, the virus has once again carved up the country into simmering, resentful, aggrieved little units. It’s too old, too cold to be doing this again. One way or another, lockdown hurts us all. But instead of unity, community and a shared sense of purpose – that extraordinary eruption of philanthropy last springtime – we seethe like rats in a sack, fractious, divided…In short, we have reached the point in the pandemic where what feels like armies of trolls do their snarling, misogynistic utmost to silence NHS staff who try to convey what it’s like on the inside. Worse even than the hatred they whip up against NHS staff, the deniers have started turning up in crowds to chant “Covid is a hoax” outside hospitals full of patients who are sick and dying. Imagine being forced to push your way through that, 13 hours after you began your ICU shift. Some individuals have broken into Covid wards and attempted physically to remove critically ill patients, despite doctors warning that doing so will kill them.”**

So what now of the new sense of togetherness and joint endeavour? There are two destructive factors at work. The first is simply extreme tiredness, both physical and emotional, and explains why the NHS and the Government have been so desperate to bring down the levels of hospitalisation in the second phase. In Clarke’s book, which ended in April last year, the long hours were compensated for by excitement at the drama which she had volunteered to join, and by her justified pride at the way in which the entrenched procedures of hospital medicine had been revolutionized in the face of the crisis. But now it has just gone on too long.

The second is a product of the incivility of contemporary protests, which draw their language from un-moderated social network sites. A community is not a thing, but a set of relationships embodied in discourse. There is a need to interrogate official statistics, up to and including the current debate about vaccine effectiveness. There are quiet reasons for vaccine hesitancy, from inherited folk beliefs to fear of needles. What so demoralizes overstretched medical staff are the ease and frequency with which dissent becomes face-to-face aggression.

Those working in emergency medicine have always had to deal with ungrateful, shouting drunks. I was once in an A and E unit with a slightly injured child late on a Friday evening where there were more police than nurses in the waiting room.

But now the pubs are closed. The verbal violence is coming from those who respect nothing except their own views, and accept no constraints on their expression. It is not to be borne.

*Rachel Clarke, Breath taking. Inside the NHS in a time of pandemic (London: Little, Brown, 2021). **