from David Vincent in Shrewsbury, UK: Free and not free

June 11.   In the lockdown, I have tried to be sensible.  I have maintained my hours of work despite the absence of timetabled commitments.  I have written diary entries.  I have resisted drinking all of our not very capacious wine cellar.  My one besetting sin has been newspapers.  Deprived of hard copy I have set up online feeds from the Guardian, The Times (for an alternative view), the Financial Times (for hard evidence) and the New York Times (for the rest of the world).  Unlimited words, limitless time consumed.

Much of the knowledge thus gained has not illuminated my life.  Today I learn that there is a looming shortage of marmite (caused by a decline in beer brewing, who knew), and mounting anxiety about the closure of public lavatories.

Occasionally, however, there is a story that seems to encapsulate all that is now going wrong.  Yesterday’s online Times has an article headlined: ‘Lockdown eased to allow lonely to meet another household.’  It was part of the good news narrative that Johnson is trying to promote.  Day by day things are getting better.   In every other regard it brings no comfort.

First there is the nominative disarray I discussed yesterday; the confusion in this case between those living alone, and those who are lonely.  A third of UK households are occupied by one person.  Some of those are lonely; most are not.  All of them with grandchildren are probably missing them.

Second there is the small print.  Everyone can go and see their grandchildren except those in lockdown, which includes all those over seventy.  My wife and I, as it happens, are bang on the demographic average for the birth of our first grandchild (we were 63).  But now we have more years and more grandchildren.   Under the new regulations, we are too old to see them.  It’s as if the Government had announced with a fanfare that everyone was now free to play football, except those under thirty.

Third there is the surrounding argument.  The fifth paragraph of the same article reads:  ‘However, the government’s claim to have made the right decisions at the right time on the pandemic was dealt a severe blow when one of the architects of lockdown said Britain’s death toll could have been halved by imposing it a week earlier.’  What has collapsed in the last few weeks is not the infection rate but public trust in the entire official management of the crisis.

Every recent decision, whether about schools, testing, opening shops, allowing grandparents out of the house, quarantining international arrivals, has immediately been met by criticism, counter-argument and in some cases legal action.  The point is not so much the rights and Priti Patels of each issue, rather the belief that everyone is free to advance their own view and can find an ‘expert’ somewhere to back them up.  Deference towards politicians, and towards those who advise them, has disappeared.  In the early days there was a tendency to accept what we were told in the grave surroundings of No. 10.  We needed to believe that those with power were doing the right thing, and anyway it was difficult for amateurs fully to understand the science and the projections.  That comfort is no longer available.

The largest argument, referred to by the Times journalist, is about what was not done in February and March and how many tens of thousands of people died as a result.  The Government’s repeated hope that this kind of retrospective analysis could be left to a post-pandemic enquiry is in vain. 

We are all historians now.  And that is a measure of the trouble we are in.

from David Vincent in Shrewsbury, UK: Staying alive

June 10.  If we are to learn the right lessons from the pandemic, it is crucial that we are careful with the meaning of words.

Monday’s Guardian carried a disturbing headline: ‘Epidemic of Loneliness’.*  This was a phrase much deployed in the public debate about loneliness in the years leading up to the present crisis.  It had two sets of meanings.

The first was a general metaphor.  It just meant that loneliness was a large and negative event.  If we say that someone received in an ‘avalanche of complaints’ we do not mean literally that they were covered in a mountain of rocks, just that they experienced a lot of trouble.

The second was more serious.  It was at the centre of an attempt to medicalise a social condition.  linking the experience to other crises such as smoking and obesity.  By this means the effect was dramatized, and campaigners hoped to appropriate longstanding concerns with major public health issues.

Critics were concerned about this use of language.  Whatever it is, loneliness cannot be caught by someone breathing on you.  It seemed an inappropriate descriptor before the present crisis, and now it would appear indefensible.

But in the Guardian, no less an authority than Professor Martin Marshall, President of the Royal College of General Practitioners, was cited as saying:  ‘The Covid-19 pandemic is also creating an epidemic of loneliness, not just for older people, and sadly there are some people who will fall through the net.’

The story was actually about the tragic discovery of individuals who had died alone, either of Covid 19 or of another condition for which in their lockdown they had failed to seek treatment.  A pathologist cheerfully described them as ‘decomps’, ‘people found dead at home after not being heard from for a couple of weeks.’

There are many ways in which ill health can be exacerbated by the experience of enforced and unwelcome solitude.  It is known that those living alone are less likely to seek medical assistance, even in normal times.  Associated forms of depression, or melancholy as it was once termed, can lower immune systems and increase vulnerability to a range of serious illnesses.  Conversely, various kinds of disability can have the effect of turning chosen solitude into an imprisoning loneliness. 

It might be expected that these interactions will increase the incidence and danger of loneliness in the present crisis, although there remains little quantitative evidence that this is happening on a significant scale.  The Office for National Statistics yesterday published its latest report on the experience of coronavirus in which it confirmed that the numbers ‘feeling lonely often / always’ in the lockdown remained at 5%.  As in earlier surveys, the old seemed more resistent to this condition than the young.**

With the total UK death rate now passing sixty thousand, lives will have been lost in every kind of social setting.  The evidence so far suggests that locked-down interiors, whether care homes or private residences, present the greater risk.  A recent Wall Street Journal analysis of the US population found that the virus had spread more widely in the most crowded households, irrespective of population density.***  .

When the final calculations are made, it is likely that those dying alone because they are alone will be far exceeded by those dying in company because they are in company.  Solitude has its compensations, and staying alive may be one of them

* Guardian, 8 June, 2020.

* Source: ONS survey of adults aged 16+, 3 April to 3 May.  https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/bulletins/coronavirusandlonelinessgreatbritain/3aprilto3may2020

*** Ian Lovett, Dan Frosch and Paul Overberg, ‘Covid-19 Stalks Large Families in Rural America’, Wall Street Journal, June 7, 2022.

from David Vincent in Shrewsbury, UK: How the old are reacting to lockdown

May 28.  Many of us are daily resisting the pressures to place us in a box called ‘the elderly’.  With the hard medical realities this is not easy.  There is no question that as you pass into your sixties, then into successive decades, the risk of dying from Covid-19 shows a sharp linear increase.  With matters of emotion and behaviour, on the other hand, there are grounds for resisting such age-determination.  Nonetheless the social scientists now conducting detailed research into how people are coping with the crisis have a tendency to group their findings into age brackets. 

Following yesterday’s examination of solitude and loneliness revealed in the Nuffield / UCL Covid 19 Social Study, here are the findings more broadly about the interaction between age and experience (most of the data shows little change over the lockdown period).  Whilst the figures are statistical facts (subject to the issues of category definition and sample quality), the explanations of cause and consequence are matters of judgement. So, feel free to interpret these findings.  The two categories used are 60 and over, and 18-29 year-olds.

The elderly are more likely than the young to:

  • Comply with Government guidelines
  • Show confidence in Government
  • Have feeling of life satisfaction
  • Have a sense of control of finances, family relationships, future plans
  • Be concerned about meeting up with family
  • Be concerned about going to cultural venues

The elderly are less likely than the young to:

  • Experience depression and anxiety
  • Employment stress
  • Financial stress
  • Have thoughts of death or self-harm
  • To have been physically or psychologically abused
  • Experience loneliness
  • Be concerned about meeting up with age-group friends
  • Be concerned about going out for a coffee, drink or meals
  • Be concerned about having time alone

Some of the differences are smaller than others.  There is virtually no variation by age in taking exercise or experiencing face to face contact.

Taken in the round, the striking feature is the lower incidence in the key categories of depression, anxiety, stress and loneliness amongst the older population, despite their much greater exposure to serious illness and death in the pandemic, and their greater likelihood of being locked down.

Addenda.  Since writing this, the Times has today published results of a reworking by a team from Exeter, Manchester and Brunel Universities of a BBC survey of 2018 which questioned 46 thousand people from 237 countries about their experience of loneliness.  As with the UCL evidence, the new research demonstrates that loneliness falls rather than increases with age

Sources

The Times.  28 May 2020

from Brenda in Hove, UK: A walk in the park

Hove Park, UK

“Thinking about the things we used to do! 🎶🎶 – like a walk in the park …”

Most days I go for a 20 minute walk (government guideline time!). We are fortunate to live abutting a park so we are very familiar with the seasons and many of the people who walk there. Many are walking their dogs and often one stops for a chat. There is a small cafe selling breakfasts and lunches and tea and coffee.- and, among others, lots of mothers with small children meet there. There is also a gym as well as people with personal trainers doing their thing. There are tennis courts and table tennis facilities. Altogether, a friendly, active, humming kind of place – that was! 

It is not like that any more. It strikes one as anything but relaxed. People walk at a two metre distance and they do so in a purposeful way. Cyclists go past you, children on scooters, runners – all going about their daily activity as if their life depends on it. There is little in the way of eye contact, no tarrying, no chatting, no bird watching, no photography (despite the breathtaking beauty of the cherry blossoms at this time of the year).  The cafe is, of course, closed – as is the gym. The young mothers have disappeared. No tennis. No table tennis. A police car cruises around the boundary from time to time. I don’t know why they bother. A more orderly bunch of people would be difficult to find. 

Yesterday, a woman called across the path to me “it’s very cold today.” She had a slightly desperate air about her. “It is,” I said. “Just when we thought the winter was over.” “I don’t have heating in my flat”, she said. We had a short conversation about keeping warm and not mistaking a cold for corona virus – and I awkwardly exhorted her to keep warm and safe – and moved on. I thought of all the lonely people whose daily routine included a coffee or meal at the cafe and a walk (and chance encounter) – and how a walk for some is an important contributor to their mental health. For those who suffer from depression this corona virus has visited a double crisis upon them. Many live alone and even their short venture out provides no contact. If you add in the fear and anxiety that many people must be feeling, not just about the virus itself but about their jobs and mortgages and future, we have a serious issue which must be causing enormous suffering. 

A Guardian columnist (#AndrewSolomon) writes that “from now on, when someone who hasn’t experienced clinical depression and anxiety asks me what they feel like, I won’t have to resort to florid comparisons. I’ll say: “Remember when the Covid-19 pandemic hit town?”  And they will understand.”