David’s blog 49#: The World Turned Upside Down

When this novel Coronavirus reared its head at the end of 2019 it attracted some media interest and those who think about epidemics and pandemics sat up. A global pandemic has long been at the top of the list on national and institutional risk registers, yet there has been a pattern, repeated around the world, of an understandable reluctance to see normal life turned upside down by a virus. Whether it was school headteachers calling for exams to be allowed to go ahead, politicians saying there was no need to change planned elections, pub chain owners saying they couldn’t see why there premises needed to close, or some of us realising our holiday was not going to happen, the reality of what we face has taken a time to bed in. Ideas about pursuing herd immunity, of taking the short term hit but protecting economies have been swept aside by the very real prospect of health services being totally overwhelmed. Many countries acted as if they would avoid these outcomes through some form of national exceptionalism. As I write it seems that only Belarus and Brazil are maintaining this approach. I fear they too will find that the virus doesn’t acknowledge their perceived uniqueness.

We will likely see significant variations as regards infection rates, treatment outcomes and broader social impacts. This will reflect political and societal responses in different countries, regions and cities, though not just those made in the last few months. Ratios of doctors, nurses, beds and ventilators to populations will be up for examination, as will stocks of personal protective equipment. Systems that were considered highly efficient in 2019 may come to be seen as having had a dangerous lack of resilience. It is also clear that the pandemic has the potential to see a wholescale revaluation of the value placed on a range of jobs, of how we protect vulnerable communities and the way we engage and communicate with our citizens on health matters.

Front-line medical staff have rightly been praised, with outbursts of public appreciation to be seen around the world. Looking forward, how they are valued and recognised by the systems in which they work is going to be a fundamental issue, especially given the sacrifice many of them have made. The profile of hospital support staff has also been increased, cleaners, technicians, porters, admin and catering staff are now much more visible. Outside of the medical sphere those stuck within their house are enjoying a new appreciation of postal staff, refuse collectors and delivery drivers. Many parents have certainly gained a greater appreciation of the value of teachers. When we undertake our essential shopping there is now a greater appreciation of the work of shopworkers, especially should we discover stocks of toilet roll or hand sanitiser. We are getting an enforced opportunity to re-evaluate what is important to us and our lives.

Many countries have taken steps to try and protect their elderly or immune-compromised citizens. This has seen some tremendous community responses, with volunteers taking on the delivery of food, medicines and working to help counter isolation. Ballachulish, a village in the Highlands of Scotland was one of the first to organise this kind of approach in the UK, but many other areas have done similar. This impulse to help others shows the strength of communities and many governments, including in the UK, are now seeking to harness this.

Of course, the homeless and rough sleepers are highly vulnerable. Sleeping on the street, there is no effective way to self-isolate and your underlying health is also more likely to be impaired. In many cities, including London, Edinburgh, Paris and Toulouse, there has been rapid action to establish specific accommodation to support people in this situation. Those who have complex health conditions, including substance misuse, pose particular challenges but it has been impressive to see civic authorities and the voluntary sector combining to tackle these.  

We are all guilty of choosing the medium of communication we are personally most comfortable and familiar with. And we certainly can’t fault any individuals or organisations for struggling to find the right approaches when dealing with an unprecedented situation. But COVID communications across the world reveal a lot of learning points. Not every citizen watches every news broadcast, some rarely watch it at all. Messages to the general public have developed rapidly and some of it has contributed to what has been described as panic buying. We also need to think about the impacts of lock downs on those experiencing domestic violence and children at risk. What can we do to support those with mental health issues? There has been some great work in recent weeks to address these by government agencies and the voluntary sector, but more will need to be done as we go forward.

We should not be surprised when people buy more when they are confronted with imminent lockdowns and the nuances about still being able to shop for essentials get lost in alarming headlines. Complaints about people using public spaces two days after senior figures have been advising people to make use of them reflects an under developed policy. Telling people, they should exercise in their own gardens reflects a limited grasp of many people’s reality. I have a particular issue about the repeated claims that all answers, useful advice and access to life’s essentials is to be found on the internet.  For sure there is an enormous amount of good stuff out there, but also lots of spurious advice, food delivery slots are limited, and IT access is not universal. Not every older citizen in the UK is a “silver surfer”, not everyone can afford unlimited internet access or the kit to take advantage of it. We need to make use of a range of mediums and provide appropriate messages for specific audiences. This will aid understanding, support positive engagement and so bring communities with us on this fight. We must continue to share and discuss what we do, drawing strength from each other’s experience. Down that path we can hope to get back to not just the world we knew a few months ago, but one where some important lessons have been learnt.