Coronavirus Bill — House of Lords, 2020-03-24
Topic: Health
John Alderdice (Liberal Democrats, Centre to centre-left): My Lords, I direct the House to my medical and research interests noted in the register. The Minister, in his excellent introduction to the debate, referred to the lessons from the 1914-18 war. I understand that reference and have some sympathy for it. However, my friend the anthropologist Scott Atran has pointed out that there are certain dangers in using the terminology of war, because it tends to turn people towards various "isms": racism, chauvinism, ethnocentrism and xenophobic nationalism—exactly the opposite of the things that we want to find in our global community at the moment In truth, a more accurate reflection would be to address the lessons of the 1918-20 flu pandemic, which crossed the world and led to the deaths of tens of millions of people. However, two things about that experience are different from our own. One is that people experienced it immediately after the war, when tens of millions of people had died. To some extent, they were emotionally almost numbed by the whole business of massive death. Secondly, unlike us, who are used to antibiotics, vaccination and an expectation that people will not die of infections, people at that time were very much aware that people died of infections, sometimes in large numbers These facts contribute to what another colleague of mine, Dr Kerry Sulkowicz, the president-elect of the American Psychoanalytic Association, has referred to as the second pandemic of the moment, which was referred to by the noble Lord, Lord Blunkett, and other noble Lords: a pandemic of anxiety. It is not that he suggests that this is an inappropriate or pathological anxiety. On the contrary, it is a very realistic anxiety, because what is ahead of us is profoundly dangerous and challenging. We do not even know how dangerous and challenging, so anxiety is not an unreasonable response; it is a natural, human response. However, it produces problems in reaction. It leads some people to be so overwhelmed that they deny the reality. Even coming through London today in my car, not by public transport for safety reasons, I still noted groups of people out on the street in much more than twos and threes, not taking seriously the very sensible advice that they have been given publicly by the Prime Minister, Ministers and other experts Sometimes it leads to people being paralysed by the anxiety so that they do not know how to deal with things, but it also often causes illness—not just psychiatric and emotional illnesses of various kinds, but physical illnesses. Many people will be falling ill, physically and mentally, as a result not of the coronavirus directly, but of the psychological sequelae of it. There are many sequelae, not just anxiety. Reflect, for example, on what it will mean for many people, particularly older people on their own, to face three months or more without ever having touched a person or been touched by them. As human beings, the physical dimension of life is of enormous importance. They will be losing that and undoubtedly reacting in ways we do not know, because it has never happened in this wise before Many years ago, I was called to do work at a hospice where the staff were finding difficulty in continuing their work. It became apparent that this was because of the repeated, incessant, unremitting experience of the deaths of those they were working with. Reflect for a second on what it will mean for health service staff, who have been relatively well used to getting people better, to find that hundreds and hundreds of their patients will die. How will they manage, psychologically as well as physically? Can the Minister say how much thought has been given to addressing these problems There are many other things that I could mention but I will say two. One is that there are, in the voluntary, private and community sectors, employee assistance programmes that have been relieving the health service of having to deal with many of these problems. They are not going to be able to survive financially if there is no assistance for them. The noble Baroness, Lady Hollins, who is not in her place, has asked that we also remember the problems, as have been mentioned, for those who are vulnerable because of learning disability. Finally, because there will be more people admitted on formal orders, can we monitor how many more patients come in than would normally be the case on such orders, so that we have a sense of the increased burden on the psychiatric services?