•Psychological stress is associated in a dose-response manner with an increased risk of acute infectious respiratory illness, so fear and lockdown measures would probably have increased infection.19
•27 million missed GP appointments by October 2020.20
•350,000 missed specialist referrals for cancer.21
•Cancer Research estimated there could be 35,000 avoidable cancer deaths as a result of lockdown.22
•30% of those who had a stroke during the pandemic delayed seeking emergency medical attention due to Covid-19. There were 825 excess deaths for stroke and 1,834 excess deaths for cardiovascular diseases (including cardiac arrest) as a result of delays to seeking help (or potentially the result of undiagnosed Covid-19).13
•Deaths from diabetes were 161.6% above average, potentially due to delays in care, from anxiety about seeking care or an overburdened healthcare system.13
•Until 8 September 2020, birthing partners were prevented from attending scans and early labour, causing stress and leaving women to endure difficult labours, traumatic news and miscarriages alone.
SOCIETY
•45,000 extra homeless people since the start of lockdown.23
•More than three-quarters of councils across England saw an increase in homelessness in their area since the start of the pandemic. More than four in 10 have seen a significant increase.24
•Half of children entitled to free school meals did not have access to the scheme during Covid-19 lockdown in the UK.25
•20% increase in babies suffering non-accidental harm.17
•There was a rise of 49% in the number of calls to domestic abuse services.26
•Two-thirds of domestic abuse victims were subjected to more violence from their partners during lockdown.27
•5.6 million people are struggling to afford essentials or have borrowed to make ends meet. The amount of arrears and borrowing among this group attributable to the impact of coronavirus is £10.3 billion.28
•A 25% reduction in pre-pandemic learning for primary school children and a 30% reduction for secondary school children.13
•The first lockdown saw the cancellation of 15,000 theatrical performances resulting in a loss of £303 million.13
ECONOMY
•The UK’s GDP fell by 9.9% in 2020, the worst result of any G7 country, and worst contraction the UK economy has experienced since the Great Frost of 1709.29
•The increase in public sector net borrowing (March to November 2020 rise in OBR estimates) could be as much as £385.2 billion.13
•Unemployment is expected to increase by between 450,000 and 2.45 million above pre-pandemic levels.13
•More than a quarter of pubs do not believe they will stay in business after lockdown.13
•The creative industries project a loss of £77 billion in 2020.13
•The manufacturing sector faced a Gross Value Added (GVA) loss of £71.7 billion from the first two lockdowns.13
•The construction sector faced a GVA loss of £40 billion from the first two lockdowns.13
•The retail sector faced a GVA loss of £33.8 billion from the first two lockdowns.13
•The impact on hospitality was a £37.4 billion loss.13
ELLA, 47
My fear is authoritarianism. That other people will think they know what is best for us. I don’t believe in our leaders, so I can’t trust my environment and the world feels unanchored.
People have lost their minds with fear this year. We aren’t used to fear anymore. They are searching for a crescendo in life, an epiphany which they normally get from Netflix. They’ve imploded with the crisis of Covid. I think if people practised more mindfulness, if they were more present in the moment, they would have managed better.
This year has been a wake up call that people are shit with knowing they are temporary. I am OK with dying; we are here for a finite time. I’d like my children to live longer than me, but I don’t think I’m entitled to a longer life than I am going to get.
Lockdown has taught people to ignore feelings and ignore faith. When churches close, when schools close, and isolation becomes the norm, you cannot experience faith in the full. I am not a Christian, but I know what is right and wrong and I trust my faith. The government killed God. It’s as simple as that. To put protecting yourself from death above everything is killing God. I wasn’t brought up with religion, but I have faith. I believe my consciousness will live forever.
The art of living is not just about having brilliant things happen, it’s also about carrying the burden of loss. Life is about feeling.
Courage is fear in disguise.
17. WHY FEAR SHOULD NOT BE WEAPONISED
‘Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.’
Marie Curie
In the introduction I confessed my discovery that I was more frightened of authoritarianism than death, and more disturbed by manipulation than sickness. Has my fear helped or hindered me? For several weeks into lockdown in the spring of 2020, fear gave me a sick feeling of dread in my stomach a few seconds after I’d woken. Oh God, this is real, it’s not just a bad dream. That can’t have been a healthy way to start the day. Many studies have shown the link between psychological stress and the immune system.1 Fear also disconnected me from the usual pleasures of life and my senses were dulled. Even the spring blossom smelt sad. I was not in control of these responses; fear took over. But fear also gave me new intellectual and creative direction. It’s made me reconsider what I want from my government. Fear made me write a book.
Fear, like hope, can be very motivating and is not inherently bad. It is an adaptive emotion that mobilises our energy to respond to threat. The challenge is to identify when fear is being used deceptively or to manipulate, or is not well-calibrated to the actual threat and overwhelms us. If we are nudged towards a ‘greater good’ we play no active role in deciding what ‘good’ is. We have handed over the big decisions. We are like children being guided by adults who know best. If rule is by ‘science’ and we, the ignorant population, don’t get to review the software code of the models behind our new commandments, it is akin to the peasantry enduring sermons in Latin before the first English translations of the Bible.
The obvious argument in favour of fear is that the use of fear is acceptable if it works, if it kept us safe and if there is a net benefit for society. What did the government policies – lockdown, restrictions, a blitzkrieg of behavioural psychology – keep us safe from? Not unemployment, not other types of ill health, not death and certainly not fear. In fact, they couldn’t keep us safe from Covid-19 either. Lockdowns don’t work. Now these are strong words. You may splutter – ‘but, but, but!’ – and think my position is ludicrously counter-intuitive. But many international studies now offer the empirical evidence that lockdowns failed to contain the virus, and at the same time they are a blunt tool which causes great harms. The efficacy of lockdowns is not central to the tenets of this book, but if you want more of my thinking on lockdowns you can read the ‘Lockdowns don’t work’ essay in Appendix 2. Now, back to fear and why it should be not weaponised:
1. FEAR SLOWS RECOVERY
‘Fear is a disastrous way to do public health messaging,’ said Lucy Easthope, ‘and goes against everything we know about how to do health risk communication. Working on CBRN threats (chemical, biological, radiological and nuclear weapons) taught me that weaponising fear to get the response you want causes you insurmountable problems in long-term recovery. Health risk communication is a science but most of that science has been ignored, not followed, during the Covid epidemic.’
Easthope told me ‘it’s going to take a long time for us to come out of this’, because the government deliberately exaggerated the risks of the disease. Fear will slow recovery. And then the next problem is that the ‘government don’t know what normal looks like. They are genuinely muddling through, but they don’t know that recovery is when the bird
s are singing and children are playing in the playground, not mass testing and death dashboards. The humanistic recovery planner would say stop the dashboards. Stop. We don’t do it for Clostridium difficile.’
It is obvious and intuitive that fear will inhibit our recovery. In fact, Easthope said it means recovery will be ‘1,000 times harder’. But let’s flesh out an example. As an MP told me, masks were introduced to give people confidence to go shopping. People were scared and the economy didn’t bounce back hard enough after the first lockdown. Thus, masks were mandated.
Introducing a measure without an exit strategy can create more problems. In this case, it is that we are still wearing masks. They have turned the UK population into walking billboards that announce we are in a deadly epidemic. Every time you go into a public space you are reminded by masks of the epidemic. And then the idea that they help (even if they do not) is reinforced. Did you survive your trip to the supermarket? Only because you were wearing a mask! Did you contract Covid on the Tube? No? It must be the mask that saved you! The unintended consequence of the masks is that they keep the fear alive and modify our behaviour, and this has proven useful as far as the behavioural scientists are concerned. As late as January 2021, David Halpern was referring to the useful ‘signal’2 masks give.
Fear also slowed the reopening of schools, as Gavin Morgan, SPI-B advisor, told me, because parents and teachers over-estimated the dangers. Fear means the ‘roadmap’ to recovery is measured in the tiny tottering steps of battle-weary statesmen who must avoid the landmines of error, lest they detonate public condemnation and media derision. Of course, it makes total sense that our rulers wield fear against us, when we realise that they are also ruled by fears.
If we want to recover, if we want life to go back to normal, we need to dial down the cortisol. One of the simplest measures the government could take would be to remove the mask mandate. They are not backed up by convincing scientific evidence or medical necessity (at least, the government hasn’t shown us this evidence) and they are primarily a behavioural psychology tool which is a perfect example of unintended consequences. Masks are a visual metaphor signalling danger, perpetuating the fear and disrupting the human connection and communication which will be vital to society’s recovery.
2. THE PUBLIC HAVE NOT BEEN CONSULTED ON THE ETHICS, OR CONSENTED
If psychologists wanted to make people very frightened in a lab experiment, it would be difficult to obtain the ethics approval, especially for an experiment which mimicked this scale and severity. Informed consent for participants would be essential though. Participants would not be allowed to leave the lab unless they were as happy and in as well a state as they arrived. They would certainly not be left in a state of fear.
The British Psychological Society has a Code of Ethics & Conduct.3 Under ‘Ethical Principles’, it states: ‘Psychologists value the dignity and worth of all persons, with sensitivity to the dynamics of perceived authority or influence over persons and peoples and with particular regard to people’s rights.’ It goes on to say that in applying these values, psychologists should consider consent, issues of power, self-determination and compassionate care.
It seems to me, and to the psychologists who wrote to the BPS, that the behavioural psychologists advising the government have blatantly failed to practise in a way that is consistent with those stated ethical values regarding the fear messaging.
Importantly, we the public have never been consulted about the subliminal methods of manipulation they wield against us. Perhaps we didn’t take it seriously enough when they were pushing forward seemingly innocuous changes like making cigarette packaging plain, or encouraging prompt tax returns. But using fear, shaming and scapegoating manipulate our emotions in far more serious and harmful ways.
Ultimately, do campaigns of fear express the best of humanity? Do we imagine a healthy, virtuous and pleasant society populated with scary ads designed to force us into following rules? Is that really what we want?
3. FEAR CREATES COLLATERAL DAMAGE
The use of fear intrudes on our private lives, our minds and our physiological health. The messaging of fear exposes us, against our will, to harmful and offensive messages and creates unnecessary anxiety. That is exactly why the Advertising Standards Authority has codified against the use of fear.
The fear salesmen – the government, the psychocrats advising them, the media and the scare-mongering scientists – peddled their wares to us throughout 2020 and into 2021. There is no money back guarantee, no refunds or exchanges, the sale is now complete. Was fear a bad purchase?
Chapter 16, ‘Terrifying Impacts’, provided a brutal list of the impacts of the policy of fear and the social and economic restrictions that were enabled by the compliance that fear generated. The government has been remiss in not quantitatively analysing the costs and benefits of its Covid policies, probably because the numbers will not look good. On 22 March 2021, just one day before the anniversary of lockdown, Chris Whitty acknowledged in a press briefing that the government had known ‘right from the beginning the lockdown was going to have really severe effects on many people’s health’.4 He added: ‘For many people, physical or mental wellbeing have been very badly affected by this. Ranging from increased levels of domestic abuse, loneliness – particularly in older people who felt very much isolated in their areas – physical health, people maybe exercising less, greater amounts of alcohol consumption.’ He also said that coronavirus restrictions would affect livelihoods for years, with government able only to ‘reduce and not eliminate’ those effects.
At the worst end of the scale there is concern that fear and isolation might have driven suicide attempts, but it is too early for the data. Humans are intensely social and as Patrick Fagan observed in a comprehensive essay on fear, self-isolation and confinement at home can contribute to many ‘psychopathological outcomes – such as fatigue, sleep disorders, cognitive impairment, delusions, anxiety, depression, hostility, loss of self-esteem, and lower wellbeing – as well as, ironically, a compromised immune system’.5
One of the most distressing collateral damages is the mental health epidemic among children. Children as young as eight ‘are self-harming amid an unprecedented mental health crisis fuelled by the stress of lockdown’,6 said accident and emergency consultant, Dr Dave Greenhorn. It is estimated that 1.5 million children and 8.5 million adults will need support for depression, anxiety, post-traumatic stress disorders and other mental health difficulties in the coming months and years, according to the Centre for Mental Health.7 As their chief economist said, ‘the numbers are stark’.
It is the personal stories which illuminate the crisis. Quantitative analysis for the policies is overdue, but the analysis must also be qualitative – we need to hear people’s stories. This is why I interviewed a range of people whose lives were affected by the policies of fear.
I followed up with a few of these interviewees, to see how they were feeling. I was pleased to hear that Susan, 15, felt much better and stopped self-harming once she was back at school. Jane had started taking anti-depressants and felt better once she was back at work. Unfortunately her husband had been diagnosed – very late due to healthcare delays – with a rare and difficult type of cancer. Mark was trying to challenge his agoraphobia by going shopping occasionally and this time felt the benefit of the return to the office. Jimmy, who tried to kill himself, is now, thankfully, coping with the support of his family. Sadly, Dave, the doctor, told me that the woman with children who suffered irreversible brain damage following a suicide attempt died soon after we had spoken.
An onslaught of scare-mongering is known to be a health risk. The report COVID-19 and the 24/7 News Cycle: Does COVID-19 News Exposure Affect Mental Health? found, unsurprisingly, that ‘the 24/7 news cycle covering the virus may amplify perceived threats and have harmful effects on mental health’.8 And in the US, the CDC (Centers for Disease Control and Prevention) suggests that after a disaster people take care of their emotiona
l health by taking ‘breaks from watching, reading, or listening to news stories. It can be upsetting to hear about the crisis and see images repeatedly. Try to do enjoyable activities and return to normal life as much as possible and check for updates between breaks.’9
The links between fear and anxiety and health cannot always be proven to be causal, but there is obvious cause for concern and potential for fear messaging to reduce health and happiness. It serves us to remember the basic Hippocratic principle: ‘First, do no harm.’
4. LEADERS BUILD FALSE MORAL AUTHORITY AND PROFIT
Sometimes, those who rule do not have our best interests at heart. A little scepticism is healthy, even necessary. Of course, we won’t solve this conundrum by saying we don’t trust politicians and by retreating from political life. The opposite: we need to ask questions, even when we are being encouraged to fall into line.
Norman Baker, former Liberal Democrat MP, wrote an article10 for the Daily Mail about the day that anthrax was deliberately released in a tunnel on the Northern Line by scientists from the UK government’s Porton Down laboratory. As he explained, it was far from the only time they’ve used Britons as guinea pigs for experiments. These are the kinds of incidents in British history which would startle and horrify most people, who assume unethical experimentation is the preserve of the Nazis.
We had a conversation about the Covid crisis. He emphasised that ‘even in a democracy we should never assume the government of the day is right or even well-intentioned. That’s not how a democracy works. Even now, at a time of a public health crisis, it is our duty to question. That doesn’t mean to assume the government is lying. We know enough to ask whether governments are acting in your best interests or theirs. People have a very low opinion of politicians, and recent reasons have included the Iraq war and the expenses scandal. But, for some reason, they believe the government unwaveringly about an issue of their security, such as an epidemic.’
A State of Fear: How the UK government weaponised fear during the Covid-19 pandemic Page 25