Another Year, Another COVID Christmas
Here we go again… just when you thought it was safe to get back with the family, friends or colleagues to celebrate Christmas, the Omicron variant of SARS-2 (Covid-19) arrives, shattering some of the plans you may have made. Another year has flown by and once again travelling abroad, office functions, and family parties appear to be heading towards a freeze.
In the UK, within the last week, wearing masks in public places has become mandatory again. About 10 days ago, while on the tube, I noticed that almost 40% of travellers were not wearing masks. That number had dropped to about 10% yesterday when I visited some friends; although in very crowded shops on Oxford Street and Westfield shopping centre, the numbers of people wearing masks were surprisingly low.
On the London Underground, Transport for London (TfL) kept announcing every few minutes that masks were compulsory unless there were any exemptions. Surely for close to 10% of people to have exemptions is a surprisingly high rate of pathology than one would normally expect. A vast majority were young people who looked healthy. Perhaps people were experiencing some unknown anxiety or phobia in this age group that we have not identified as yet. We must acknowledge that they have had a particularly stressed time for all kinds of reasons and the end is not yet in sight.
This observation of not wearing masks, brought to mind a story (possibly apocryphal) shared by an A&E physician friend. He was approached by a patient who wanted an exemption to wear masks. The physician smiled and said, ‘yes, of course. There are three reasons for exemption: stupidity, selfishness or immortality – which of these should I write on the certificate?’ Needless to say that patient walked away in a huff.
There are likely to be many others to do with arrogance and ignorance. As I write this, news of parties in Downing Street last Christmas are filtering out. Seeing that those in power were not following the rules they had made led many people to feel disheartened, disenchanted, and let down.
Anti-science attitudes as evidenced by anti-vaxxers and anti-politician feelings have contributed to these negative responses. This may well have led to a lack of altruism which was in great evidence when the pandemic hit these shores.
The change in people's feelings and actions over the last 20 months or so has been amazing. During the first lockdown in 2020, when the Prime Minister asked for 250,000 volunteers nearly three times that number registered. People created street WhatsApp groups, looked after the older and people who were living alone.
So what has led to this loss of altruism and regeneration of selfishness?
The messages about hanging on to vaccination doses even if they are reaching expiry dates give a subliminal message of selfishness which then becomes accepted. Leaders have to lead by example and if the perception is about falsehoods and people see that their leaders are getting away with it, it sets bad precedents.
There is no doubt that over the last 20 months or so, a series of lockdowns have narrowed and restricted our world, world-view, and social interactions. We may have even forgotten how to mix socially. Freedoms to mix and travel have been curtailed severely. Restrictions and narrowing one's external world and may well have contributed to an increased rate of mental illnesses, as well as a general anxiety about living and surviving.
The Christmas holidays have always been a stressful time for people for a number of reasons. Research has noted that irrespective of religious denominations, Christmas is a time for reduced life satisfaction and emotional wellbeing, though a higher degree of religiousness can reduce this stress and anxiety.
A survey by the American Psychiatric Association published last week showed that 41% of Americans admitted that their stress levels increased during the holiday period whereas only 7% acknowledged a reduction. This survey was conducted between November 7-21 with a sample of 2119 adults. The combination of the pandemic and holiday season was seen as contributing to increased stress.
Over half (54%) of the health workers reported that their stress levels increase during holidays in general, and one third (33%) were expecting higher stress levels when compared with last year.
This survey also reported that parents are more likely to be worried – both about Covid-19 infection among their children but also being able to afford gifts. With the Omicron variant gathering pace and more likely to be affecting children more, it is not surprising that parents are worried.
Interestingly younger adults were more likely to report being anxious (and yet they appear to be less likely to follow the restrictions). This may reflect a double bind at the level of altruism versus self-preservation and the sense of immortality young people often have which may make them feel invincible.
In this survey, Hispanic respondents were more likely to report feeling more stressed in comparison with last year. Laura Spinney, in her excellent book on the history of Spanish flu of 1918 and beyond, noted that health and social inequalities contributed to both morbidity and mortality, and that is exactly what has happened in this pandemic too. Poverty and race then as now have contributed to differential rates of death and infections. So in spite of increases in productivity and better economic state, very little appears to have changed in the last 100 years.
These survey findings reflect the attitudes of a US American population, but the observations are interesting in the context of other countries too. Americans are faced with two important holidays – Thanksgiving and Christmas – within a month of each other whereas in the UK and elsewhere, the scenario may be somewhat different. Nevertheless, stress related to Christmas is well recognised.
There is little doubt that several surveys in the last year have shown increasing rates of anxiety, phobias, depression and more. These can, however, be seen as expected human responses to the pandemic rather than full-fledged psychiatric disorders and so, with this in mind, it is vital that normal reactions and responses are not pathologized.
Restrictions on actions do lead to increased anxiety, panic and reactive depression but another recent study reported that patients with severe mental disorders such as schizophrenia were 3.74 times more likely to die of Covid-19 infection. These variations across psychiatric patients need to be borne in mind by health workers who are likely to be on the front line of health care.
The past year has also been a year of success with vaccinations. Among the UK population, 88% over the age of 12 have received the first dose, 80.9% have received the second dose. This has taught us that there is still vaccine hesitancy in many groups but it has also taught us to remain vigilant and focused as the virus is not going to disappear overnight as it seemingly appeared.
Christmas is a time for giving.
Wealthier nations need to come together to offer vaccines to underserved populations in low-income countries. None of us is safe from this virus until everyone is safe and we know that vaccinations work.
We need to acknowledge the sacrifices the younger generation have made through the last 20 months and that these have been worth it. Selfishness from leaders downwards needs to give way to altruism. Cooperation locally, nationally, and internationally should be the gift that keeps giving, not only over Christmas but forever. That is the only way we can manage this virus. Exemption from the patents of vaccines, altruism from the leaders who lead by example and vaccines for everyone globally would be my wish.
As Plan B kicks in the UK, and we are back to working from home, it is important for everyone to look after their wellbeing by looking after their physical, emotional and mental health. It is imperative that we look after ourselves and also others who need help but maybe hesitant to ask for it. Take time out for yourself, use relaxation, physical exercise, yoga, mindfulness or whatever floats your boat to maintain your wellbeing – only then can you look after others. And give before you are asked.
Have yourself a very merry, healthy Christmas. Happy holidays and a very happy New Year.
Stay safe, stay well, stay healthy.