Dr Zenobia Storah, Child and Adolescent Clinical Psychologist
For those of us who have spent the last two years surveying unfolding events in dismay, these past few months have been a strange time. We witnessed the greatest imposition of restricted civil liberties ever seen in peacetime and observed with disbelief the supine (sometimes enthusiastic) response of media, political ‘opposition’, most institutions and public bodies, even in the face of ever-increasing evidence of the enormous societal cost. We now find ourselves emerging from the Covid tunnel, blinking in the daylight. The vestiges of the strange and disturbing era we inhabited not so long ago lurk around us still, like impressions left by a bad dream. But for the most part the world seems ready to move on, and indeed the good old healthy habits of normal human interaction and social engagement appear to be returning and almost everyone (outside of Twitter) is fed up with Covid. In the words of Lord Frost ‘it is as if someone flicked a switch and we have all agreed to forget that any of it happened’ (1). And indeed, it seems likely that this is exactly how the government – and all those that supported the imposition of arbitrary, unevidenced and harmful restrictions – would like it to be.
But happen it did, and it is strange that from the rear view of this post-pandemic world, the events of the past two years seem even more unbelievable than they did at the time. Indeed, so extraordinary has this period been, it is sometimes hard to remember the exact course of events, the particular indignities and suffering that the people of this country (and many others) were subjected to, and the very real threat that was posed to the fundamental principles that underlie life in a liberal democracy.
It is disconcerting to experience this difficulty in remembering, because it is disorientating and keeps us unsettled and disconnected. Yet psychologically it is not surprising. When people process extraordinary – and indeed traumatic events – they do so with the benefit of the passage of time, and through interaction (talking through their thoughts, feelings and experiences with others, especially those who have had similar experiences). Through these means people make sense of what happened, creating a narrative that places events in time and incorporates them into their personal (and shared) stories. Over the past two years, however, events unfolded that were so bizarre and so relentless that it has been difficult to stop and reflect. It appears that for now, at least, it has all stopped and with relatively normal social interaction returning, and several restriction-free months behind us, we can – both individually and collectively – reflect on our experiences and start to process events which must be amongst the most extraordinary of our lives to date.
How else but with hindsight and through discussion do we make sense of what we witnessed and endured: the three lockdowns, with their draconian restrictions on our movement, our work, our education, our leisure and our relationships? How else do we attempt to reflect upon the numerous baffling events in that journey – the tightening and loosening of restrictions, interruption to every aspect of our lives and forced separation from loved ones? Masks introduced in the height of summer and with Covid levels rock bottom, keeping ‘two metres’ apart, mourners prevented from comforting one another, playgrounds cordoned off, swings padlocked, sex outside ‘established relationships’ banned, frightening government messaging everywhere (‘Look her in the eyes…’), Eat Out to Help Out, ‘The Rule of Six’, ‘Covidiots’ on beaches, people reporting their neighbours, coffees with friends that we were told would kill. Evening curfews that did not make sense, Vallance and Whitty’s scary graphs, scotch eggs, ‘tiers’ that people dodged by wining and dining in the next town, defiant gym owners that refused to be cowed, students behind barricades at Manchester university, further school closures, testing, testing, masks, masks, no leaving the country, £10,000 fines for going to the airport, vaccinations for the vulnerable, then for the not so vulnerable, then for everyone, coercion, scapegoating, Alpha, Delta, Omicron, Plan A, Plan B, dire warnings from the dying gasps of the Zero Covid movement.. and here we are. It has been exhausting.
The eyes of the world have turned to other matters. But despite the disorientation and the unspoken wish that we should forget, it is more important now than ever that we remember and document what has passed and continue to name the great harms caused by government response. The evidence is in: catastrophic economic, social and personal harms that continue to mount. We must not accept normalisation of the measures that caused this either because of the passage of time or the ardent wish to ‘‘move on’. In failing to continue to call them out for what they were – extraordinary, harmful, unevidenced – we fail to facilitate a proper national discussion about how such restrictions and mandates came about and risk a return to such extraordinary action in the future, justified by some new ‘crisis’. For the minority of us who have struggled to accept the government’s Covid response and to understand almost uniform uncritical acceptance of an unprecedented assault on individual rights, freedoms and personal responsibility, this strange ‘New Normal’ feels unnerving precisely for this reason – it feels fragile and untrustworthy.
A stark attempt at such glossing over was seen in the recently published and wholly inadequate draft terms of the impending Covid-19 Inquiry. Whilst stating that the Inquiry’s aim is ‘to examine the UK’s preparedness and response to the Covid-19 pandemic, and to learn lessons for the future’, the terms exclude so many questions about government action, decision-making, evidence base and justification for restrictions, methods used to ensure compliance, lack of cost-benefit analysis, failure to evaluate measures and the full range of serious harms inflicted upon society, that this could be the subject of a whole other article.
Others will be better able to bear witness to a broad range of social, health and economic harms that must be fully recognised as the dust settles. For my part, my role as a child and adolescent clinical psychologist means I have focussed on the psychological harms. My work led me to experience alarm and incredulity at what was playing out weeks into lockdown. Meanwhile, professional bodies representing those who work with children and young people, as well as institutions, organisations and most professionals themselves, seemed to accept self-evidently harmful measures as necessary, despite it being clear almost from the off-set that the virus was not posing a significant threat to the young. When society embarked upon the unheard of strategy of ‘locking down’- which involved the unprecedented confinement of people to their homes, closure of schools and the dramatic scaling back of essential services – and when that strategy rolled on long past the promised ‘three weeks to flatten the curve’, it was clear that children would be suffering, emotionally, socially and developmentally. It was also clear that they would be at significant risk of physical harms: the most vulnerable in terms of abuse or neglect, and all children due to the impact of confinement on physical health and healthcare – lack of sufficient exercise, daylight, and disruption to routine medical and dental services.
Anyone working with children knew this. We know how schools and services operate to support families and our children’s development and well-being, to monitor them and to keep them safe and healthy. This is especially so for the most deprived and the most vulnerable. We know how important sport and extra-curricular activities are in children’s lives, how necessary the events are that mark out their lives and aid their social development – parties, school plays, school trips, play dates, sleepovers, celebrations – and how crucial children’s relationships and extended networks are to their emotional development, as well as to families’ abilities to function smoothly. We knew that during crucial stages of development – which includes all of childhood, adolescence and young adulthood – and especially when there are additional vulnerabilities or complex needs, children need unfettered access to family, friends, services and support.
Most people working with children in the UK will have some grounding in developmental theory and understanding of the utmost importance of early experiences in shaping personality, future behaviour and psychological vulnerabilities. These ideas have spread steadily and become popularised throughout society since the 1950s and reached a point since the 1990s – with initiatives such as Surestart, the Early Years Foundation Stage, Thrive and other trauma-informed initiatives in schools, as well in more recent projects such as the Duchess of Cambridge’s Royal Foundation Centre for Early Childhood – where most people would have some awareness of critical stages of development, children’s social and emotional needs and understand the importance of attachments and healthy relationships in their lives. All those working with children – in youth groups, in schools, in hospitals, in the family courts – would have at least some rudimentary training in these principles. Here in the UK, pre-pandemic, there was universal acceptance amongst all professionals working with children of the principles of the UN Convention on the Rights of the Child and, in particular, a shared belief that children’s best interests should always be paramount. Throughout my professional life, these principles have been reflected across the legal, education and healthcare systems.
Something unexpected happened in Spring and Summer 2020. I found myself standing apart from my colleagues. I could understand that in the initial stages of the pandemic, due to the particular threat that Covid posed to the elderly, the government’s decision had been to focus on protection of older members of the population. But as the weeks wore on and I imagined the harm being done to children across the country, informed both by my training and my professional experience, it was clear to me that too much weight was being focussed on the protection of adults at the enormous expense of the less obvious (but more long-term) damage to the future and well-being of children and young people. And yet those who I would expect to be my natural allies due to shared knowledge and experience remained silent. There was no national, grown-up discussion anywhere about how we might balance the need to protect the most vulnerable from Covid with the interests of the young, and how we could remain faithful to our national commitment to children’s best interests being paramount. Any attempt to introduce such discussion was met with derision and accusations of moral decrepitude. To my astonishment, this was also the case on professional online forums, where it became increasingly difficult to raise concerns. It seemed to me that psychologists, who describe themselves as ‘scientist-practitioners’, should be asking serious questions about society-wide decisions to impose restrictions and mandates that would inevitably harm children and young people (and other vulnerable groups). At the very least, they should all be calling for a broader discussion, which they would be uniquely placed to inform, and at best, an extremely high bar (in terms of cost-benefit analysis) for the introduction of such measures. Yet the general view amongst those working with children and young people – and the official view of most professional bodies including my own – was that the moral responsibility of child professionals was to support government policy (at whatever cost to society and whilst asking no questions – or so it seemed to me) and then to work to mitigate the impact on mental or physical health. The alternative view – that policies that kept children out of schools, cut them off from families and friends, kept them from participating in outdoor sports, normal play, activity and socialising and prevented them from accessing healthcare and other support services should not be in place at all – was anathema. This was disturbing and confusing. I could not understand how, given values and knowledge we had all shared before March 2020, this had come about.
I withdrew from discussion with most of my colleagues. Since my return to work in June 2020 I had started to see exactly the issues that I had expected and feared. I offered face-to-face clinics from this time, even seeing private cases in my own home, despite regulations. I was receiving queries from parents who were worried about children’s mental health and symptoms, but who could not access CAMHS (Child and Adolescent Mental Health Services) or whose children would not or could not engage online (at the time the only option open to most young people). In NHS clinics I heard about families – often with multiple children with complex needs – who were really struggling due to reduced income, strained relationships due to inadequate space, the pressures of lockdown and home schooling and the inability to access their normal support services at the same time as being cut-off from extended family and friends networks. These adult pressures (as is often the case) were frequently expressed in children’s anxieties and behavioural difficulties. In the neurodevelopmental clinics, I saw a sudden increase in behavioural difficulties and children presenting with tics and ‘tic-like attacks’ (which appeared to be stress-related). I saw parents who had wholly absorbed government fear messaging and developed routines and practices within the family home that were harmful to children’s psychological health and promoted health anxiety (e.g. excessive hand-washing, children stripping at the front door on return to the house so that all their clothes could be immediately washed, family members using communal areas at different times in order to reduce chances of transmission). I understood that it was normal practice in many families for children who were positive with Covid to be isolated from other members of the family for days at a time (encouraged by official guidance). I worked with patients with existing histories of self-harm and eating disorder who had relapsed due to the pressures of being confined to the home and having had the resources and experiences that helped them avoid harmful coping mechanisms removed or restricted. All the while, government policy continued to keep schools closed, restrict children’s social lives, the nature of their play and interactions and pushed fear messaging (some of this specifically aimed at young people).
By the time Autumn 2020 arrived, I started to see children in clinic who had not returned to school in September, either due to parental anxiety or due to ‘emotionally-based school refusal’. Vulnerable secondary school children told me about the difficulties communicating their distress and asking for emotional support during the school day due to the wearing of face masks and other infection control measures in schools. I completed an increasing number of assessments in family homes with children who would not leave the house, either due to generalised anxiety or fear of infection. I saw some children (all with complex needs) and families in clinic, who informed me that I was the first professional they had seen since March 2020. I saw one family in December who had not left the family home since March and had only ventured out (fearfully) to see me because they were desperate for a diagnosis.
From mid-2020 research and reports started to be published that supported the obvious conclusion that observations from my own practice reflected what was happening across the nation (e.g. references 2,3,4,5). And yet still the vast majority of child professionals appeared largely uncritical of government policy. Worse still, they appeared to be reluctant even to think about the impact of what was essentially an unethical generation-wide experiment on children’s development. An interesting and particularly galling moment for me was when I made a renewed attempt at online discussion with other professionals at the time that research was starting to clearly evidence the damage being done to children. In December 2020, I posted the pre-print of a large German study that reported numerous psychological and physical adverse effects of mask-wearing in children (6), a practice which, at that time, was ‘strongly encouraged’ in all secondary schools in the UK. In response to this post, I received a resounding silence. One comment (no ‘like’) from a fellow child psychologist, who simply wrote, ‘Interesting’.
It is a strange experience to feel both isolated and helpless amongst professionals and colleagues with whom – up until 9 months previously – you had shared knowledge and values, and particularly whilst you can all plainly see real damage being done to the very group you were previously united in concern for.
I started to make contact with a small number of other professionals who seemed equally concerned and were starting to voice their views in closed online forums. I found like-minded individuals through various social media platforms and spoke to those who were starting to talk about an initiative that eventually became HART. I formed working relationships with other lobby groups linking concerned professionals and citizens, such as Us for Them. It turned out there would be more than another twelve months of this nonsense to get through – more restrictions and mandates (including a further three months of school closures –utterly unethical, given the evidence that was already available) as well as other psychologically harmful measures, including the unnecessary regular testing of healthy children and masking within schools. In this climate, being part of a collective of concerned professionals and citizens offered solace and friendship, but also a means by which we could each play a small part in raising awareness of the damage being done to children and young people’s mental health and development as well as other issues. There was an effort to collect evidence and document what was happening, there were open letters to various government and healthcare bodies co-authored and signed, media interviews (with a limited number of media outlets or independent journalists who were prepared to hear something other than the official Covid narrative) and articles and papers written. There were reports written as psychological evidence for court cases involving challenges to restrictions and mandates. There was an opportunity to speak about mental health as a ‘collateral harm’ of lockdown policy at the ‘Question Everything’ conference in July 2021 and to provide testimony at an All Party Parliamentary Group (APPG) on Covid testing in schools. There was also some online abuse to endure and some opining from other psychologists that I, and my fellow misfits, should be ‘struck off’.
So now we find ourselves apparently at the other side of restrictions, mandates and other manifestations of government overreach. It is hard to know what factors were significant in getting the UK to a place where restrictions are no longer viable or popular. With the shift in leadership at the Department of Health in June 2021, with Omicron, widespread vaccination of the vulnerable and the de-escalation of fear messaging, Covid appears to have lost its edge and its fear factor. However, the combined efforts of many disparate groups who would speak against the grain – backbench politicians, brave scientists and doctors and journalists, indefatigable lobby and advocacy groups such as HART, Together and Us for Them – will have played their parts. Maybe, also, two years of lost life and experience is more than enough for even the most Covid-wary to bear. And perhaps too, public opinion has shifted because the evidence of the harms caused to society and especially to the young and the most vulnerable is irrefutable.
As we move away from anxious and more heated times, concerns that were raised by those of us who have been critical of government policy appear to be gaining acceptance. Amongst child professionals I notice a shift. Although I do not hear overt criticism of lockdowns and other non-pharmaceutical intervention, there appears to be increasing recognition of harms sustained by the young. In conversations with colleagues I hear concerns about the impact of ‘missed developmental stages’ and behavioural, emotional and social difficulties that follow from these. I hear about the enormous challenges faced by schools and local authorities in coaxing school-refusing children back into education and managing the psychological difficulties of those that are in school. I hear about children who remain health-anxious, with red-raw hands from over-washing and fear of going out, children with new mental health conditions and those whose pre-existing mental health difficulties have worsened or returned since lockdown. We are all aware of the enormous backlogs in our services at a time when there is unprecedented demand. And we are all aware of the terrible deaths of Arthur Labinjo-Hughes (7), Star Hobson (8) and Logan Mwangi (9), and understand that these children might still be with us were it not for lockdown and its consequences. Meanwhile, the reports continue to mount, quantifying and describing the shocking fall out of the past two years (10, 11, 12, 13).
It is deeply disappointing that we needed to get to this point, however. We always knew what circumstances and experiences children needed in order to thrive, to be physically well and to be mentally healthy, and we knew that the unprecedented social experiment that took place from March 2020 deprived them of many of these things and would put many at risk of serious harm. The collateral damage outlined in all these studies and reports could have been foreseen and warned against by many more child professionals than ever spoke out. In moving into the post-pandemic era, it is essential that we continue to speak of these harms, to measure and describe them and to share these findings with our colleagues and the general public. We need to welcome into the discussion the concerns of many people who, at the time, were persuaded that reduced transmission of Covid trumped everything else, including the safety and mental and physical health of children and young people. It would be good to reach a point where there is full acknowledgement of the harms caused and the catastrophic errors made that led to them. Perhaps the Covid Inquiry will lead society to ask itself how we ever got to a point where children and young people were routinely subjected to harmful and unevidenced interventions and restrictions. As we support recovery, all those working with children and those in government must re-commit to the principles of the UN Convention for the Rights of the Child. And we must ensure that we never subject a generation of children to such experiences ever again.
- Britain is being overwhelmed by a rising tide of statism, entitlement and dependency (telegraph.co.uk)
- Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 – PMC (nih.gov)
- Youth mental health in the time of COVID-19 – PubMed (nih.gov)
- COVID-19 related increase in childhood tics and tic-like attacks | Archives of Disease in Childhood (bmj.com)
- Corona children studies “Co-Ki”: First results of a Germany-wide registry on mouth and nose covering (mask) in children | Research Square
- Logan Mwangi: vibrant child murdered after months of terror | Crime | The Guardian
- Covid pandemic drove 60,000 more secondary school children into clinical depression (telegraph.co.uk)
- Pandemic has delayed social skills of young children, says Ofsted chief | Children | The Guardian
- Covid-19: Pandemic has disproportionately harmed children’s mental health, report finds | The BMJ
- Lost but not forgotten – The Centre for Social Justice