Pieces of the Puzzle: Key Sectors and Workers (Britain in Lockdown, Part 4)

Names have been changed throughout this article1.

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On the morning of Monday 16th March, Alex was starting his week as a teacher in an East Midlands secondary school. At the start of the school year he’d taken on a new role as the department’s Key Stage 4 lead- ‘it means I’m in charge of GCSE Maths, as well as doing the job of a regular teacher‘- and with GCSEs rapidly approaching, the school was getting students ready for the upcoming challenge. Maths mock exams were still underway. Although all the coronavirus indicators were flashing red, the school still had a duty to teach students and prepare them for their exams.

A week later, the school gates had shuttered indefinitely. On Wednesday 18th, the school made plans to suspend classes for Year 8 through 10, and shortly afterwards the order came to close all schools by the end of the week. The next two days were surprisingly calm: ‘the majority of people were just carrying on with their life really, and trying to keep the kids calm and answer questions.‘ But Alex acknowledges that it wasn’t always easy to maintain an atmosphere of calm, because ‘we had year 11 mocks that week. As a result, some kids that didn’t take their maths tests seriously started causing a lot of anxiety with the other students‘.

police on patrolBy Tuesday 24th April, Marie, a police officer (and Alex’s wife) was preparing to go out and police a city in lockdown. New powers were being rapidly developed, to fine rule-breakers, and if necessary, to use reasonable force to break up groups. However, the new powers are rarely used in full, as Marie explains:

‘We follow a four-step protocol- Engage, Explain, Engage again, and then Enforce as a last resort. Even if we did Enforce and take people back home against their will, are we going to sit with them? No, because we’ve not got the resources… So you could arrest them, but you can’t just nick everybody. We police by consent, and we try not to arrest people for this kind of thing unless it’ll cause a great deal of harm if we don’t. Personally, I haven’t fined anybody, but we threaten it often when people aren’t listening to us.’

Trying to persuade people can be exasperating, but it’s the only way to keep the country on your side as you navigate through testing times. Sometimes, a bit of gallows humour can do the trick. ‘The other day, I was speaking to some sunbathers in the park who just weren’t getting it, and I said, look, if you don’t understand what 2 metres distance is, it’s a dead person between you and them.’ Nonetheless, it’s an uphill struggle, and for a police force which is dealing with a notable increase in domestic violence call-outs, it’s difficult to find the bandwidth to keep people safely indoors.

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Patterns of Work and Life

COVID-19 has changed all of our lives so quickly that, despite the libraries of thinkpieces and blog articles, none of us has a holistic perspective of the changes happening around us. We see the tendrils of change instead in our own lives, as our patterns of work shape themselves around our new reality. For most of us, this means working from home, perhaps typing reports in our pyjamas or trying to organize Zoom calls over intermittent wi-fi connections. For others, it means coming home late and making PPE by hand to cover a supply shortfall.

One of the key lessons of the lockdown has been that quieter days aren’t necessarily less stressful. Grace, a Floating Support worker based in London, leads a team which supports people who typically live in their own accommodation and have additional mental health needs. Typically, support workers would meet people in cafes or other places outside the home, sit down to chat with them and find out if they need any specific support. But now ‘work has become entirely focussed on checking if people are well or unwell by phone, delivering them food, and making sure our service users don’t have to go out.

phonecrackService users of mental health support services often aren’t well-connected; many have poor wi-fi connections (if any) and may have lost or broken their phones, making contact difficult. In addition, ‘we’re helping people who are rule breakers in general, both through necessity and because of their mental health and drug use. People with severe mental health issues often can’t cope with being indoors all the time, and fill their time with going out.’ Lockdown exacerbates other mental health issues, and is likely to be a huge strain for people with addictions. Grace sometimes feels frustrated that stringent lockdown rules limit her capacity to actively help people.

For some workers, though, the surprise has been how much they’re still able to do. Tom, who started a medical recruitment company after over a decade of nursing, thought his business would grind to a halt when the NHS announced a freeze on hiring of health care professional for most sectors. ‘Where there’s uncertainty, people often don’t know what to do, so they do nothing… from an early stage in this process, as the ripples spread out, we noticed some people changing their minds and staying with their existing jobs.‘ However, the number of applicants has been steady. The vacancies are still there, and candidates are still needed to fill them, although most applicants won’t get a definite answer until after the acute stage of this crisis is through.

There’s been a good deal of what Tom calls ‘panic buying’, from locum agency nurses looking for something more permanent, to operating theater (surgical) nurses who can’t work because all elective surgery has been postponed, and are ‘madly applying‘ to a spectrum of vacancies. It’s hard to know whether some of these applicants are serious about changing their jobs, or just stuck in a difficult position. ‘The thing is, once this is all resolved, there’ll be a huge, full-steam-ahead push to clear the backlog of elective surgery. I would expect that private hospitals will be taking on NHS load as part of that process. People who needed elective surgery before this will continue to need it, and perhaps need it even more critically if their symptoms get worse.’

For some key workers, this period is the busiest they’ve known. Through her police radio, Marie has always received a large number of call-outs to domestic violence or abuse situations. ‘In the past, the police weren’t taking it seriously. They were going to crime scenes, saying ‘oh, it’s just a domestic thing’, and people were getting killed. So now the amount of safeguarding has dramatically increased.’ Six weeks into the lockdown, domestic disputes are at fever pitch, neighbours are at one another’s throats, and the police are facing an uphill battle to keep people safe from coronavirus- and each other.

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Without precedent

One word has been thrown around a lot since all of this started. Airline companies are ‘bleeding cash at an unprecedented speed’, Chinese universities promise an ‘unprecedented global research effort’, Irish unemployment is at an ‘unprecedented level’. It’s a cliché, but it’s true: for most of us, our jobs, and our lives, are transformed in unfamiliar, topsy-turvy ways. We are inventing new protocols and processes on the fly.

This summer, for the first time since GCSEs were introduced, no final exams will take place. Instead, teachers like Alex will be compiling grades. ‘We’re going to use the mock exams and other data to create a predicted grade, and then they’re going to assess that against previous years and against our targets, just to make sure we’re not tempted to try and go a bit higher and inflate grades. We also need to rank students within each grade, from, say, the highest 7 to the borderline 6-7 students, so that if the government wants movement, they can shift students up and down if they need to.‘ It’s a rough process, and it’s going to be a bumpy ride in the summer when students receive their results. Meanwhile, Alex is setting online homework and trying to motivate students to think of their future, instead of settling in for one very long summer holiday.

Many of the people Grace works with are recovering from drug addictions, or still using. Both groups have received methadone as a treatment, but for safety reasons, they were required to pick up their prescription in person every day. For individuals with HIV or other underlying health conditions, that’s no longer safe, but ‘the drug services have no way of delivering to someone’s flat. We can pick it up for them, but that’s also complicated, because it’s a controlled substance.‘ She isn’t dealing with a huge amount of extra stress personally, but she feels worried for the people she works with. The same is true for Tom; speaking to nurses every day, he often hears stories reminiscent of conflict zones. ‘You’ve got patients coming in faster than the ambulances can unload them, and nowhere to put them. People have been dying in triage because there’s so many people waiting and not enough staff‘. He applauds the resilience of health workers, but thinks the health care system will face another shock after the acute crisis is over: nurses leaving the profession, and others needing extended leave. ‘Sadly, I think there’ll be a high mental health cost to be paid by the nurses who are on the frontlines‘.

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Outside of the health sector too, key workers have been firefighting effectively until now, but the problems are broadening in scope as the lockdown extends. As Marie tells me, ‘for people who don’t have adequate housing, it’s really tough; they’re trying to keep their kids busy, they don’t have much money, they may rely on school meals, so they haven’t got enough food.2 Many of the same people who are most in need of an escape also don’t have gardens in which to cool off, so they are struggling to hold things together while spending nearly all day inside the house.  ‘For most of us this is only temporary, but how long is a day when you’re sat there with somebody who is violent towards you?‘ says Marie, shaking her head. ‘It’s just crazy‘.

Police, health care and support services alike are worried about a deficiency of information during lockdown. Although police are being called out to domestic violence incidents at a greater rate, they’re also very concerned about children who are at risk of abuse, who may not be aware that there are authorities they can call. Meanwhile, Grace and her team think that people with substance addictions are likely to use more during the lockdown. ‘If you have a problem with addiction, and your support program’s been stopped, and you’re at home all day without friends or family- I mean, what are you going to do?‘ Although some drugs such as crack cocaine and heroin have been less available since March, other dangerous substances including the much-feared fentanyl may be emerging to fill the gaps.

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The Lost and the Return

Some of what we’ve lost in the flood can’t be salvaged. Students who were hoping to improve on their mock exam scores may have to make do with disappointing results. For teachers like Alex, this is tough to watch: ‘we’d planned recaps, homework and revision well for next term. A lot of planning and implementing for exams is just gone. And of course, some of the kids are devastated‘. Floating support services will find that the health of some of their service users has deteriorated in isolation, while some patients seeking elective surgery will have lost more motility and function over two months at home.

It’s essential to look forward, as well as back. Although we will need to take stock of how we handled the crisis, ultimately the purpose of such a task must be to prepare us better for the future. In the short term, Grace hopes that the relevant authorities will be able to provide internet access to people who are particularly vulnerable during lockdown, while Alex and his colleagues are working to get students ready for the return to school after a long unplanned absence.

In the short term, NHS hospitals will go into the future with their debt wiped (one local trust alone had £280 million of debt written off), and a hiring crisis. They will need to hire more nurses from around the world in order to cover the immediate shortfall, and they will probably do so. But in the longer term, Tom expects people to think seriously about the values of our society in the wake of the pandemic. ‘It’s really interesting to see who the key people are who keep the country going, and- it’s not bankers, is it? Couriers and supermarket staff and nurses- these are the people that really matter when the chips are down.

 

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1- While researching this article, I spoke to four people working in, or with, key sectors in the United Kingdom through the COVID-19 lockdown.For freedom of communication, due to safeguarding concerns and for other reasons, all four preferred to speak anonymously.

2- Schools are providing free school meal deliveries to students in lower-income households, but not all schools have had the staff or the capacity to do this.

 

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