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Monday 11 May 2020

Changing the Narrative on COVID-19


This little mask is one I have been supplied with to use at work. I have to save it in a plastic bag and reuse it for the same client each time I visit. For 4 weeks I have worn this mask on 12 separate occasions for an hour at a time. 

I have been placed in a position where there are three possible narratives I can tell myself about my companion mask. 

1) 'I must wear it as directed because it is the policy of my employer and I would be at fault not to do so.' (This is what I have done.)
2) 'I should not wear it as to do so under these conditions is a hazard. I am likely to pass on infection or become infected myself by repeatedly wearing a dirty mask. To comply with a policy that research shows may result in harm goes against my duty of care to clients and my training as a nurse.'
3) 'I should speak out about the fact that professionals who need PPE are being forced to implement unsatisfactory policies based on specious information and I should campaign for improvement.' (I am also doing this.)

It's immensely stressful to abide by what you know to be a false narrative.

These three narratives co-incide with the possible positions each of us has been placed in by the government. 

1) 'I must follow government lockdown-easing guidelines because not to do so would break the law or breach public trust.'
2) 'I should not follow government guidelines where they create an infection hazard to myself or others and can be shown to depart from properly researched supporting evidence.'
3) 'I should support campaigns to call out incorrect information and unsatisfactory policies.'

Narratives 2 and 3, of course, invite official censure and disciplinary action - dismissal (in the case of masks) or sanctions or a fine (in the case of government guidelines). 

Narrative 1 ought to be the path we could all follow but there's a problem with it. It's becoming increasingly obvious to a large proportion of the population that this narrative is failing because it is a false narrative, requiring us to act in ways based on skewed interpretations of scientific evidence. The government can see that, due to its earlier decisions, it is losing power to control events and that, now, it is beginning to lose control of the narrative about what is happening. The only option then becomes to change the narrative as the Prime Minister did last night. Last night's change of direction was not about infection control or about economic expediency, it was about spin. 

Now that the message has changed from 'stay at home' to 'keep alert', the responsibility for what happens has passed to the individual. It is now my responsibility and your responsibility to prevent the spread of the virus, despite the fact that the tools we need to do so have been found missing, wanting, absent or, in the case of the moderately clear messages about lockdown, have just been pulled from under our feet.

The CQC guidelines tell me, 'if you carry out procedures' properly then there will be minimal risk', the implication being that if I or a client get infected it will be due to my failure to use a mask properly. The government is now telling us 'if you go to work or school and social distance on crowded public transport remaining alert at all times, we can keep R below 1', the implication being that, if we don't, it is due to the failure of the general public.


At some point and by some means we have to be able to say, 'No. You are asking us to play roulette with the nation's health.' You have imposed policies that are the worst of all worlds. The lockdown is massively damaging to the economy (a price most of us thought worth paying to safeguard health), yet you are starting to lift precautions before R (the infection rate) has been consistently below 1 for longer than the incubation period of the infection, thus potentially throwing away all the advantage of the lockdown.
     

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