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National Covid-19 Research
A Biopsychosocial Analysis
Determinants, Impacts, Support Needs and Learning from the Pandemic
Report Five 09/07/20
Professor Kaz Stuart, Dr Elaine Bidmead, Ruth Browning, Sam Grimwood, Dr Catriona Roberts and Thea Winn-Reed.
4
Contents
The Theoretical Framework ___________________________________________________ 7
Method ___________________________________________________________________ 8 Narratives of Covid-19 Survey and Research ________________________________________________ 9 Mental Wellbeing Survey _______________________________________________________________ 9 Student Wellbeing During Lockdown Survey _______________________________________________ 10 Health in Cumbria During Covid-19 _______________________________________________________ 10
Characteristics of Participants ________________________________________________ 11
Biological Characteristics ________________________________________________________ 11 Age ________________________________________________________________________________ 11 Gender _____________________________________________________________________________ 12 Ethnicity ____________________________________________________________________________ 12 Pre-existing Health Issues ______________________________________________________________ 12 Summary of Biological Characteristics ____________________________________________________ 14
Psychological Characteristics _____________________________________________________ 14 Mental Wellbeing ____________________________________________________________________ 14 Summary of Psychological Characteristics _________________________________________________ 15
Social Characteristics ___________________________________________________________ 16 Relationship Status ___________________________________________________________________ 16 Employment Status ___________________________________________________________________ 17 Range of Jobs ________________________________________________________________________ 17 Housing Situation ____________________________________________________________________ 19 Area _______________________________________________________________________________ 20 Garden Space ________________________________________________________________________ 20 People Living in the Same Housing _______________________________________________________ 21 Hobbies ____________________________________________________________________________ 22 Sports ______________________________________________________________________________ 23 Religious Beliefs ______________________________________________________________________ 23 Region _____________________________________________________________________________ 24 Summary of the Social Characteristics ____________________________________________________ 24
The Impact of Covid-19 ______________________________________________________ 26
Biological Impacts ______________________________________________________________ 26 Contracting Covid-19 __________________________________________________________________ 26 Shielding, Quarantine and Isolating Behaviours _____________________________________________ 27 Impact on Other Health Conditions ______________________________________________________ 28 Access to Food _______________________________________________________________________ 31 Summary of Biological Impacts __________________________________________________________ 31
Psychological Impacts __________________________________________________________ 33 States of Mental Wellbeing _____________________________________________________________ 33 Emotive Responses ___________________________________________________________________ 34 Causes of Worries ____________________________________________________________________ 35 Causes of Stress ______________________________________________________________________ 36 Loneliness __________________________________________________________________________ 38 Ability to Sleep _______________________________________________________________________ 39 Self-efficacy _________________________________________________________________________ 39 Barriers and Enablers to Mental Wellbeing ________________________________________________ 40 Summary of Psychological Impacts _______________________________________________________ 42
5
Social Impacts _________________________________________________________________ 43 Losses Due to Control Measures _________________________________________________________ 43 New Social Activities __________________________________________________________________ 44 New Caring Responsibilities ____________________________________________________________ 45 Educational Impacts __________________________________________________________________ 46 Employment Impacts __________________________________________________________________ 47 Financial Impacts _____________________________________________________________________ 49 Overall Changes ______________________________________________________________________ 50 Summary of Social Impacts _____________________________________________________________ 51
Support Needs ________________________________________________________________ 51 Biological support ____________________________________________________________________ 52 Psychological support _________________________________________________________________ 52 Social support _______________________________________________________________________ 53
Learning __________________________________________________________________ 56 Learning for the NHS __________________________________________________________________ 57 Learning for Education and Social Care Sectors _____________________________________________ 59 Learning for Employers ________________________________________________________________ 59 Learning for Society ___________________________________________________________________ 61
Mental Wellbeing During Covid-19 Survey ______________________________________ 63
Findings __________________________________________________________________ 63
Changes to mental wellbeing during the Covid-19 pandemic ___________________________ 63 Quantitative Data ____________________________________________________________________ 63 Qualitative data ______________________________________________________________________ 67
Strategies used to support mental wellbeing ________________________________________ 70 Quantitative Data ____________________________________________________________________ 70 Qualitative data ______________________________________________________________________ 72
Others struggling to maintain mental wellbeing _____________________________________ 76 Quantitative and qualitative data ________________________________________________________ 76
Challenges to maintaining mental wellbeing ________________________________________ 77 Quantitative and qualitative data ________________________________________________________ 77
Further Support Needs __________________________________________________________ 77 Qualitative data ______________________________________________________________________ 77
Summary of the Mental Wellbeing During Covid-19 Survey ____________________________ 79
Student Wellbeing During Lockdown Survey ____________________________________ 80
Student Ages __________________________________________________________________ 80
Student Genders _______________________________________________________________ 80
Life Satisfaction _______________________________________________________________ 81
Time in Home Education ________________________________________________________ 82
Time Doing Exercise ____________________________________________________________ 83
Access to Healthy Food _________________________________________________________ 83
Boredom _____________________________________________________________________ 84
General Wellbeing _____________________________________________________________ 84
School Support Received ________________________________________________________ 85
Summary of the Student Wellbeing During Lockdown Survey Findings ___________________ 85
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Conclusion ________________________________________________________________ 87
Participants ___________________________________________________________________ 87
Biopsychosocial Findings ________________________________________________________ 87
Support Needed _______________________________________________________________ 88
Learning from the Pandemic _____________________________________________________ 88
The Student Wellbeing During Lockdown Survey Findings _____________________________ 89
Recommendations _________________________________________________________ 90 Biological ___________________________________________________________________________ 90 Psychological ________________________________________________________________________ 90 Social ______________________________________________________________________________ 90
Next Steps ____________________________________________________________________ 91 Thanks _____________________________________________________________________________ 91
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The Theoretical Framework This national research into Covid-19 is being undertaken with a biopsychosocial lens, that is to say, exploring how people’s biological, psychological and social factors influence them with regard to Covid-19 and how they respond to Covid-19 and its control measures biologically, psychologically and socially. A range of biopsychosocial factors were structured into a two-dimensional analytical framework. One dimension identified pre-existing factors about individuals, whilst the second dimension identified the consequences of Covid-19. Some factors were known prior to the research and formed a skeleton analytical framework. This was expanded iteratively as each narrative was explored with new factors recounted in narratives added to the framework. To date 305 narratives have been collected and analysed through our own call for research, and in addition, a 11,275 strong data set from partner Edukit. Data to be added for the next report includes: a further 75 survey entries, 301 data sets from Healthwatch, 20 stories / interviews / poems.
8
Method This research has adopted a mixed method approach, combining qualitative (word based) and quantitative (number based) data together to create a sense of what is happening and for how many people this is true. The data has also been gathered with mixed data collection tools; some people have submitted personal narratives as stories and poems, whilst others have completed qualitative and quantitative surveys. We have also joined forces with partners to ensure an even richer and broader range of perspectives can be brought together. The data sets have included:
Name Type of Data Owner Response Rate to Date
Inclusion in this Report
Narratives of Covid-19 Survey
Qualitative University of Cumbria
380 305 narratives included in this report Further 75 to be analysed
Open narratives / interviews on Covid-19 research
Qualitative University of Cumbria
20 To be included in next report
Additional Mental Wellbeing During Covid-19 Survey
Mixed quantitative and qualitative
University of Cumbria
36 Included in this report
Student Wellbeing During Lockdown Survey
Quantitative Edukit 11,275 Included in this report
Health in Cumbria During Covid-19 Survey
Mixed quantitative and qualitative
Healthwatch 303 To be included in next report
In summary, this report contains the findings from 305 respondents to the narratives of covid-19 survey, 36 respondents to the mental health during covid-19 survey, and 11,275 respondents from the Edukit student wellbeing during lockdown data. This gives a total of 11, 716 views.
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Narratives of Covid-19 Survey and Research As the participants were asked to share their stories, there were no prompts for particular pieces of information. Whether responding to the survey or to an interview the only questions posed were to: tell us something about life before the pandemic, and to explain the impact it was having, what support needs they have, and what they thought should be learned from the situation. In this respect, consequently, these two forms of data collection were highly self-directed, open-ended and qualitative. The data from the online survey was coded using the existing categories in the theoretical framework, and where a new code emerged, it was added to the framework. In this respect the coding was abductive and the framework continually emerging. A second step in the analysis was to count the frequency of references to each code. A note of caution is needed here; because questions did not prompt the elicitation of particular data, absence of a term does not necessarily mean it was not true for the individual, they may simply have not mentioned it. For this reason, the data in the graphs does not total the number of participants (n=305) and cannot be converted into percentiles. The third analytical process was to add the frequency of the occurrence of an impact, support need, or learning against the characteristics of the participants. In this endeavour we are seeking patterns where particular groups may be predisposed to particular outcomes. It is too early to know if this will be fruitful or not. This analytical process is mixed method in that the abductive analysis is inductively developing a qualitative framework of codes to enable us to understand people’s experience, and these experiences are then turned into quantitative data (or quantitised) in order to understand the prevalence of them. The following charts show both these aspects of the data. The quantitising of the qualitative data has, however, ‘flattened’ the richness and nuance of the respondent’s stories, reducing the complexity and depth of the impacts. To address this some illustrative quotes are added to each chart. The narratives and poems emailed in and the interviews conducted were collated in text format and then analysed thematically under the main headings of the theoretical framework. As before, any new codes added new dimensions to the framework. This data will be included in the next report to further bring to life the quantitised data in charts. This research is limited in that the respondents to the main survey are mostly aged 45-65, female and living in detached properties with gardens (see characteristics below). From this respect it is high in validity as regards the people most represented, but cannot be taken as representative of society in the whole. Mental Wellbeing Survey The psychological impact of Covid-19 and its control measures seemed particularly striking from the narrative research and prompted a second survey to be launched on the 28th May 2020 and circulated to all previous respondents. This survey comprised quantitative and qualitative questions in an online survey. There were 36 responses between 28th May 2020 and the 22nd June 2020. There are two limiting factors to this data set. Firstly, the sample is very small (n=36) and secondly, the sample is skewed, as per the main survey, to women aged 45-65 who live in detached houses. From this respect it is not illustrative of the experiences of the breadth of society and is therefore also not generalisable.
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Student Wellbeing During Lockdown Survey A national organisation called Edukit helps schools to gain better insight into student needs through wellbeing surveys and helps to connect them with impactful youth services. During the pandemic Edukit have been surveying school pupils in order to understand how their wellbeing has been affected by Covid-19 and home education. Their online survey is quantitative, asking young people to select one answer from a pre-defined range. They had 11,275 responses at the time of writing from across the UK. Edukit’s data was analysed and cleaned before it was shared with the University of Cumbria. We analysed the data using descriptive statistics and present the range of scores for each question. The addition of this data set brings the average age of participant significantly lower than in the narratives of Covid-19 survey alone, however, the questions are not as open and a more limited range of findings emerges. Health in Cumbria During Covid-19 Healthwatch Cumbria are an independent organisation set up to champion the views of patients and social care users in Cumbria, with the goal of making services better and improving health and wellbeing. They have been inviting people to share their experiences of health during Covid-19 via an online survey. The survey comprises 34 questions that are both defined quantitative answers and open qualitative answers. At the time of writing there were 301 respondents from Cumbria. This data is currently being analysed using descriptive statistics and thematic analysis and will be reported in the next version of findings.
11
Characteristics of Participants It was important to understand the range of biological, psychological and social characteristics which people already experienced before the pandemic. These are likely to be determinants of social and health outcomes themselves (Marmot, 2010; 2020), particularly in the context of Covid-19, where, for example, living in a small house with many occupants might impact on a person’s ability to stay in social isolation. The data analysis from the ‘narratives of Covid-19’ survey is organised into biological, psychological and social characteristics and then impacts. The characteristics describe the sample for the ‘narratives of Covid-19’ survey and the ‘mental wellbeing during Covid-19 sample, but do not include the data set from the ‘student wellbeing during lockdown’ survey which is kept as a discrete section following this analysis. Biological Characteristics Age All the respondents disclosed their ages. The respondents were most frequently aged 46-65 (n=157), followed by 26-45 year olds (n=89), perhaps because these groups are well connected on social media, have time to engage in research, and are keen to make a contribution to recovery from the pandemic.
1
20
89
157
38
00
20
40
60
80
100
120
140
160
180
under 16 17-25 26-45 46-65 66-85 86 or over
Frequency of Ages (n=305)
12
Gender The majority of participants (96%, n=293) disclosed their gender. 79% (n=231) were female, 20% (n=60) were male and 1% (n=2) indicated they were ‘other’. This indicates that a gender bias will exist in the findings. Whilst this is an assumption, women may be experiencing increased caring responsibilities with elderly parents and / or home education. Recent research indicates that contributions to journals by female researchers have fallen during the pandemic, while those by male researchers have risen. This has been attributed to the majority of childcare falling to women (Zimmer, 2020).
Ethnicity None of the respondents indicated any ethnicity. Pre-existing Health Issues A total of 189 people (62%) identified a pre-existing health issue. A range of 55 health issues were identified by the respondents and these were grouped into the 15 different areas shown in the chart below.
20%
79%
1%
Percentages of Gender (n=293)
M F Other
13
Being ‘on medication’ was a key indicator of health issues (n=24) and applied to people experiencing different health issues:
“Hypothyroid after thyroid cancer 2yrs ago…require lifelong medication” (P.90) “Rheumatoid arthritis and asthmatic so shielding due to medication” (P.202)
“On regular medication for thyroid disease (once a day)” (P.205) Cardiovascular issues were the most prevalent (n=39) followed by people with transplants (n=31). Transplant recipients were high in the sample as the survey had been circulated through the British transplant community.
“High blood pressure and Glaucoma” (P.237) “…kidney transplant …diabetic” (P.47)
“I have myeloma & breast cancer” (P.195) Respiratory issues were cited by 12 people, for whom Covid-19 as a respiratory disease, would be particularly worrying.
“I have medication for asthma and high blood pressure” (P.15) “I am obese, and have mild asthma…and as a 9yr old suffered with pneumonia which has
limited my lung function” (P.88) “Cystic fibrosis, double lung transplant, diabetic due to CF, immune comprised” (P.124)
“…my wife has an autoimmune respiratory disease” (P.182)
31
24
1012
7
31
8
39
42
8
3 3
22
2 1 2
7
0
5
10
15
20
25
30
35
40
45
Unspecif
ied
Undergoing t
reatm
ent
On medica
tion
Disabilit
y
Resirato
ry iss
ue
Skin co
ndition
Transp
lantee
Cance
r
Cardiova
scular
Anaemia
Neurological
Orthopae
dic
Senso
ry im
pairment
Gastrointes
tinal
Disease
Endocri
nal
Pregnan
t
Allergi
esOther
Frequency of Pre-existing Health Conditions (n=189)
14
Summary of Biological Characteristics The age range of respondents indicates that a large proportion of the sample are potentially in an ‘at risk’ group. Children and adolescents have proven to be less likely to experience Covid-19 at all, and to experience fewer symptoms if they do catch it. The disproportionately large number of women completing the survey may be a factor affecting the analysis, as there is a difference in risk factors between the sexes for suffering from Covid-19. This could hypothetically lead to a lowered sense of risk for female respondents as opposed to males. The health issues disclosed do, however, indicate the respondents are likely to be at risk given cardio-vascular, respiratory and wider health issues. The age range of respondents, together with the number of reported pre-existing health conditions, including cardio-vascular and respiratory diseases, indicates that a large proportion of the sample are potentially in an ‘at risk’ group. Notwithstanding, women are generally experiencing better outcomes having contracted Covid-19 than men, and children and adolescents are less likely to experience Covid-19 seriously or at all. Psychological Characteristics Mental Wellbeing A total of 72 people (24%) identified a range of nine pre-existing areas of mental wellbeing. These could be positive or negative, issues they are dealing with or an indication of their state of mind prior to lockdown.
Of these, most identified areas that impact negatively on mental wellbeing (n=50, 16% of respondents) including depression (n=24), anxiety (n=16), loneliness (n=5), PTSTD and anorexia nervosa (n=1 each).
24
16
25
2 1
94
9
05
1015202530
Depressio
n
Anxiety
PTSD
Felt l
onely
Lacke
d confid
ence
Anorexia Nervo
saHap
py
Satifi
ed with
life
Feel se
nse of belongin
g
Frequency of Pre-existing Mental Wellbeing Issues (n=72)
15
“Anxiety and PTSD” (P.11) “I have PTSD and can find social situations very difficult” (P.168)
“Being treated for depression/low mood after a self-harm relapse” (P.169) “Depression; lonely” (P.188)
“Anxiety …Depression …Panic attacks” (P.242) A total of 22 people (7%) indicated attributes associated with good mental wellbeing including: happiness and sense of belonging (n=9 each) and feeling satisfied with life (n=4).
“I live in a tiny village happily on my own in the North Pennine Fells… I'm fine & actually happy pottering around outside all day” (P.233)
“I am well, happy, active enjoying Today, ever day!” (P.234) “..feeling safe, secure, lucky, happy, relaxed and settled” (P.28)
“Speaking personally the sense of community local to us has strengthened hugely” (P.235) “…people seem more content and happy to be at home” (P.279)
Summary of Psychological Characteristics The 7% of people indicating areas of good mental wellbeing may have some insulation from the effects of Covid-19 and its control measures. Conversely, the 16% of people indicating issues relating to poor mental health may be at greater risk from the psychological impacts of Covid-19.
16
Social Characteristics Relationship Status A total of 292 respondents (96%) disclosed their relationship status. There were four different types of relationship statuses mentioned including: being married, single, with a partner, or other.
The majority of the respondents were married (n=128, 44% of those who indicated), or in a relationship with a partner (n=88, 30%).
“I live with my husband” (P.8) “Living with wife in rural village” (P.46)
“Live with a partner” (P.57) Being in a relationship may mitigate against some of the negative aspects of loneliness although this in itself provides potential for relationship tensions and difficulties in such intense times.
“living in a small flat with my partner means we are managing projection and containing these anxieties and depression, which can be exhausting!” (P.7)
“Some tension between me and my husband” (P.12) “being at home with my wife and daughter all the time has been trying at times” (P.192)
28 people were single, 9% of the entire sample, and 10% of the people indicating their relationship status.
48, 16%
128, 44%
88, 30%
28, 10%
Percentages of Relationship Status (n=292)
Single Married With partner Other
17
Employment Status There were 407 employment statuses mentioned in the survey. These exceeded the total number of participants (n=305) because many people also discussed the employment status of partners and many also had dual roles (e.g. in employment and volunteering). A total of ten different employment statuses were identified. The most frequent of these for the participants was working at home (n=73) and being unemployed or redundant (n=65). For partners, the most common status was being furloughed (n=43). This suggests a wide range of complex home environments – both partners working, one working one unemployed, one working, one furloughed, both unemployed and so on. These can all create tension through lack of money at home, worry about the future and ‘unequal’ demands.
The complexities are brought to life with the following quotes: “Normally have my boyfriend here with me part-time but he is living away from me as he is
a key worker and he does not want to compromise my health” (P.2) “…work part-time as I'm a key worker. Offered to work full time but have been redeployed
so working in a totally new role” (P.170) “Husband furloughed, I'm teaching from home” (P.209)
“Working from home and home schooling is a huge challenge” (P.219) “I have a hugely increased workload through volunteering, work, schooling, living with a key
worker” (P.219) “I own a shop, 16 staff on furlough so I’m doing all the work now… it’s really hard & quite
stressful” (P.271)
Range of Jobs A total of 64 people indicated the type of job they were doing or were furloughed from. 61% of these were in keyworker roles and as such, might be at a greater risk than people in non-keyworker roles.
73
30
65
24
1 4
3037
52
21 198
43
01020304050607080
At work
- at h
ome
At work
- keyw
orker
Unemploye
d redundan
t
Furlo
ughed
Leav
e - unpaid
Leav
e - paid
Maternity
leav
e
Retired
Volunteer
Other
Frequency of Employment Status (n=407)
Personal Status Partner / Housemate Status
18
“As a key worker, I support children leaving the care system” (P.112) “I and my partner are both keyworkers” (P.152)
“I've been furloughed” (P.176) “I have been furloughed from work” (P.272)
A range of 32 different jobs were indicated by those in employment and these were coded into 11 different types of jobs.
The employment most frequently cited was that of teaching, followed by healthcare – both key worker roles, and both sectors with female gender bias. “I am a headteacher at a local primary school. We are open for the children of key workers
and vulnerable children and I have been at work every day we are open” (P.8) “Work partly in Dragons Heart Hosp as research nurse- redeployed” (P.187)
39, 61%
25, 39%
Percentage of Key-workers (n=64)
Keyworkers Non-keyworkers
18
97
32
8
2
65
2 2
02468
101214161820
Educa
tion
Health
Socia
l Care
Policing
Infrastr
ucture
Universi
ty
Psychologic
al
Holistic
Journalism
Self-e
mployed
Other
Frequency of Jobs (n=64)
19
“…am a teacher and so am working in a childcare hub and linking with pupils/parents/staff online now” (P.245).
These very different employment statuses will have an impact on people’s exposure to Covid-19 as well as their ability to deal with the effects of the pandemic. Some of the employment statuses are both determinants and impacts – being furloughed for example, only exists due to Covid-19, and will reduce a person’s exposure to Covid-19.
Housing Situation 86% of the respondents indicated where they lived. A range of 18 living spaces were inhabited by the respondents. These were very diverse including everything from a barge to a bedsit.
Respondents most frequently lived in semi-detached or detached housing indicating they may also have a relatively high socio-economic status. A total of 14 people lived in small or precarious arrangements such as park homes, temporary accommodation or bedsits.
“I live with my husband in a small semi with a back garden” (P.9) “Detached bungalow, large garden, rural setting” (P.274)
“I live in a 2 bed flat with my partner and 2 year old daughter” (P.300) “I live in a Park home” (P.190)
“I live in a large barge with my husband” (P.162)
01020304050607080
Home owner
Detached
spac
e
Semi d
etach
ed
Terra
ced
Flat
Bungalow
Cottage
Farm
Renting h
ouse
Bedsit / s
tudio
Bedroom in house
Council housin
g
Ex-co
uncil house
Park home
Housing A
ssoca
tion
Barge
Homeless / t
emp
Care home
Hospita
l
Frequency of Housing Situation (n=263)
20
Area In addition to this, the majority of people who commented (n=99) lived in a rural area (n=52 or 53%) as compared to urban areas (n=34 or 34%). This may also indicate a level of relative affluence.
“Live with my husband and 2 dogs in a 4 bed bungalow in a rural location” (P.11) “Living with wife in rural village” (P.46)
“helped by our fortunate living conditions and rural location” (P.261) Garden Space A third indicator of the socioeconomic status of this group is their access to garden space. Of the 132 people who indicated their garden space, 92% had gardens. Whilst the size of the garden may vary significantly, access to private green space is a privilege.
34, 34%
52, 53%
8, 8%5, 5%
Percentage of Area (n=99)
Urban Rural Suburban Seaside
4%
92%
3%1%
Access to Garden Space (n=132)
No garden Garden Allotment Patio Area
21
“We live in a large five bedroomed semi detached house with large garden” (P.272)
“Detached bungalow, large garden (P.274) “Live in a large house with a large garden in a village” (P.282)
People Living in the Same Housing Many of the respondents (n=266, 87%) indicated whether they had other people living in their housing. A range of 16 different co-habitation arrangements were mentioned, some of which have changed since the pandemic control measures were put in place.
The most frequent of these, corresponding to the relationship status, is living with a partner or spouse (n=98). A total of 70 people indicated they have with dependents living with them, including parents, children and step-children. Since lockdown 15 people indicated they had new people living with them as a result of the pandemic.
“I live with my wife and two daughters, aged 18 and 21” (P.6) “Live with a partner” (P.57)
“Live with husband and a two year old” (P.58) “Live with husband and one teenage child” (P.87)
“I live alone in a small terraced house” (P.179) The amount of living space a person experiences may have a huge impact on their ability to cope with an extended lockdown or shielding. Having a large house you own, with a garden, with few others in it, in a rural area could be considered protection from the impacts of
32
93
5 10
58
2 2 312
6 102
112 38
1 5 10
102030405060708090
100
Noone
Partner
/ spouse
Ex husb
and
Parents
Children
Step Child
ren
Adult child
's girlf
riend/b
oyfriend
Other family
member
Siblin
gs
Grandch
ildren
House mate
s
Friend
Foste
r care
r
Lodge
r
Hospita
l inpati
ent
Other
Frequency of People Living in the Same House (n=266)
Normally Since Lockdown
22
Covid-19 as opposed to living in a bedsit, with no outdoor space, with other people in an urban environment. Hobbies The 305 respondents mentioned a range of 453 hobbies, an average of 1.5 hobbies each. A range of 27 different hobbies were identified.
The most frequent hobby was gardening, mentioned by 78 people. This suggests that more people may have gardens than indicated above. Reading and writing was the second most frequent (n=67). It seems notable that many of the activities listed are not impacted by Covid-19. Exceptions include world travel, socialising, camping and shopping. This meant people could continue to engage with them, and perhaps even engage in them more if furloughed or unemployed. These hobbies might also offer a distraction from Covid-19 which could insulate individuals from the impacts of the pandemic.
“I enjoy reading” (P.8) “a positive I am cooking more healthy food” (P.15)
“I am currently reading a lot” (P.48) “We like cooking” (P.178).
2936
2822
78
3
25
2
27
1
19
5
19
3
67
9 7
19
2
31
39
1 1 2 2 1 20
102030405060708090
Art /
pai
nt /
sket
chSe
w /
knit
/ cra
ftDI
Y / p
rope
rty
/ wor
ksho
pCo
okin
gGa
rden
ing
Danc
ing
Mus
ic /
inst
rum
ent /
sing
ing
Herb
alist
Film
s / T
VM
otor
cycl
ing
Boar
d ga
mes
/ jig
saw
Com
pute
r/El
ectr
onic
Gam
esTr
avel
Lang
uage
sRe
adin
g / w
ritin
gM
indf
ulne
ss/M
edita
tion
Phot
ogra
phy
Fam
ily li
fe /
socia
lisin
gCa
mpi
ngSc
outin
gM
embe
r of v
ario
us…
Hist
oria
nPr
actic
al C
onse
rvat
ion
Wor
kBi
rd w
atch
ing
Lego
Pro
ject
sSo
cial M
edia
Curr
ent A
ffairs
Shop
ping
Frequency of Hobbies (n=453)
23
Sports A total of 222 people (73%) engaged in sports activities. A range of 25 different sports were identified.
Walking was the most frequent sport engaged in (n=49) and this has been possible, even if for only an hour a day, throughout the lockdown.
“My hobbies include walking” (P.7) “I like the quiet and the birdsong and lack of traffic when I'm cycling” (P.10)
“I like walking” (P.88) Some other sports may have been possible such as cycling and some have been mediated by online platforms such as yoga. Many sporting activities, however, are contingent on other people, other places, or equipment (e.g. boxing). In this respect, people’s sporting activity will have been differentially impacted by Covid-19. As sport and exercise has a longer term impact on health, loss of any form of exercise may have later consequences in two respects, firstly using the sport as a release of stress and secondly through the mental health impacts of being unable to train for competitive or high performance athletes worrying about being able to maintain skills and fitness. Consequently, in the context of Covid-19, exercise can be seen as a protective factor or risk factor, a characteristic and an impact. Religious Beliefs Four people said they were of the Christian faith, and no one mentioned any other religious beliefs.
“three of us have a Christian faith and attend Church” (P.6) “…love of God will see me through” (P.249)
7 5
49
5
1721
15 5 2 1 1 3 2 1
35
8 71 2
37
3 1 1 1 10
10
20
30
40
50
60
Swim
min
gCl
imbi
ngW
alki
ngHo
rse
Ridi
ngRu
nnin
gCy
cling
Row
ing
Kaya
king
Gym
Golf
Wei
ghtli
fting
Boxi
ngKe
epin
g Fi
t/Ph
ysio
Gene
ral S
port
Saili
ngYo
ga/P
ilate
sTa
i Chi
Yoga
Foot
ball
Netb
all
Cros
sfit
Zum
baSc
uba
Divi
ngRu
gby
Badm
into
nFi
shin
g
Frequency of Sports (n=222)
24
Region A range of 69 different places were mentioned by 102 participants (33%). These were grouped into 24 different counties / countries as shown below.
The most frequent counties were Cumbria (n=27) and Lancashire (n=15), perhaps because of the location of the research team. The data does, however, show that people from across England (n=91), Wales (n=10) and Scotland (n=1) participated. There were no participants from Ireland or Northern Ireland. The data is therefore biased to England and furthermore to the north of England.
“I live in Carlisle” (P.3) “I live in Gwyddelwern, Denbighshire. North Wales” (P.59)
“Live on outskirts of Carlisle” (P.168) “West Cumbria” (P.275)
“I live in Whitehaven, Cumbria” (P.277) “I live in a seaside town, in the southwest” (P.51)
Summary of the Social Characteristics The social characteristics section was the most complex with factors encompassing relationships, living arrangements, housing, employment, hobbies and sports. This raises a few key points. Firstly, very disparate social characteristics will influence the different ways in which people experience Covid-19 and its control measures. Secondly, social networks and their proximity may act as an insulator (people to turn to) or as a risk factor (too many people around / to support). The notion of ‘occupation’ has emerged as being of
1
27
1 1
15
14 3 2 1
10
13
1 1 2 24
26
24 3
5
0
5
10
15
20
25
30
Scot
land
Cum
bria
Tyne
and
Wea
rNo
rthu
mbe
rland
Lanc
ashi
reM
anch
este
rYo
rksh
ireDe
rbys
hire
Liver
pool
Ches
hire
Wal
esNo
rtha
nts
Shro
pshi
reHa
mps
hire
Cove
ntry
Oxf
ords
hire
Hert
ford
shire
Lond
onBe
dfor
dshi
reCa
mbr
idge
shire
Dors
etKe
ntEa
st S
usse
xSo
uth
Wes
t
Frequency of County (n=102)
25
significance, occupation within occupational therapy, used here to refer to engaging in meaningful activity, whether a job, hobby or sport, and this would seem to have significance in how people manage Covid-19. The overlap between the biological, psychological and social has become apparent. A person’s age or gender may influence what one does in one’s life. Health status may affect how one feels. Activity, of all sorts, may support mental wellbeing and health. As a result, whilst separate these are deeply interconnected. The analysis of characteristics is also beginning to highlight that a background characteristic may also be a determinant of how Covid-19 is experienced, and so the division of cause and effect may also be intertwined rather than a duality.
26
The Impact of Covid-19 Biological Impacts Contracting Covid-19 All of the respondents commented on their Covid-19 status, and / or that of other people they knew. This led to 354 responses from the 305 respondents.
Respondents most frequently indicated they knew of someone who had contracted Covid-19 (n=136, 45%).
“I know someone who has had the virus” (P.6) This included three participants who experienced bereavement as a result of the virus:
“Two people (one family) we know have died from the virus” (P.5) “Unfortunately I know quite a few people who have been severely affected by the virus who
have ended up in hospital or who have died, most of whom I would have considered ' healthy, well and reasonably young'” (P.297)
Only two respondents knew they had contracted it personally from a test result, and only three had negative test results. This would suggest that only a very low percentage of respondents have been tested (n=5, 1.6%).
2 3 1 5
47
68
42
7
136
3 7
33
0
20
40
60
80
100
120
140
160
Teste
d and had
it
Teste
d not had
it
Teste
d no resp
onse
Not test
ed
Shown sy
mptoms since
C-19 known
Showed
symptoms b
efore C-19 kn
own
No symptoms
Family
had th
e virus
Know someo
ne had
it
Know someo
ne who has
died from it
Many f
riends k
now someo
ne who had
virus
Other
Frequency of Covid-19 Symptoms (n=354)
27
“I have been tested and know I have had the virus” (P.200)
“I have been tested and know I have not had the virus” (P.187)
A total of 115 respondents (38%) had shown symptoms, 47 people had shown symptoms since announcements about Covid-19 became public and a further 68 indicated they had shown symptoms before public announcements.
“I have had symptoms of the virus” (P.186) “Had flu like symptoms in January, colleagues from Italy visited” (P.79)
“Due to her daily contact with the sick in A&E including travellers from China, I'm certain that we were both ill with Covid-19 in early January - the symptoms fit and we both suffered
for around 3-4 weeks” (P.238)
Shielding, Quarantine and Isolating Behaviours A total of 70 respondents indicated whether they were shielding, had quarantined or self-isolated (23%) or not, however, non-disclosure does not necessarily mean this was not true for them.
A total of 37 people had shielded, either individually, as a family, or living with a partner who was shielding. Only five respondents mentioned having gone through a period of quarantine. One person under 70 and three people over 70 had self-isolated. One person was living away from home and 20 people were living separately within the same house in order to protect family members from the exposure to Covid-19 they had as key workers. Three people commented that they were unable to isolate as they had to attend work duties.
“We will be, as all shielding are, very restricted until a vaccine is found” (P.202)
32
93
5 10
58
2 2 3 12 6 10 11 38 1 5 10
20406080
100
No-one
Partner
/ spouse
Ex husb
and
Parents
Children
Step Child
ren
Adult child
's…
Other family
member
Siblin
gs
Grandch
ildren
House mate
s
Friend
Lodge
r
Other
Frequency of People Living in the Same House (n=266)
Normally Since Lockdown
28
“recent lung cancer patient so "shielding"” (P.229) “We are isolating as a family, having quarantined apart (my husband and children at home
and me in an empty house nearby) for two weeks to make sure we were all safe, before moving back together” (P. 178)
“Am pregnant so having to isolate” (P.270) “Normally have my boyfriend here with me part-time but he is living away from me as he is
a key worker and he does not want to compromise my health” (P.2) “We try and maintain 2mtrs apart if in the same room. He stays in the lounge and I stay in the sun room most of the day. If we watch tv together I sit as far away as possible in the
lounge. He is staying in the main bedroom with the en-suite and I sleep separately and use the family bathroom. We have separate towels” (P.193)
Living away from the people you love, living in physical isolation, and losing physical contact may have a long-term adverse effect on health and wellbeing. Loneliness, for example, is known to adversely impact on life expectancy. Shielding, quarantine and isolation are protective measures, which may themselves give rise to adverse health effects over an extended period of time. Impact on Other Health Conditions A total of 42 people (14%) mentioned they were experiencing worsened health conditions aside from coronavirus.
Health issues had worsened for 33 respondents, for example people with diabetes, blood pressure problems, irritable bowel syndrome, and allergies. This may be connected to
33
26 6
0
5
10
15
20
25
30
35
Health conditionworsened in
lockdown
Health conditionworsened as appt
delayed
Need oxygen Operation delayed
Frequency of Worsening Health Conditions (n=42)
29
changes in health lifestyle (e.g. food and exercise) as well as the increase in other psychological and social impacts. Stress, for example, can drive increased consumption of sugary food, which may increase blood sugar levels, worsening Diabetes. Some examples support such links:
“I have a stress-related skin condition which is flaring up at present” (P.203) blood sugar levels have become erratic” (P.6)
“I already take medication for anxiety, partly to help my IBS symptoms, and my tummy is telling me I’m more anxious than usual!” (P.8)
Six people now needed oxygen specifically, but the reason for this is not known, and could be Covid-19 related, or due to a decline in other respiratory conditions.
“Currently have an NHS bed and NHS supplied oxygen” (P.200) A total of three people disclosed that they had delayed treatments or operations which would also adversely affect their health. This biological impact is only beginning to emerge in research data and may have a significant impact on society.
“Chronic health condition. Regular medication. I was waiting for hospital appointment for treatment prior to Covid-19. Under the circumstances, I feel like I can't 'chase' this
appointment!” (P.177) “I have been referred to hospital for further tests as an urgent case on 1/04/20 my
appointment will be June 23rd!” (P.275) “I have regular injections… These have been suspended for three months. This will comprise
my immune system and make me more vulnerable to catching the virus” (P.21) Changes in Health Choices 35 participants (11%) of the respondents commented on changes in their health choices and lifestyle.
30
The most frequent factor was eating more (n=10), perhaps driven by extended periods at home with food readily available and offering comfort or distraction from the current context. Conversely four people were eating more healthily with time to cook. No one mentioned eating less food. With regard to exercise, ten people found lockdown was impacting negatively and they exercised less, whilst six people mentioned increased exercise as they were furloughed. For some people the diet and exercise factors compounded each other:
“I'm snacking more and exercising less than usual” (P.256)
“I am overeating more due to having time to cook and bake” (P.129) ”Seems that people may be healthier in mind and body as they value having time to do
things, to cook instead of going to McDonald's, to exercise with the children instead of going to the gym” (P.247)
“We do lots of baking and home cooked meals too” (P.202) “…doing more gardening and cooking than usual” (P.203)
“I've enjoyed having time to do household chores and cooking” (P.297)
“I like to walk, jog and attend exercise classes...I’m missing those…became ill with the virus (?) on 23rd March…been very tired since…so have hardly exercised at all. I miss that” (P.14)
“…lack of exercise” (P.19)
“The amount of people cycling walking and running has been phenomenal…a healthier nation is something positive I would like to see out the back of this” (P.17)
“…getting more exercise which is good” (P.26) “Enjoy exercise and have relished once daily opportunity to do it!” (P.146)
Whilst having minimal immediate impact, changes in healthy choices over an extended period of time may establish habits (for better or worse) that will affect health longer term and is therefore of significance.
15
4
0
6
10
0
2
4
6
8
10
12
14
16
Eating more Eating morehealthily
Eating less Exercising more Exercising less
Frequency of Changes in Health Choices (n=35)
31
Access to Food Only 64 people mentioned how they were accessing food (21%). The most frequent response (n=22) was having food delivered to their door, however this was not possible for everyone and a number of people either relied on friends and family for food (n=11), or shopped for other friends and family themselves (n=13).
“We are having online supermarket deliveries” (P.142) “…online delivery of food and medication supplemented by neighbour doing occasional
shopping” (P.240) “Friends delivering food to doorstep” (P.45)
“…sister and I have been taking it in turns to take groceries to our grandparents” (P.153) “deliver shopping to my mother (78) and shielding” (P.278)
Whilst buying food might appear trivial, the ability to choose the food you want to eat is an important factor in healthy choices. People may feel inhibited to ask for what they want, to specify exactly what they like, or be unable to buy products that have sold out. This means many people may have very different eating habits due to the availability of food, with potential impact on life satisfaction, happiness and nutrition. Summary of Biological Impacts As a result of Covid-19 and its control measures respondents were experiencing a range of impacts including: contracting Covid-19, bereavement, shielding and isolation, worsening health conditions, changes to health choices and access to food. Some of these are significant and have immediate impacts, whilst others will have significance later in life as cumulative effects. Many of them are linked to the biological, psychological and social characteristics of the respondents. Only people with underlying health issues need to shield, and isolating at home alone is very different to isolating with someone. The use of the word ‘isolation’ is also problematic, in that some people identified feeling isolation when were at home abiding by the lockdown rules whereas others use the term for when they are in total
0
5
10
15
20
25
Delivered Friends bring it Shop for others Shop for self
Frequency of Type of Access to Food (n=64)
32
isolation for two weeks with no access to the outside world. This ambiguity in the use of the term may cause some reliability issues in the findings. The biological impacts are therefore distributed unevenly across the population. These biological impacts also interact with other psychological and social impacts, with isolation perhaps leading to psychological issues, for example. The data has therefore supported the value of a biopsychosocial cause and effect modelling for understanding such a complex phenomenon.
33
Psychological Impacts States of Mental Wellbeing Eight different states of mental wellbeing were mentioned by 256 of the respondents (84%).
Generalised anxiety was most frequently reported (n=84) followed by stress (n=51) and depression (n=33) as negative mental wellbeing states. A further 18 people said they generally had worse mental wellbeing. 16 people referred to new obsessive compulsive disorder, however, it is hard to distinguish what is appropriate or obsessive hand washing and sanitation given current government guidance. 8 people reported new or worsened panic attacks prompted by the pandemic and its control measures. The following quotes give some insight into what people are experiencing: “Increased stress, anxiety and depression. Huge feelings of uncertainty and some fear” (P.3)
“I am struggling with depression” (P.6) “waves of anxiety & stress & worry for the future personally for self & family & for my
business & employees” (P.271) “…think the main effect is stress, anxiety and feeling helpless” (P.275)
“I am feeling despondent and wonder if I will die before the pandemic is over” (P.282)
Countering these 210 references to negative states are 15 people who said they experienced no change to their mental health and 31 people who experience less stress as a result of furlough or increased family support.
“enjoying being in my home more” (P.15) “Less stress than normal as partner at home” (P.52)
“Not a huge impact as I am able to work from home and socialise with friends and family online” (P.88)
“I feel happier than when I was working. I feel out of place at work” (P.176)
18
84
33
51
816 15
31
0102030405060708090
General
ly worse
Anxiety
Depressio
n
Stresse
d
Panic a
ttacks
Obsessive
compulsiv
e
No chan
ge
Feel le
ss str
essed
Frequency of States of Mental Wellbeing (n=256)
34
Emotive Responses Correlating to the overall deterioration of mental wellbeing is the prevalence of negative emotions the respondents were experiencing. There were 342 references to emotional responses, more than one per respondent, and a range of 25 emotions were named.
“Everyone in the house has experienced a wide variety of emotions during the first week…from the positive feelings around not rushing around to the more negative. Anxiety,
panic, frustration, anger” (P.59) “I think I am fairly resilient” (P.101)
“I feel lonely and abandoned.” (P.135) “…feel overwhelmed every so often” (P.222)
“I have experienced lower mood and feelings of worthlessness (P.301) 23 of the emotional states were negative, and the most frequently cited emotion was worry (n=59). One neutral and one positive emotional state were each mentioned too. The second most frequent emotional state mentioned was acceptance (n=35) indicating a neutral emotive state. The positive emotive state identified was happiness (n=24), which was caused by a range of factors such as increased time at home, increased exercise, less work stress and more time with a partner.
“I worry about the family we can’t see” (P.100) “I am worried about my parents who live a long way from here…are elderly &
vulnerable” (P.109) “Shopping has been a worry” (P.116)
“We are worried that we won’t have enough money if the lockdown continues” (P.122)
“Now we have all settled into a new way of life” (P.217)
20
59
26
8
27
4
2213
209 5 5 5
101 3 3 3 4 7
19
410
15
3524
010203040506070
Moo
d sw
ings
(sel
f /…
Wor
ried
Fatig
ue /
exha
ustio
nUn
appr
ecia
ted
Dem
otiv
ated
Trap
ped
Ange
rPo
wer
less
Disa
ppoi
nted
Sad
/ cry
ing
Fort
unat
eM
ore
sens
itive
Vuln
erab
leLo
ssGu
ilty
Wor
thle
ssFu
ll of
adr
enal
ine
Lost
app
etite
Ove
rwhe
lmed
Joyl
ess
Lone
lyAb
ando
nned
Rebe
lious
Resil
ient
/ co
ping
Acce
ptan
ceHa
ppie
r
Frequency of Emotive Responses (n=342)
35
“…we are simply accepting that this is a situation that we find ourselves” (P.235)
“really enjoying family time” (P.58) “My husband…is now working from home, which is helpful because of the time saved on the commute….nice to have him around…lunchtime and for a cup of tea in the morning. He also
seems to have more energy, I think the commute was quite tiring” (P.201) “Personally enjoying not having to travel for work anymore” (P.261)
“I have had a better work life balance.” (P.278) “…people seem more content and happy to be at home” (P.279)
“…good have some time out from the stress of the work place” (P.294) “I feel happy and relaxed” (P.295)
Causes of Worries As worry was the most frequent emotive state, the different causes of worries were analysed. There were 29 different causes of worry indicated in the respondents’ narratives, and a total of 338 occurrences of worry. This means each of the 59 people reporting worry above had an average of six causes of worry each.
“My neighbours continue to flout the social distancing rules” (P.27) “Our new worry would start when they ask School to go back in case the kids catch it and
bring it home” (P.32) “The thought of bringing home covid is ever present and terrifying” (P.112)
9 10
38
33
7
30
14
42
27
1318
84
1116
7 510
49 7
3 4 3 4 3
9
17
05
1015202530354045
Socia
l dist
ancin
gFo
r tho
se le
ss fo
rtun
ate
Abou
t edu
catio
nIm
pact
soci
al is
olat
ion
How
long
will
last
Fam
ilyKe
ywor
kers
KW b
ringi
ng it
hom
eCa
tchi
ng it
Pare
nts c
atch
ing
itEl
derly
clie
nts c
atch
itIm
pact
you
ng p
eopl
eIm
pact
eco
nom
ySu
ppor
ting
othe
rsPr
ecar
ious
wor
kFi
nanc
e / p
ensio
nUn
able
to m
ourn
Med
ical
app
oint
men
tsRe
fuse
to w
orry
Futu
re p
lans
The
next
spik
eGo
ing
shop
ping
Too
muc
h di
gita
l tim
eIn
activ
itySo
cialis
ing
agai
nDy
ing
alon
eHo
w to
care
for c
hild
if co
ntra
ctO
ther
in a
busiv
e re
latio
nshi
psTh
e ne
w 'n
orm
al'
Frequency of Causes of Worry (n=338)
36
“…worrying about family but also about the kind of society we'll return to (high unemployment, inequality, recession etc.)” (P.157)
“the behaviour of others has caused me some stress and anxiety” (P.192) “I worry for our health” (P.227)
There is a range of worries about the virus itself, e.g. contracting it (n=42) (the most frequent worry) or dying alone (n=4). A range of practical worries existed too, for example about going shopping (n=7) or caring for a child if sick oneself (n=3). Many of the worries are for other people – parents (27), children and young people (n=18), those less fortunate than oneself (n=10), indicating a high degree of empathy and altruism in the respondents. Many worries are future oriented too, such as what the new normal will look like (n=17), or when the next spike will occur (n=9). Some examples of worries are identified below:
“…dying without family with me” (P.149) “I don't want to be the one to bring home and possibly cause my daughter to be very ill and
possibly die” (P.71) “I do worry about what would happen if my mum who is 87 and has a heart and lung
weakness gets the virus” (P.10) “worries about my family who have a history of COPD and those who are still working in the
care industry” (P.88) “I am worried about how our family will deal with schools reopening” (P.178)
“I still worry about others who are stuck in flats or houses with no garden, and for the young people who aren’t able to socialise” (P.217)
Causes of Stress Similarly, data on the causes of stress were also identified in the narratives. 39 references to causes of stress were made across seven different areas.
7
4 4
8 8
11
4
0
2
4
6
8
10
12
Otherpeople's
behaviour
Medicalappts
cancelled
Collectingmedication
Relationshipissues
Not'performing'
Managingfamily
anxiety
Unable tosupport
mourning
Frequency of Causes of Stress (n=39)
37
The most frequent stress was managing the anxiety of another family member (n=11). These could include partners losing jobs or being on furlough, the anxiety of elderly parents worried about accessing food and medicine, and that of children anxious about exam results and lost learning. In addition to these caring stressors, family tensions were also a source of stress (n=8) with references to poor relationships being over-stretched in lockdown. Some people were stressed by the sense that they should be performing better in this ‘window of opportunity’, comparing themselves to those on social media who were learning a new language, de-cluttering houses, baking, re-writing songs and so on (n=8).
“My partner has just been made redundant from his labouring job so we are trying to survive on my part-time wage” (P.5)
“Stress is coming in a number of ways mainly my elderly Mum. Over this period the isolation has impacted on her mental capacity!” (P.9)
“All my children were due to sit exams this year (GCSEs and A Levels)…we've needed to revise their future plans allowing for more uncertainty” (P.272)
“Arguments with husband. Inflexibility of husband to recognise importance of both our jobs
at the start” (P.91) “We do get concerned but try not to snipe at each other, and try to talk about what has
troubled us at the end of the day so we can settle it before sleep” (P.94) “My marriage was already a little rocky and this is just thrusting our issues to the forefront”
(P.124) “…was some arguments at first due to my anxiety” (P.293)
“there's this idea that we should all become suddenly very creative etc…. I think some folks
are trying too hard & may not live up to their expectations of themselves in this respect” (P.109)
As the lockdown eases people are beginning to behave in more diverse ways and this was causing stress. Being around people not complying to rules in shops, seeing people flouting rules on TV, seeing litter, and other anti-social behaviours were beginning to cause stress (n=7). “People not taking this contagion seriously, had several confrontations with people getting
too close” (P.79) “…customers tend to take their frustration out on the workers, passively or verbally…making
our job harder, asking questions about covid19 that we cannot answer, not keeping their distance, becoming enraged when asked to queue, not respecting our personal space and
shouting at us when they cannot get what they want” (P.227) Other stressors were health oriented, for example, medical appointments being cancelled (n=4), working out how to collect prescriptions (n=4), and how to support grieving family members (n=4), all added a mental wellbeing toll.
“I’m also stressed about money, jobs and my kids potentially going back to school” (P.285)
38
“…been suffering with shortness of breath and pain for 6 weeks now, I need a lung function test and CT scan, but it was cancelled just as the virus took hold” (P.30)
“Still have to collect meds and do it from the back door as I dare not go in the shop. I need to get medications sorted out for delivery” (P.95)
My best friends mum died in hospital of coronavirus…Her funeral was the next day, I was not allowed to go, I cannot hold my friend and cook her food, or walk alongside with her as
she buried her mum” (P.30)
Loneliness Loneliness was reported by 24 people. This was mostly a negative experience for people (n=19) with people feeling isolated and lonely. Only five people mentioned feeling happy in their own company.
“I feel lonely” (P.104) “I feel lonely and abandoned” (P.135)
“very stressful and lonely” (P.153) “Feel very isolated and vulnerable” (P.189)
“I enjoy my own company and like peace and quiet, so I am enjoying being locked
down” (P.295) “I am quite introverted anyway, so pretty self-sufficient and happy in my own
company” (P.4)
Whilst the frequency of loneliness is relatively low (6%), it is considered significant as loneliness has been shown to adversely affect longevity, particularly for elderly people. Social-isolation and shielding may therefore adversely affect biological factors over time.
5
910
0
2
4
6
8
10
12
Content alone Lonely Isolated
Frequency of Loneliness (n=24)
39
Indeed, it was anger at continued isolation that prompted some people to identify feelings of rebelliousness (n=10). Ability to Sleep Changes to the ability to sleep were also only mentioned a few times (n=22, 7%) but has further reaching consequences.
Nine people reported changes to their sleep – finding it harder to fall asleep, stay asleep or to wake. A further 13 people were having nightmares. In the long term, sleep disturbance can create other biological issues such as increased hunger as well as further psychological issues such as low mood and irritability. This may then impact on the social domain, creating relationship tensions.
“sleeping quite badly” (P.38) “Sleep has been affected…getting panic attacks in the night, which are very scary when I am
on my own…some nights when I barely get 2 hours sleep” (P.149) “impacts sleep-wake really early” (P.184)
“also horrendous nightmares” (P.97) Self-efficacy Self-efficacy is a person’s ability to control and manage their own lives, achieving what they want. There were 103 references to changes in self-efficacy, mostly for the worse, but some also for the better.
9
13
0
2
4
6
8
10
12
14
Sleep disruption Nightmares
Frequency of Sleep Issues (n=22)
40
The most common loss of self-efficacy manifested is demotivation (n=27). People also felt powerless (n=13), lost their purpose (n=12), lost productivity (n=) and experienced poorer mental focus through reduced concentration and capacity (n=10). These would all erode one’s ability to work, support family, home educate, and to make healthy choices. These could all create adverse longer term effects biologically, psychologically and socially.
“Over this period the isolation has impacted on her mental capacity” (P.9) “concentration is shot” (P.53)
“Found it hard to concentrate and settle to work at home” (P.283) In contrast 31 people identified improvements in self-efficacy indicated by achieving more things around the house (e.g. outstanding DIY jobs) and being more creative in increased leisure time (n=12).
“catching up on housework/decoration” (P.129) “enjoying completing DIY jobs and gardening” (P.40)
“Home gym set up and different hobbies explored e.g. puzzles, films and quizzes compared to normal” (P.154)
“I am learning new skills such as how to preserve and ferment food from my garden. I also like making my own face and body creams and liquid soap” (P.67)
Barriers and Enablers to Mental Wellbeing A total of 295 people mentioned strategies they had in place to support their mental wellbeing and issues which had prevented them from looking after their mental wellbeing (97%). 17 positive strategies were identified and three barriers as shown in the chart below.
5 59
12
27
13
1
12
19
0
5
10
15
20
25
30
Poor conce
ntratio
n
Reduced m
ental ca
pacity
Less
productive
Loss
purpose
Demotivate
d
Powerless
Gained purpose
More creati
ve
Achieve
d small
things
Frequency of Changes in Self-Efficacy (n=103)
41
The most frequently cited support for mental wellbeing was personal space. This highlights how a social characteristic has a great bearing on psychological outcomes, and that mental wellbeing will be more challenged for people living in limited or overcrowded space. The next most frequent answer was being unable to utilise normal strategies (n=36). This was in part due to lockdown restricting physical social support, access to hobbies and sports, and having to live in a restricted space. Acceptance featured frequently (n=35) as a strategy to increase mental wellbeing, rather than stressing about what had happened in the past and what might happen in the future. Some examples of strategies are included below:
“We try to keep to a routine in which we do jobs and activity stuff in the morning, usually together, then have our own space in the afternoon” (P.94)
“I have taken up meditation and mindfulness training which helps a lot.” (P.97) “My wife has taken up oil painting and our son has started to sew cloth masks for all of our
neighbours” (P.182) “Have removed myself from certain social media groups as finding social distancing bringing
out the worst in certain people” (P.261) “keeping away from news updates” (P.263)
“I have adapted to these strange new circumstances” (P.86) “As a family we are fairly accepting of the situation” (P.250)
The range of positive strategies is encouraging and could be suggested via local authority publications as ways to deal with the pandemic. It indicates that people are not passive ‘victims’ of circumstance and are actively trying to look after themselves, and yet, they are still experiencing significant psychological challenges. The shadow side of this is to consider what increased psychological effects Covid-19 may be having on people with less resources, resilience and strategies.
9
2231
2 1
35
1722
16
51
8 72
49
71 2
11
36
13
0
10
20
30
40
50
60
Min
dful
ness
Pers
onal
stra
tegi
es
Fam
ily
Hum
our
Wro
te li
ving
will
Acce
tanc
e
Adap
tatio
n
Stop
ped
soci
al m
edia
Trus
t sel
f
Relig
ious
faith
Decid
ed n
ot to
hav
e ch
ild
Daily
/ w
eekl
y ch
eck
in
Onl
ine
Choi
r
New
hob
bies
Pers
onal
spac
e
Ope
ning
up
of re
stric
tions
Ther
apist
Chru
ch
Wor
se a
s los
t hob
bies
Unab
le to
use
stra
tegi
es
Unab
le to
acc
ess n
etw
orks
Frequency of Barriers and Enablers of Mental Wellbeing (n=295)
42
Summary of Psychological Impacts The psychological impacts of Covid-19 are wide ranging and experienced, on the whole, by most people regardless of other characteristics. They include deteriorations in overall mental wellbeing, negative emotions, a wide range of worry and stress, loneliness, poor sleep and reduced self-efficacy. Any one of these issues has significance for the individual experiencing it. Whilst a moment of difficulty might easily be accommodated in our lives, enduring anxiety, stress, depression etcetera over a number of months from a wide range of sources could become profoundly difficult. These psychological impacts interact with the biopsychosocial characteristics. For example, an underlying health condition might increase anxiety about contracting Covid-19, an underlying depressive condition could exacerbate a depressive response to Covid-19, and living in a cramped space with high demands from other occupants can lead to higher levels of stress and a lowered ability to cope. These impacts may also act forward, creating further health and social impacts. Living under stress may exacerbate blood-pressure issues, skin conditions and fatigue syndromes, as well as placing strain on relationships. The sample for this survey is biased towards a 45-65 year old age range, who live in good housing with access to garden space. Despite the assets of maturity and space, they are experiencing deteriorations to their mental health. This must lead us to consider the mental wellbeing of people with fewer assets, and to consider how they may be supported to use a range of personal wellbeing strategies or professional wellbeing services.
43
Social Impacts Losses Due to Control Measures There were 399 references to missing things in life. This means people identified more than one thing that they each missed. A range of 19 different items were missed. These were mostly oriented around people: partner, parents, friends, family, children, grandchildren, colleagues, clients, pupils, support network. The physicality of being with people was missed (social contact and hugs). A range of activities were also missed such as events (i.e. birthday parties, weddings), hobbies and sports.
The most frequently missed things were family (n=56) and friends (n=55).
“Missing friends and family… my two year old daughter is definitely missing company” (P.58)
“I miss our son and daughter-in-law who are in Manchester and there are a couple of friends I miss seeing” (P.172)
“Being isolated from friends, family and colleagues has been the hardest thing for me” (P.278)
The next most frequent things missed were sports (n=43) and hobbies (n=32). Teachers and lecturers were missing their usual contact with pupils and students (n=30), perhaps illustrating how powerful changes to our social lives can be. 27 people commented that they were very much missing ‘social contact’:
“I follow live sporting events which I’m missing very much at present” (P.106)
“I usually swim a couple of times a week to help manage my stress levels…I'm really missing that!” (P.203)
“Our usual hobbies cant be done as they all would have us break the emergency proclamation of not going into public places” (P.182)
7
19
55 56
1015
27 2420
94
30
4
149
138
32
43
0
10
20
30
40
50
60
Partner
Parents
Friends
Family
Children
Grandch
ildren
Socia
l contac
t
Events
Structu
red ro
utine
Colleag
ues
Clients
Pupils / s
tudents
Hugs
Freedom
Shops
Childcar
e support
Support
network
Miss hobbies
Miss sp
orts
Frequency of Losses (n=399)
44
“Sad to have lost all those things I carefully put into place to carry me through living alone, like art classes and walking with a rambling group” (P.253)
“I miss my work colleagues and students” (P.42)
“I teach at the local 6th form college and therefore teaching/ supporting learners from home” (P.67)
“I am a teacher, facilitation and engaging students has become very difficult via distance learning” (P.82)
“I miss the kids and the team and learning online is rubbish” (P.35)
“Am missing social contact with friends and older parents who are shielding/been in hospital during lockdown” (P.170)
“I do miss our freedom, social contacts and usual routines” (P.250)
New Social Activities People were finding new ways to navigate social life, and digital media were increasingly important in this time. 117 people referred to positive changes in their social lives across four different areas.
The most frequent new activity was accessing family via online platforms such as zoom, skype, facetime, and Whatsapp. This enabled people to visually see one another if not physically contact one another. For 33 people the lockdown meant they spent more time at home with family as they were not working, children were not going to school, and there were no other places to go. 19 people were using these online platforms for other social activities and networks. Social groups and some exercise classes were moving online ensuring people could remain in contact. A few people (n=8) had increased their contact
57
19
8
33
0
10
20
30
40
50
60
Online - family Online - other social More contact distantfriends
More family time
Frequency of New Social Activities (n=117)
45
with distant friends during this time as they were worried about them and had increased time to contact them.
“I am in daily FaceTime contact with my parents and my in laws as they are all elderly and
are completely isolated at home” (P.7) “…we meet socially via Zoom. Pilates session run via Zoom quite successfully and various
committees via Zoom/Skype. Weekly family quiz via Zoom” (P.208) “Have strong links with local church and with immediate family.” (P.251)
“We are spending a lot more time together as a family unit” (P.262) “Zoom with family, friends volunteer team, political party, mindful session” (P.263)
New Caring Responsibilities A total of 106 of the respondents (35%) mentioned they were giving support to people in new ways. Support for others was often referred to in practical terms, particularly with reference to shopping and picking up prescriptions. For others the care was more permanent as they had to care for elderly parents or sick family more intensely. Even if not living with family people also reported feeling a greater responsibility to family members, psychologically.
18 people were supporting aged parents and 15 looking after children with needs. Children and teens generally needed more support (aside from education) as they were struggling with the lock down too (n=13).
“…also supporting my 94 year old grandmother who lives alone” (P.6) “I am shopping for our household plus two others to support people in isolation” (P.8)
“Being forced to work while caring for a disabled child is impossible” (P.30)
18
6
1
17
2
13
21
15
2
11
0
5
10
15
20
25
Aged pare
nts
Carer fo
r pare
nt
Moved out
Support
for shielding
Distan
t family
Children
/ teen
s
People local
ly
Child w
ith need
s
Friends in
redundan
cy
Community su
pport
Frequency of New Caring Responsibilities (n=106)
46
“Our son is no longer able to go to his specialist school and this is isolating for him. He struggles with the lack of routine and we struggle with the lack of respite” (P.114)
“Helping to care for elderly parents” (P.207) “I am carer to my husband” (P. 278)
“my 2 year old daughter is definitely missing company” (P.58) “have parental responsibility for a yr 10 grand-daughter who is missing friends and
school” (P.258)
Despite social isolation there seems to also be a new found social cohesion, and many people were supporting people in the community (n=21), via community support groups (n=11) or particularly those who are shielding (n=17) who cannot go out. This is a very positive outcome of the pandemic, exemplified in these comments below:
“I hope neighbours stay this connected!” (P.210)
“We are all trying to support vulnerable neighbours” (P.216) “Kicked into action though in the community and so have been helping neighbours” (P.245)
“I support quite a few elderly people who live in their own” (P.84) “I am also doing some shopping etc for a couple of friends who have health issues
and trying to support someone who suffered a sudden bereavement just before the lockdown started” (P.203)
Educational Impacts Changes had occurred in all forms of education. Nurseries and childcare groups closed as well as schools, colleges and universities. These educational impacts were mentioned by 105 respondents (34%).
4
42
23
8 96 6 7
05
1015202530354045
Early
years
lack
devpt
Home schoolin
g
HS chall
engin
g
HS posit
ive
Worry m
issed
exam
s
Online HE c
hallenge
s
PhD studies c
hallenge
d
Doing new onlin
e learn
ing
Frequency of Changes in Education (n=105)
47
42 people said they were home schooling their children and this was associated with increased stress for many of them (n=23). A small amount (n=8) thought home schooling was positive. Young people were worried about missing exams (n=9), and university students worried about learning online (n=6) or losing access to laboratories for PhD research (n=6). For some people though (n=6), being at home had given them opportunity to undertake new studies online. The quotes below show a wide range of experiences:
“Working from home. Schooling my children. Not easy!” (P.15)
“Having the whole family at home takes up more time in entertaining the children and home schooling” (P.118)
“I am a university student in my second year of my degree…have 2 young children needing
education…exhausted and struggling…submitting work I could have done a lot better” (P.90)
“We are getting out into the garden every day, we’ve done nature study, made more bird boxes, making a garden pond, built the kids a mud kitchen, all since lockdown” (P.202)
“I home school our 4 year old with materials sent from school and eldest child educated via teams having lessons almost as normal with school” (P.250)
“had GCSEs cancelled so feeling lost” (P.170)
“I have to depend on my teachers ranking me to get my final A level results to be able to get into uni” (P.74)
“My eldest daughter will not return to university until September at the earliest” (P.6)
“I am a university student in my second year of my degree…have 2 young children needing education…exhausted and struggling…submitting work I could have done a lot better” (P.90)
“My university course is online” (P.179)
“I was due to submit my PhD and I am now really struggling to concentrate on it in an evening. Some days I feel like giving up!” (P.216)
“as a phd student in education… it's hard to feel like my research is still 'real' or even matters in the current climate. I worry about whether schools will want/even be able to
participate in my research when we do end the hard lockdown” (P.43)
“study online courses” (P.220) “Have completed online courses in online teaching to support!” (P.245)
Employment Impacts Employment is being increasingly impacted by the pandemic. The furlough scheme protected many people from redundancy, but now, after months of lost income and a reduction in furlough payments, unemployment is rising nationally. 295 respondents (97%) commented on changes to work, and this included a range of impacts not only to employment status, but also the nature of work and feelings about work.
48
40 people were unable to work and were on furlough. Only nine respondents to date had lost their employment altogether, although changes in hours (n=18) and redeployment (n=5) were highlighted. The nature of work has also changed, sometimes in terms of responsibilities (n=25) but also in other respects. 39 people felt their work life balance had diminished and stepping away from online work was cited as being very difficult. In contrast four people felt life balance had improved for them. 29 people found their workload had increased compared to six who found it had decreased. The benefit of less commuting (n=16) was tempered by the strain of increased digital meetings (n=14). A few people felt unsafe at work due to exposure to Covid-19 (n=4) or due to a lack of PPE (n=5). Home education was also compounding the difficulties of working at home for some (n=5).
“…at the moment I am unable to work as travel is not allowed” (P.172) “I have been furloughed from work” (P.272)
“both our jobs are redundant” (P.12) “I am working at home but needing to work long hours with back to back meetings with no
breaks” (P.15) “Also my work has changed to a shift pattern and a new role which means I feel very out of
my depth” (P.154) “More uncertain about work tasks as we have to be redeployed/change our normal way of
working” (P.205) “The difference between work and personal time has blurred in to 1” (P.265)
“I have had a better work life balance” (P.278) “NHS staff and Carers are dying due to lack of PPE” (P.116)
“ Staff continued seeing these patients with no PPE at all” (P.156) “my work has decreased” (P.290)
“Work has increased for both…partner works in pharma sales - respiratory products” (P.173)
24
16 14
4 4
9 10
39
4
9
29
6
18
5 4
9
40
25
5
16
5
0
5
10
15
20
25
30
35
40
45Di
gita
l
Less
com
mut
e
Onl
ine
mee
tings
Unab
le to
take
bre
aks
Mak
ing
staf
f red
unda
nt
Miss
colle
ague
s
Less
aut
onom
y
No w
ork
life
bala
nce
Bett
er w
ork
life
bala
nce
Redu
ced
job
satis
fact
ion
Wor
kloa
d in
crea
sed
Wor
kloa
d de
crea
sed
Chan
ges t
o ho
urs
Lack
of P
PE
Feel
at r
isk a
t wor
k
Lost
job
Unab
le to
wor
k
Job
com
plet
ely
chan
ged
Rede
ploy
ed
Used
tim
e fo
r car
eer p
lans
Hom
e ed
disr
uptio
n
Frequency of Changes to Work (n=295)
49
“…working from home, which is helpful because of the time saved on the commute” (P.201) “Work is much busier due to constant “meetings” (P.261)
“both very worried that our jobs may vanish” (P.276) These changes to work may increase the psychological stress people are experiencing. Whilst working online may pay dividends for individuals viz commuting and flexibility, the additional strain of constant online meetings may create burnout, affecting biological as well as psychological health. These factors need to be weighed carefully in planning for new ‘normal’ workplace practices.
Financial Impacts Given that people are receiving less pay and losing their jobs, some respondents commented on the financial impact of the pandemic, but only 61 or .20% of respondents referenced this, again reinforcing the sense that there is a socio-economic bias in the results.
A range of nine issues were mentioned. These included statements about being generally worse off (n=21) as well as specific causes of lost income including pension decreases (n=2), pay cuts (n=6), or lost share values (n=17). The fact that respondents have shares and savings (n=2) again illustrates that some in the sample are advantaged socio-economically.
“Have had to stop freelance work so financially affected” (P.10) “losing a large portion of my wages has made me have to consider relying on my
savings” (P.60) “He is using savings which is upsetting” (P.63)
“I am consider myself to be in a very fortunate circumstance with employment, health and finances” (P.175)
“my husbands pension investment has plummeted” (P.193)
5
2
21
2
6
17
53
0
5
10
15
20
25
Okay Pensiondecreased
Worse off Havesavings
Had paycut
Lost sharevalue
Savingpetrolmoney
Takenmortgage
holiday
Frequency of Changes in Finance (n=61)
50
“we have taken a 20% pay cut to secure staff wage” (P.250) “Some financial stress due to loss of one important income” (P.261)
Losses in income can affect lifestyle choices which may impact on health outcomes in later life (e.g. eating lower quality food) or psychological outcomes (e.g. worrying about payments). Whilst these factors may not have been experienced by many in this relatively privileged respondent sample, it will be a significant factor for other people who have always lived in poverty or who now find themselves in poverty. Overall Changes A range of six comments were made about changes to social life since the pandemic. 80 people commented on these further adverse effects.
The most frequent of these was feeling guilt from being unable to support close family members who were struggling. 21 people were finding lockdown made home life more intense than usual and not leaving the house was described adversely by 14 respondents. Intimate and familial relationships were being adversely affected by this (n=11). These social changes will be causing many of the psychological impacts described earlier.
“I am carer for my 86 year old mother- she lives alone and is reasonably independent but has poor mobility - the fact that I am unable to visit her every day .has caused me some
anxiety” (P.191) “I've only left the house 3 times in the whole of lock down” (P.297)
“…being at home with my wife and daughter all the time has been trying at times” (P.192)
21
14
5 610
24
0
5
10
15
20
25
30
Intense
at home
Not leav
ing the house
Int.relat
ionship im
pact
Fam. re
lationsh
ip impac
t
Strugg
le socia
l dist
ancin
g
Unable to
provide s
upport…
Frequency of Overall Changes (n=80)
51
Summary of Social Impacts The respondents highlighted a wide range of social impacts including substantial losses, new caring responsibilities, educational impacts and employment impacts. Some new activities were highlighted and online platforms were instrumental in maintaining social contact. Generally the social impact of Covid-19 was negative, although a few instances of improvements were noted by 0.2% of respondents. These social impacts are creating the psychological impacts identified earlier and may also impact on health outcomes in the biological domain despite the relative privilege that age and assets brings this sample of respondents. Living on the breadline, with increased care responsibilities and loss of earnings would put significantly more pressure on a person. In this respect, this survey implies the difficulties other socio-economic groups might face through those experienced by a well-insulated group. The analysis of social impacts again reinforced the dynamic and inter-related nature of BPS impacts and characteristics. Support Needs A total of 389 references were made to support, an average of 1.3 per person.
The most frequent support need stated were social supports (n=287, 74% of references to support), next most frequent were biological supports (n=49, 13%), and psychological support was the least frequently stated need (24, 6%). 29 people (7%) said they did not have any support needs at all.
“Only social support from family and friends” (P.28) “Social support will be needed for children - and society in general I feel” (P.245)
“I can see the need for mental health support going forward to reduce anxiety over being close to others or in a crowd etc” (P103)
“No support needed” (P.42)
13%
6%
74%
7%
Percentage of Different Support Needs (n=389)
Biological Psychological Social None needed
52
Biological support The biological supports included five different items. Continued shielding support (n=9) and food shopping (n=12) were highlighted as on-going needs for those who have underlying health issues. Perhaps due to the high mortality rates in care homes, 14 people stated they wanted support for their elderly relative to continue to live at home. Three people stated they needed routine treatments and appointments to be reinstated to meet on-going health needs. Eleven people mentioned the need for a vaccine as that would be the only sure way to end pandemic control measures and to ease public fear.
“We are shielding and totally reliant on neighbours to shop etc” (P.51) “We gave hesitated to hospitalise him for treatment and have tried to manage his
conditions at home” (P.278) “How do I have medical appointments?” (P.131)
“Some medical help as I normally see a podiatrist every 2 months so my feet are in danger of getting worse if the clinics are closed for very much longer” (P.257)
“This means I'm unlikely to be able to do much until a safe and tested vaccine is available” (P.266)
Psychological support Despite the high range of mental wellbeing impacts, only 24 people stated they wanted any psychological support, but this may be because this would be provided through the social supports detailed in the next section.
“Possibly mental health support” (P.16) “With regard to mental health support I will seek this if I feel it is necessary” (P.17)
9
3
14
1211
0
2
4
6
8
10
12
14
16
Shielding support Routineappointments
Care for aged athome
Food shopping Vaccine
Frequency of Biological Support Needed (n=49)
53
There were two forms of psychological support mentioned. The most frequently mentioned was mental health support (n=20) including access to professional and holistic therapies. The second psychological support mentioned was ‘feeling safe’ (n=4).
“Will seek CBT and hypnotherapy to address anxiety” (P.11) “Support to feel less anxious about going out and mixing with people again” (P.270)
The mechanism for this was not identified, but may be through the biological vaccine, or through community reassurance in social support. Social support 287 people mentioned a range of eleven different social support needs.
20
4
0
5
10
15
20
25
Mental health support To feel safe around others
Frequency of Psychological Support Needed (n=24)
37
27
52
27
15
53
2
18
5
44
0
10
20
30
40
50
60
Finan
cial su
pport
Socia
l support
Stayin
g in / f
inding…
Getting b
ack to
work
Self e
mployment s
upport
Educa
tion / c
hild ca
re
Lega
l support
Community su
pport
Community gr
ants
To re
adjust
priorit
ies
Frequency of Social Support Needed (n=287)
54
The most frequent social support need cited was educational and social care support (n=53) for children. This has increased over time as schools have been shut for most children for three months and concern for learning and development has escalated. Equally escalating over time is the need for support to remain in work or to find new work (n=52). This need has increased, as the furlough scheme has reduced, the economic depression becomes more apparent, and more people are being made redundant. Support for self-employed people was also a requirement for 15 people in the survey. A total of 27 people wanted support to get back to work – either in resettling into a routine, or to feel safe in the workplace.
“Support for education of my son” (P.243) “Mental health support and respite/social care” (P.44)
“Employment support” (P.131) “Financial support being self employed” (P.214)
“I don't know how I will manage return to workplace” (268) “New employment or return to work, rebuild business” (P.6)
The third most frequent support need stated was ‘to readjust priorities’ (n=44). This reflected people’s sense that health, wellbeing, family and the planet should be higher priority than economic growth and materialism. How to achieve this was unclear and would need to be addressed in further research, specifically dedicated to questioning how people would like to see this readjustment happen.
“Re-adjust priorities in life” (P.6) “People’s health will always be more important than the economy” (P.74)
“People have been given the opportunity to recognise what actually is important in life” (P.116)
“I am happy the Earth is finally getting a break” (P.158) “we need to far less materialistic in every way” (P.186)
The need for financial aid was mentioned by 37 people. An unprecedented number of universal benefit claims have been recorded since the pandemic struck, coupled with very high levels of unemployment (Department for Work and Pensions, 2020). Many more people have been recorded as turning to food banks, including people who would never previously have thought they would need this form of support. As we enter a period of economic depression following an era of austerity the needs of the most deprived sections of society and those living in the most challenging circumstances should be financial priorities. “Financial support for my partner would be good as I am currently supporting both of us on
a part time salary” (P.97) “Financial support to pay off debts” (P.6)
“Financial support would be good as we have spent a lot of money on making sure we had plenty of food in for our daughter” (P.192)
55
Two more categories remain. Two people referred to the specific need for legal advice as they navigated the new policy terrain and their rights within it. At the other end of the scale 27 people stated they had ‘social support needs’ generically, but the specifics of those needs were undisclosed.
“Legal advice re work, I've asked our union and he just said no-one will be furloughed, blanket policy. So I'm probably going to end up sick” (P.30)
“Social support” (P.27) No Support Needed
29 of the respondents stated they did not need any additional support, further reinforcing that many people are resilient enough or privileged enough to manage:
“At present I cannot see that I will need any support providing I remain on full pay” (P.48)
“As I have so much support I don't need anything at the moment” (P.49)
Summary of Support Needed Support needs spanned the biological, psychological and social domains, but were most prevalent in the social domain. These supports, however, could be seen as cross cutting. Increased financial aid, for example, would ease psychological distress and social issues such as overcrowded housing. Equally, community support could be seen to decrease loneliness and increase access to prescriptions and food. 10% of the respondents said they needed no support at all, reinforcing the finding that they have lots coping strategies which help in making them relatively self-sufficient. It is worth revisiting the sample, who are predominantly age experienced (45-65) and socio-economically privileged (detached houses, gardens, stocks and shares). This must not detract our attention from the many less privileged people in society who may have more acute, complex and enduring needs.
56
Learning Respondents expressed views about the way the government had handled Covid-19. There were 490 references to the governance of the pandemic, an average of 1.6 per person. 22 different comments were made, only one comment was positive.
The most frequent sentiment was about the speed of the governments’ actions, with 71 people saying it had been too slow; respondents also commented that control measures were not clear (n=26) or adequately enforced (n=20). Proactive management of the virus was seen to be lacking with statements pertaining to insufficient testing (n=61) and the need for more contact tracing (n=23). A cluster of statements pertained to a lack of learning from other countries (n=17), scientists and professionals (n=82) and data (n=18). Another cluster of comments pertained to a lack of preparedness, including: unprepared (n=27) and needed emergency planning protocols (n=27). Accountability also featured, with people feeling the government had blamed others rather than accepting culpability for issues (n=11), or that they have not been adequately held to account (n=12). Other comments included the evident undervaluing of ‘working class’ or ‘key’ workers (n=17), the impact of years of disinvestment or privatisation of key services (n=16), the lack of support for care
71
27
18
912
26
17 19
11
32
19 17
27
18
61
35
2320
16
0
10
20
30
40
50
60
70
80
Too slo
w
Unprepare
d
Handled bad
ly
Handled w
ell
Not held
to ac
count
Lacks
clarit
y
Didn't apprecia
te worki
ng clas
s
Focu
ssed on ec
onomy not p
eople
Blamed others
Didn’t learn
from others
/ professi
onals
Let d
own care homes
Didn't learn
from other
countri
es
Needed emergency
planning
Were not data
led
Provided in
suffic
ient testi
ng
Needed more co
llaborat
ion
Needed contac
t traci
ng
Didn't enforce
contro
l measu
res
Shouldn't p
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Frequency of Views about the Government (n=490)
57
homes (n=19) and the economy, rather than people, taking priority in decisions (n=19). 18 people specifically said the pandemic had been handled badly, as opposed to nine who thought it had been handled well, however the 481 critiques of governance here indicate a dissatisfaction with the UK’s government.
“listening to QUALIFIED professionals would have saved countless lives” (P.112) “I think the government was far too slow to impose lockdown and quarantine” (P.268) “We now need clearer messages when announcements are made such as when saying
things like unlimited exercise and go for a drive” (P.277) “Need for more rapid action and better enforcement” (25)
“I think the country should have been more prepared and we should be testing and tracking” (P.9)
“The government acted way to slow and did not learn from other countries” (P.73) “scientists warnings were not acted upon and lockdown status in England should have
happened earlier” (P.115) “We need to standardise how we are recording stats eg death rate so that the data is
reliable” (P.300) “It's clear we were unprepared” (P.165)
“where was emergency planning? We knew this was coming sooner or later, we should have been prepared!” (P.220)
“…blame the front line carers for misusing ppe…The government lied” (P.94) “Politicians to be personally accountable” (P.102)
“The drivers, the cleaners, bin men, post men, all those who do grunt jobs continue to plod on, and the mostly protected elite live their lives pretty much as they want...” (P.94)
“I think the schools were closed a week too late and I suspect that was to support the economy rather than for people’s wellbeing” (P.8)
“The NHS needs to be funded and supported by whatever government is in power” (P.50) “I have been very angry at our government’s handling of this” (P.59)
“I rage at the governments slowness in putting measures in place” (P.90) “The government lied” (P.94)
“The NHS and social care sectors have been neglected, underfunded and undervalued” (P.175)
“I sympathize with the govt, but personally feel they've handled it well” (P.254)
Learning for the NHS There were 106 comments across six areas identifying learning for the NHS and what support it now needs, representing 35% of the respondents.
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The most frequent learning point pertained to the ease with which volunteers had been brought back into the NHS. Whilst this may not be sustainable at such scale, it does show that people may be willing to volunteer more (n=28). Next most frequent was the statement that the NHS needs more funding (n=26). Taken together, these represent a public view of an underfunded and over stretched service. Allied to this, 20 people thought there should always be spare capacity in the NHS, stating that it should not run at full capacity all the time. To make the NHS more efficient and to enable different people to access healthcare more easily, 24 people mentioned the need to retain the advances made in digital or telehealth over the last few months. Six people thought NHS staff needed more pay and two people stated they felt NHS staff would need some form of counselling after the trauma they had recently experienced.
“I have also applied to go back and work in the NHS to help out” (P.108) “NHS have been amazing despite tight resources” (P.128)
“Public services (health, local authorities, police, etc.) shouldn't be run at full capacity under normal conditions. They should always have some spare capacity, even if that looks a bit
inefficient” (P.179) “Think all go appointments should be video linked with face to face only when
necessary” (P.32) “Gov should increase investment in these services so they are pandemic proofed and the
workforce are rewarded for what they have done during this crisis. They are not paid enough to risk their lives the way they are doing” (P.107)
“I'm concerned about the mental health of our NHS workers who are all incredibly stressed” (P.41)
“It is obvious that the NHS needs more funding and that the current model isn’t working” (P.191)
“The NHS and social care organisations have done amazing work with the immense strain…. should be funding review for the NHS and other support services” (P.175)
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26
2
28
20
24
0
5
10
15
20
25
30
Increase NHSpay
More NHSfunding
NHS stafftrauma
Consider NHSvolunteer
service
Always keepspare capacity
Keep digitalhealth
Frequency of Suggestions for NHS (n=106)
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Learning for Education and Social Care Sectors 98 people (32%) made comments about the learning for the education and social care sectors. There were five different suggestions in this area.
The most frequent learning was to better fund education and social care (n=30) echoing the comments about the NHS above. Given the challenges to care homes, it was unsurprising that providing more PPE to the education and social care sectors was also recommended (n=25). Of equal frequency were calls for welfare reform to protect the most disadvantaged people in society (n=15) and to end involuntary homelessness (n=15). The pandemic seems to have raised people’s awareness and intolerance of inequity in this respect. Thirteen people thought continuation of online provision of education and some social care services would also be beneficial long term.
“We badly need a Universal Basic Income” (P.203) “I’m hopeful that people will value the NHS and schools more since they have seen the vital
roles they play in society” (P.8) “I think we can learn from some of the use of online tech” (P.9)
“More PPE for all key workers at all times” (P.119) “More PPE for community NHS / social care staff” (P.152)
“So much could change...the poor can be looked after, the homeless can be homed” (P.23) “Society will become more online based and NHS services will become more virtual and
reduce time wasted” (P.85) “Invest money in online learning platforms” (P.91)
Learning for Employers There were five areas of learning for employers identified by 104 people (34%). The most frequent was to keep flexible working arrangements open, including working from home,
30
25
15 1513
0
5
10
15
20
25
30
35
Increasedfunding
Need more PPE Need welfarereform
End involuntaryhomelessness
Consider futureof online
Frequency of Learning for Ed and Social Care (n=98)
60
adjusted hours, and variable holiday arrangements. The benefits these had brought individuals in enabling caring responsibilities were highly valued. Allied to this, 30 people thought that employers should listen more to them as employees with regard to decisions about organisational changes – many people felt ‘done to’ rather than ‘consulted’. This issue came from a balance of people with positive experiences of employee voice being acted on and those having no voice. 18 people specifically commented on the value of online working, and nine wanted continued home working, although in the section on social impact, both had been linked to increase stress and deleterious work life balance. For those on furlough or with reduced hours, an improved work life balance had been valued and prompted comments that more free time led to more productivity in the work place – a work smarter rather than work harder ethos.
“I am lucky… my employer continues to pay me” (P.9)
“My employer has refused to furlough me” (P.30) “not much actual support from employers” (P.43)
“currently employed & in full pay but not working as my employer cannot provide me with a laptop at present” (P48)
“Work day reduced as no longer driving to/from work which adds 2.5 hours” (P.70) “I hope employers will be more receptive to different ways of working and will be more
understanding of their employees' individual circumstances. I had requested working from home before and was told it was not possible, which clearly it is” (P.153) “More flexible working…Less admin and red tape, more action” (P.165)
“Home working is definitely possible and could be used to drastically cut pollution and rush-hour congestion” (P.256)
“I hope we don’t go back to normal. I think there will be more home working” (P.261)
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30
9
18
10
0
5
10
15
20
25
30
35
40
Keep flexibleworking
Value employeevoice
Keep homeworking
Kep digital workplatforms
More free timemore productive
Frequency of Learning for Employers (n=104)
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Learning for Society There were 215 learning points mentioned that reflected wider societal changes that were seen as needed, rather than sectoral advice. The first set of observations were around people’s compliance with the pandemic control measures. 23 people thought the public were taking things too seriously and over reacting, for example in obsessive cleaning and panic buying. Conversely, 24 people thought the public were not taking the pandemic seriously enough and 23 specifically thought people were not compliant enough (linked to the call for the government to enforce stricter rules).
“…so many people are not taking this seriously” (P.2) “society should take on board the seriousness of the situation and don't panic buy” (P.48)
“Getting a bit OCD about cleaning/sanitizing” (P.53) “I take the social distancing seriously. I do not meet friends” (P.67)
“People not taking this contagion seriously” (P.79) “…people should be taking it more seriously” (P.124)
“Hit the non compliant individuals in their pockets and name/shame them or imprison them “ (P.240)
“Strong easy Instructions for all to follow with stricter penalties for non compliance” (P.275) Also noting public behaviour, two comments reflected that we should re-evaluate assumptions and remember that people are kind (n=14), as evidenced by a rise in community altruism (n=21).
“Community kindness has been amazing” (P.11) “We have a fantastic community of neighbours of various ages, and we are all looking out
for each other. I have met new neighbours that I had never spoken to before, and feel more connected to them now” (P.201)
Some people felt a change in priorities was needed (n=18) and others were more explicit in stating society should value people before money (n=13), calling for a more equitable distribution of wealth (n=22) and even a social revolution (n=14) to bring this about.
“We need to value everyone in society equally” (P.168) “Re-adjust priorities in life” (P.6)
“I think the schools were closed a week too late and I suspect that was to support the economy rather than for people’s wellbeing” (P.8)
“We need a social revolution and I hope we see one” (P.219) “I'm going to make changes when all this pandemic pandemonium is over” (P.233)
Another strand of comments was about the climate crisis, pointing out we should learn that the old ways are unsustainable, and change is possible – we have, for example, managed significantly less travel and energy consumption than we ever believed possible during
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Covid-19 (n=23). Linked to this, nine people felt we should now learn to take climate change seriously.
“We need to start appreciating the environment more and stop abusing nature/animals” (P.205)
“The recovery from Covid must also incorporate preparations and plans to tackle the climate emergency, the potential impact of which would eclipse that we are experiencing at
present” (P.218)
Summary of Learning Dissatisfaction with and anger at the government was palpable from the comments people made to the questions ‘what should we learn from this’. Many people focussed on the issues of governance in the short term, others indicated the changes that needed to be made and innovations that should be capitalised on in the realms of health, education, social care, and employment per se. Other people took a wider and more existential view, considering what the large lessons are for everyone in this pandemic. It is clear that people want this to be over, want future pandemics to be handled better, want reinvestment in services, further use of online technologies, and a refocusing on the importance of people and the planet.
23 24 24
14
2118
13 1410
22 23
9
0
5
10
15
20
25
30
Takin
g too se
riously
Not tak
ing seri
ously
People non-complia
nt
People are ki
nd
Community al
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Should re
assess
priorit
ies
People before money
Need a so
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Take
health se
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More even dist
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Frequency of Learning for Society (n=215)
63
Mental Wellbeing During Covid-19 Survey As stated previously, the psychological impact of Covid-19 and its control measures seemed particularly striking and prompted a second survey to be launched on the 28th May 2020 and circulated to all previous respondents. This survey comprised quantitative and qualitative questions in an online survey. There were 36 responses between 28th May 2020 and the 22nd June 2020. The analysis of these responses is reported below. There are two limiting factors to this data set. Firstly, the sample is very small (n=36) and secondly, the sample is skewed, as per the main survey, to women aged 45-65 who live in detached houses. From this respect it is not illustrative of the experiences of the breadth of society and therefore not generalisable.
Findings Changes to mental wellbeing during the Covid-19 pandemic Quantitative Data Respondents were asked to consider changes to their mental wellbeing on several indicators. Over two thirds (n.23, 67.6%) of respondents who ‘worried’ reported worrying more during the Covid-19 pandemic, most of whom (n. 16, 47.1%) worried a little more than they used to. Table 1. Worrying
Description of change No. % of sample % of those affected
Significant improvement 0 0.0 0.0 A little better 1 2.8 2.9 Some improvement 2 5.6 5.9 No change 8 22.2 23.5 A little worse 16 44.4 47.1 A lot worse 5 13.9 14.7 Significantly worse 2 5.6 5.9 Does not affect me 2 5.6
Fifteen respondents (44.1%) reported their feelings of stress to have worsened; most of whom (n. 11, 73.3%) felt it was a little worse. Over a third (n.12, 36.4%) of those who experience ‘stress’ reported no changes to levels and six respondents (18.2%) reported improvements.
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Table 2. Feelings of stress
Description of change No. % of sample % of those affected
Significant improvement 1 2.8 3.0 A little better 3 8.3 9.1 Some improvement 2 5.6 6.1 No change 12 33.3 36.4 A little worse 11 30.6 33.3 A lot worse 1 2.8 3.0 Significantly worse 3 8.3 9.1 Does not affect me 3 8.3
Over half of respondents experiencing anxiety reported feeling more anxious (n.20, 58.8%), half of whom (n.10, 50%) reported their anxiety to be ‘a little worse’. Table 3. Feeling anxious
Description of change No. % of sample % of those affected
Significant improvement 1 2.8 2.9 A little better 2 5.6 5.9 Some improvement 1 2.8 2.9 No change 10 27.8 29.4 A little worse 10 27.8 29.4 A lot worse 7 19.4 20.6 Significantly worse 3 8.3 8.8 Does not affect me 2 5.6
Of those affected by depression (n.27, 75%), over half (n. 15, 55.6%) reported their depression to have worsened, for most (n.11, 40.7%) it was a little worse. Table 4. Feeling depression / depressed
Description of change No. % of sample % of those affected
Significant improvement 0 0.0 0.0 A little better 1 2.8 3.7 Some improvement 2 5.6 7.4 No change 9 25.0 33.3 A little worse 11 30.6 40.7 A lot worse 3 8.3 11.1 Significantly worse 1 2.8 3.7 Does not affect me 9 25.0
Over half of respondents (n.20, 55.6%) indicated being affected by feelings of panic or panic attacks; most of them (n.15, 75%) reported no change to their condition. Four had
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experienced a worsening in condition (n.2 a little worse, n.1 a lot worse, n.1 significantly worse); one respondent had experienced some improvement. Table 5. Feelings of panic or panic attacks
Description of change No. % of sample % of those affected
Significant improvement 0 0.0 0.0 A little better 0 0.0 0.0 Some improvement 1 0.4 5.0 No change 15 6.4 75.0 A little worse 2 0.8 10.0 A lot worse 1 0.4 5.0 Significantly worse 1 0.4 5.0 Does not affect me 16 6.8
Almost half (n.14, 48.3%) of those experiencing mood swings reported no change, whilst a slightly lower proportion (n.12, 41.4%) felt their mood swings had worsened; for most (n.7, 24.1%) they were a little worse. Three respondents had seen a significant improvement. Table 6. Mood swings (i.e. more frequent or more dramatic)
Description of change No. % of sample % of those affected
Significant improvement 3 8.3 10.3 A little better 0 0.0 0.0 Some improvement 0 0.0 0.0 No change 14 38.9 48.3 A little worse 7 19.4 24.1 A lot worse 2 5.6 6.9 Significantly worse 3 8.3 10.3 Does not affect me 7 19.4
The majority of respondents (n.25, 83.3%) reported their avoidance of situations and people had worsened; most (n.19, 63.3%) reporting it had become a little worse, with the rest (n.6, 20%) reporting that their avoidance had got a lot worse. This is not perhaps surprising in view of the rules of lockdown.
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Table 7. Avoidance (i.e. avoidance of going out, avoidance of being near people) Description of change No. % of sample % of those
affected Significant improvement 1 2.8 3.3 A little better 0 0.0 0.0 Some improvement 0 0.0 0.0 No change 4 11.1 13.3 A little worse 19 52.8 63.3 A lot worse 6 16.7 20.0 Significantly worse 0 0.0 0.0 Does not affect me 6 16.7
Almost two thirds (n.20, 60.6%) of respondents reported increased disruption to their sleep; for half of them disruption was a little worse. Table 8. Sleep disruption (i.e. less sleep or more, disrupted, bad nightmares)
Description of change No. % of sample % of those affected
Significant improvement 1 2.8 3.0 A little better 2 5.6 6.1 Some improvement 0 0.0 0.0 No change 10 27.8 30.3 A little worse 10 27.8 30.3 A lot worse 5 13.9 15.2 Significantly worse 5 13.9 15.2 Does not affect me 3 8.3
Over half of those affected by obsessive thinking reported that it had worsened (n.15, 53.6%), whilst five (17.9%) reported an improvement. Table 9. Obsessive thinking (i.e. continually thinking about risks, control measures, family)
Description of change No. % of sample % of those affected
Significant improvement 2 5.6 7.1 A little better 1 2.8 3.6 Some improvement 2 5.6 7.1 No change 8 22.2 28.6 A little worse 8 22.2 28.6 A lot worse 3 8.3 10.7 Significantly worse 4 11.1 14.3 Does not affect me 8 22.2
Ten (43.5%) respondents reported becoming more obsessed with cleaning during the pandemic; the same proportion reported no change.
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Table 10. Obsessive cleaning/disinfecting (i.e. hand sanitising and cleaning) Description of change No. % of sample % of those
affected Significant improvement 1 2.8 4.3 A little better 1 2.8 4.3 Some improvement 1 2.8 4.3 No change 10 27.8 43.5 A little worse 4 11.1 17.4 A lot worse 4 11.1 17.4 Significantly worse 2 5.6 8.7 Does not affect me 13 36.1
Over two thirds of respondents affected by intrusive thoughts (n.19, 67.9%) reported that these had increased. Table 11. Intrusive thoughts (i.e. about Covid 19, impact on society, future, vaccine possibilities)
Description of change No. % of sample % Significant improvement 1 2.8 3.6 A little better 0 0.0 0.0 Some improvement 0 0.0 0.0 No change 8 22.2 28.6 A little worse 9 25.0 32.1 A lot worse 4 11.1 14.3 Significantly worse 6 16.7 21.4 Does not affect me 8 22.2
Qualitative data Respondents were asked to explain some of the changes they identified or tell us if they were experiencing any other changes to their mental wellbeing. Some respondents reported no changes to their mental wellbeing:
‘No change’ (SR34) ‘Little change really. My 80th Birthday occurred during the 'lockdown' - so what, say I!’ (SR35).
Others gave mixed reports which highlighted the positives and negatives of lockdown:
‘A cross between an increase in daily loneliness and appreciation of social interaction, especially with one or two good online friends and neighbours I meet outside shops’ (SR10). ‘Pace of life has slowed which has improved things at home - but added work stress’ (SR26). ‘Both more irritable, and more accepting of irritations, but not usually at the same time’ (SR29)
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‘I feel grumpy, slightly paranoid, despairing at times but sometimes optimistic, i.e. when I mend something in the house!’ (SR22). As I live alone, it is lonely, but do keep in contact with friends, family (SR3)
One respondent reported their wellbeing to have been ‘massively improved’ due ‘lots of silver linings’ such as reduced working hours and having more time to plan food and exercise:
‘My wellbeing has massively improved. I have worked a 40-hour week rather than 60+ hours due to no travel to customer sites. I'm eating better ... more time to meal plan and cook, exercising more and sleeping better. This has improved my productivity, I feel better organised, calmer and more confident. I'm enjoying leisure time instead of worrying about what I might have forgotten to do etc. The only increase in worry was initially around job security and the impact on my financial situation. I'm very fortunate and grateful and feel a little guilty saying how much my life has improved during the lockdown. Lots of silver linings and lessons learned’ (SR18).
Another respondent, with a pre-existing mental health condition, reported that their wellbeing had improved in some ways but the disruption to their normal routine appeared to be impacting negatively in others:
‘I have a pre-existing anxiety disorder, but I have found that lockdown has actually helped with my anxiety levels. After an initial period of adjustment, where I had an anxiety wobble caused by a change in routine, I have generally been more relaxed and taking better care of myself. Having more time at home, more time for exercise and feeling less pressure to participate in social activities has really helped. However, I have found my mood swings to be more extreme or exaggerated and my sleep schedule has gone out of the window. My body naturally wants to go to bed late and wake up late, and not having set working hours forcing me to get up has meant I've fallen back into sleeping unusual hours’ (SR9)
Notwithstanding, several respondents commented upon the stress and/or anxiety they were experiencing due to the Covid-19 pandemic and response. SR23 pointed to ‘Stress and anxiety about restrictions on my freedom and people being ill’; SR26, who works in the NHS, commented that the ‘increased risk has heightened [my] anxiety’. One respondent reported being overwhelmed by anxiety due to the pandemic:
‘I'm not an anxious person but for something that is so very dangerous and life threatening, and we have no control over, is overwhelming [...] the lack of freedom; the lack of being able to go outside is slowly crushing my soul’ (SR20).
Fear of contracting Covid-19 was also apparent. One respondent expressed concern, for themselves and family members: ‘I have underlying conditions that mean I am at increased risk of having complications should I contract Covid 19. So do my elderly parents, adult daughters and son in law’ (SR28). In a similar vein, another expressed reluctance to continue normal routines due to fear of contracting Covid-19, in this case using public transport:
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‘I live alone and have been ill. I have also self-isolated. I am self-employed with low income, so I have to work, but I use public transport for work and/or shopping, and I am fearful/distrustful of public transport safety. I don't think many people are taking precautions or care on the buses/trains and I am not sure what transport companies are doing to make things safe, so I am very worried about further contamination and illness’.
A third reported feeling anxious on multiple levels:
‘I have become more worried and anxious than normal due to worrying about friends/ family diagnosed with Covid, or who are more vulnerable. Worry for myself as although young and healthy, there have been some cases of people similar to me dying and I personally know someone young and fit who ended up in hospital … [A]s a teacher, I've also experienced anxiety at opening schools too soon when I don't feel the risk has decreased enough’ (SR7).
Some expressed concern for the family with whom they were unable to have contact; this caused apprehension: ‘I worry about my family who do not live near me’ (SR24); ‘I am concerned about the effects on my children and grandchildren’ (SR21). Others simply missed social contact: ‘Depressed cause can't see family and boyfriend’ (SR16); ‘I feel as if I’m truncated because I cannot socialise normally which is depressing’ (SR32). One respondent reported suffering from depression and that their condition had worsened because of lockdown which was making it difficult for them to function:
‘I started to get depression in oct 2019, which due to the virus and isolation has got significantly worse. I can hardly function most days and I`m finding it extremely difficult to get motivated to do my studies, of which I was already struggling with due to my dyslexia’ (SR31).
Five respondents expressed concern about the future, for one this was as basic as feeling ‘there is nothing to look forward to’ (SR24), but others expressed concern about recovering post-Covid-19, for example:
‘I do worry a little about how society will move forward from the current situation’ (SR33). ‘The longer the pandemic goes on, along with the inadequacy of its handling, the more I despair of ever leaving my house safely again’ (SR4). ‘I resent having to rely on others when I am normally very independent. I worry I will lose confidence and how to get this back’ (SR5).
One respondent appeared immobilised by their concerns about the future:
‘Fear of the future and how things will pan out after the lockdown. I am currently not working but unsure what to do - is it worth the risk to find a job or should I stay at home and not work but have no income. These cause me to worry more and
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concerns about the future and how to build a career as an inexperienced graduate’(SR36).
Responses relating to work were divided, some found their current work lives stressful: ‘Trying to cope with changes in work during the 'lockdown' has been stressful’ (SR8); ‘added work stress working in NHS under so much change’ (SR26). However, others were finding work less stressful:
I have enjoyed slightly less work-related stress as less marking time and no behaviour to deal with on a daily basis (SR17). Not having to go into work has removed a significant cause of worry and stress (SR33)
Several respondents referred to strategies they had employed to cope with, and protect their wellbeing, during lockdown. Two referred to established practices: ‘Just before the Covid-19. I completed an 8-week mindfulness [course] with CBT. This has helped me cope with Covid’ (SR13); I have nightmares which I manage with yoga and meditation (SR20). The other strategies mentioned, such as avoidance or excessive hygiene for example, might have, in normal times, been perceived negatively. However, during the pandemic respondents found them entirely appropriate:
I think 'swing' applies to all of this; the more I avoid the 'real world' (not going to populated places, social media), the less anxiety, intrusive thoughts I feel. I've also communicated less with people as they are more likely to talk about these things (SR2). I have avoided people and places as much as possible including now getting shopping delivered (SR7). Prefer not to go out to comply with government guidance and common sense around keeping away from the general population (SR30) Feel I have started to become more calm about the situation and following guidelines at all times helps (SR6) I think being more vigilant about hygiene, staying indoors, and ensuring family stay indoors is the correct response to this scenario and 'avoiding' people essential. It is not indicative of mental health concerns (SR28)
Strategies used to support mental wellbeing Quantitative Data Most respondents had contact with family and friends (n.31, 86.1%) at least once a week.
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Table 12: Contact with family Frequency used No. % of sample Several times a day 3 8.3 Daily 14 38.9 Once a week 14 38.9 Once a month 4 11.1 Once a year 1 2.8 Never 0 0.0 NA 0 0.0
Table 13: Contact with friends
Frequency used No. % of sample Several times a day 3 8.3 Daily 16 44.4 Once a week 12 33.3 Once a month 2 5.6 Once a year 2 5.6 Never 1 2.8 NA 0 0.0
A quarter of respondents (n.9, 24.9%) reported having contact at least once a week for their religious beliefs. Table 14: Religious beliefs
Frequency used No. % of sample Several times a day 3 8.3 Daily 3 8.3 Once a week 3 8.3 Once a month 0 0.0 Once a year 2 5.6 Never 25 69.4 NA 0 0.0
All but one respondent spent time outdoors at least once a week. Table 15: Time outside / in nature
Frequency used No. % of sample Several times a day 10 27.8 Daily 16 44.4 Once a week 9 25.0 Once a month 1 2.8 Once a year 0 0.0 Never 0 0.0 NA 0 0.0
Most (n.29, 80.6%) reported distracting themselves with hobbies at least once a week, although two respondents reported never doing so.
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Table 16: Distraction with hobbies / sports Frequency used No. % of sample Several times a day 5 13.9 Daily 15 41.7 Once a week 9 25.0 Once a month 3 8.3 Once a year 1 2.8 Never 2 5.6 NA 1 2.8
Two-thirds (n.24, 66.7%) reported using personal wellbeing strategies. Table 17: Personal wellbeing strategies (meditation / positive thinking / gratitude)
Frequency used No. % of sample Several times a day 2 5.6 Daily 12 33.3 Once a week 10 27.8 Once a month 3 8.3 Once a year 2 5.6 Never 7 19.4 NA 0 0.0
Three-quarters of respondents (n.27, 75%) said they never accessed professional support for their wellbeing. Table 18: Professional support (counsellor / CBT / psychotherapy)
Frequency used No. % of sample Several times a day 0 0.0 Daily 1 2.8 Once a week 0 0.0 Once a month 3 8.3 Once a year 3 8.3 Never 27 75.0 NA 2 5.6
Qualitative data Keeping busy/entertained The prominent theme with regards to coping strategies was keeping oneself busy/entertained. Respondents provided lists of what they did, including activities such as reading, gardening, undertaking projects and tasks:
‘I go outside every day. I ride my bike read cook and knit’ (SR14). ‘I read and spend time in the garden. And a good sort out/spring clean in the house is great’ (SR18). ‘I think it's important to have little projects, things that I can make progress with and get satisfaction from regardless of external events and stresses’ (SR29)
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‘I have a garden, been growing plants, been painting fences etc’ (SR3). ‘I have other strategies; reading crosswords, TV e.g. old films’ (SR22). ‘I can follow some sports events on TV and online which is a satisfactory development’ (SR31). ‘Playing and listening to music. Also spending time helping others or trying to’. (SR33). ‘DIY, Gardening, Tai Chi’ (SR5). ‘My hobby of gardening has helped’ (SR6). ‘I've enjoyed using my free time to decorate my house and build a photography website’ (SR7). ‘Enjoy practical conservation activities’ (SR8).
Two respondents emphasized the pleasure to be gained from being outdoors: ‘I love being outdoors and in open spaces, nature is my go to when I'm feeling stressed/ overwhelmed’ (SR18). ‘I sit in the garden and watch the birds and the seasons passing with coffee each morning’ (SR28).
Exercise Walking was the most highlighted form of exercise, which is perhaps unsurprising in view of the lockdown restrictions:
‘Walking is what helps me the most. Being limited to walks from home was very stressful. This is better now we can drive out for the day’ (SR23) ‘We try to have a walk every day’ (SR24). ‘If I become overwhelmed, I go for a walk/day out if my physical health allows’ (SR28). ‘I walk daily, usually on a very 'country lane' route’ (SR35) ‘My daily walk has become more enjoyable’ (SR6).
One respondent missed joining in team sports, exercising alone did not have the same impact:
‘I'd normally play netball once/twice a week which unfortunately has stopped. I have a hoop in my garden which I use but I don't get the same social / competitive or fitness aspects from it’ (SR7)
Another, commented upon exercise bringing some normality and stress relief:
‘As I am not working, I have focused a lot of my time on exercise, specifically cycling. Myself and my boyfriend have set ourselves targets so we are motivated and it’s something 'normal' to do. It’s a good stress relief and uses up a lot of free time making me feel less redundant’ (SR36).
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Contact with Friends/family Keeping in contact with others was also highly cited as a coping mechanism. Digital technology appeared to be widely used to keep these social contacts going.
I'm in regular contact with friends (SR18). More contact with family, less with friends, more with neighbours (SR2). Talking with my boyfriend helps (SR16). Contact with friends and family on social media, video conferencing and video phone calls have been very reassuring and enjoyable (SR21) Zoom meetings e mails (SR22). I speak to my mother daily and my daughter every couple of days. If I cannot talk, we text. I meet my daughter for coffee monthly and have friends round for tea. I use facebook for most of my contact with the outside world. Very little has changed. Zoom/messenger have replaced real world interactions (SR28). Technology has been great for letting me keep up daily interaction with friends and family although I'd normally see my parents every 2/3 weeks and I haven't been able to see them since lock down began. I would also normally see friends each week which again I haven't been able to do. I particularly miss having a hug but zoom / Skype sessions are as good as being able to talk at 2m distance (SR7).
Accessing wellbeing support One respondent, who had been accessing support through the GP reported this had ceased during the pandemic; they now accessed support online:
‘Was getting mild well-being support at our GP clinic - but it stopped with Covid-19. I publish all sorts on Facebook & generally receive supportive feedback. Have had good & bad experiences in Zoom meetings’ (SR10).
Others too mentioned accessing support digitally:
‘I use an app on my phone for meditating’ (SR14). ‘If I can't sleep I follow meditation videos etc on you tube’ (SR18). ‘Online exercise classes help with health and isolation, all contact on screen’ (SR20)
Two respondents mentioned doing Yoga as a coping strategy and one mentioned meditation:
‘Yoga as part of being mindful. I do this when I get angry’ (SR14). ‘I have found taking up yoga to be very good for my mental wellbeing, it makes me feel more in control’ (SR9). ‘The thing that really helps my mental wellbeing is meditation and a growing understanding of a Buddhist perspective on life. These are not religious “beliefs”, on the contrary strongly held beliefs are seen to be problematic’ (SR33).
Another cited religion and commented upon using newly released time to contemplate more:
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‘I usually go to church each week and home group which have both moved online and have been more involved with providing these than I normally would. It’s also been nice to have more time to read my bible and reflect than I feel I normally do’ (SR7).
Other coping strategies Two respondents highlighted a strategy of positive thinking through being grateful:
‘Generally being thankful for the positive things in life, engaging with the natural world and keeping in touch with people important in my life’ (SR30). ‘I give thanks each morning for a new day - I try to find little things to be grateful for (someone got me some flour)’ (SR4)
One cited trying to limit the time given to news programmes:
‘Other strategies include limiting time spent listening to the news and discussions about current affairs’ (SR33).
Another reported allocating a specific time slot in which to worry which appeared to be helpful in controlling their responses:
‘I also try to find a specific time in the day where I allow myself to worry about things. If I find myself worrying or panicking, I tell myself to save it until then. Then I create a safe space where I can deal with my worries and I often find they have diffused in the time that has passed’ (SR9)
Two others referred to coping strategies that were no-longer available during lockdown; there was a sense of loss that they were not:
‘I also have a lot of social contacts which I miss. I like to have holidays/short breaks to look forward to’ (SR24) ‘I usually go to the theatre/music concerts each month so I miss having those things to book and countdown to’ (SR7).
Others reported challenging situations that they had endured. One said their anxiety had increased due to ‘shielding’ to support their parents, concern for the future was also apparent:
‘I suffer with chronic backpain, so I struggle to get any exercise which is worsening my health. Before the virus I would go out at least once a month to somewhere scenic or to the coast which I love to do. But due to shielding for both my parents who are in their 80s I am afraid to go outside; I have become that anxious that I am considering delaying my studies if I feel the government is putting us at risk!!’ (SR31)
Another respondent, who had been accessing mental health support, commented upon her difficulty from not having someone impartial to talk to:
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‘Before lockdown I was having monthly meetings with a community mental health nurse, but I was discharged from that programme about a month ago as I have made significant improvements. I find it difficult to talk to people I know about mental wellbeing so find it easier to work through my problems constructively or speak to someone more impartial’ (SR9).
One respondent experienced a bereavement during lockdown, this had been challenging:
‘My mum died April 1st and that was really stressful as we couldn't have a funeral just an unattended one. She had MND and was my biggest source of stress so when she died, I stopped worrying about her in lockdown but miss her massively. The corona impact made her death more difficult’ (SR14).
And one reported loneliness and was quite despondent:
‘I had CBT Counselling for low depression in Winter 2018/19 but nothing since. I am NOT taking any anti-depression medication, by choice. Beyond that, I live alone & really DO NOT have any friends, only a few, old, distant ones, who I tend to contact by text or occasional phone call. I have NO social life now, whatever’ (SR19)
Others struggling to maintain mental wellbeing Quantitative and qualitative data Respondents were asked to identify others they knew to be struggling during Covid-19; most (n.26, 72.2%) identified friends: Table 19: Others struggling to maintain mental wellbeing
Others struggling No. % of Sample Friends 26 72.2 Wider family 11 30.6 Colleagues 9 25.0 Partner/spouse 7 19.4 Children 6 16.7 Parents 6 16.7 NA 2 5.6
One respondent elaborated upon the impact:
‘I have a friend in prison on remand. There is no visiting and no video alternative. He is locked up 23/24 h/p/d. There is no advocacy or support due to coronavirus, and hygiene and social distancing are extremely limited. There is much anxiety in our jails that they will be the 'next care homes'. This is a MH [mental health] need which is not being met. Jail is presumably always isolating, but at this time it is terrifyingly so’ (SR4).
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Challenges to maintaining mental wellbeing Quantitative and qualitative data Respondents were asked to identify which aspects of the Covid-19 pandemic were challenging to their mental wellbeing. Half of the respondents identified the ‘health threat’ (n20, 55.6%) and ‘social isolation’ (n.18, 50%) as aspects of the Covid-19 pandemic that was challenging their mental wellbeing; followed by ‘another spike in numbers’ (n.16, 44.4%). Only four respondents identified ‘loss of education for children’, perhaps reflecting the demographic of the sample. Table 20: Challenges to maintaining mental wellbeing
Others struggling No. % of sample Health threat 20 55.6 Social isolation 18 50.0 Another spike in numbers 16 44.4 Economic downturn 14 38.9 Changes to employment 8 22.2 Loss of education for children 4 11.1 Other 4 11.1 NA 3 8.3
Four respondents added other and specified the challenge:
‘Change of routine’ (SR9).
‘Not being able to go camping and get out walking in the countryside as much as I would like’ (SR23)
‘Not being able to socialise with friends/family like before’ (SR34).
And:
‘1. Uncertainty about the future course of the pandemic, so impossible to make plans 2. Lack of confidence in central government's competence, compassion, and fair dealing 3. Grief over lives needlessly cut short and disrupted’ (SR29).
Further Support Needs Qualitative data Respondents were asked what they wanted in terms of support and from whom they wanted to get this support; twenty people responded to the question. Eight respondents identified family and friends as the source of support they needed:
‘Local well-being support is enough but for now, it's just my family & and a friend or two’ (SR10).
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‘Friends ... to be able to talk’ (SR18).
‘More contact from neighbours and close friends. Physical good, but oral better than total isolation’ (SR35).
‘Friends’ (SR8).
‘Specific discussions with family/friends’ (SR21).
‘Just conversation with friends’ (SR34).
I would use contacts/friends (SR24)
My family (SR27).
One respondent asked for ‘an individual assessment of my risk, so I can make informed decisions’ (SR5); two others referred to more formal mental health support: ‘Psychologist’ (SR20); ‘I know I can schedule further appointments with my mental health nurse if I feel I need more support’ (SR9).
Two others would seek support from groups they are involved with:
‘Advice and guidance from Buddhist mentors’ (SR33);
‘Probably from the mindfulness community’ (SR14).
Three respondents used this question to highlight the impact of the Government’s handling of the crisis; the implication being that the Government doing better would help their mental health and wellbeing:
‘I think I'd just like to feel that the government were following guidelines from scientists properly to help with my anxiety’ (SR7).
‘A government that takes the threat to our lives seriously. Leaders who are not pursuing a herd. For honesty from the Government about risk and managing it’ (SR23).
‘Immunity strategy? Politicians that would not have us being 'world beating' chart-toppers regarding death and infection rates? (SR28).
Another respondent called for the facts:
‘All I want is less scaremongering from the media and the facts to help make my decisions about future work and social get togethers’ (SR6).
One respondent commented on not knowing where to find support:
‘Wouldn’t know where to find support. I’ve just got to endure it. Could be far worse!’ (SR32).
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Another commented upon the helpfulness of his bank, although one could also discern concerns about the future:
‘My bank have been helpful in refunding and/or reducing charges for my overdrawn account...and I have been able to claim an HMRC SE Grant due to work been curtailed, lock down and illness. To be able to retire now, aged 60, on health grounds would be good, desirable, but it is highly unlikely, as I don't pay into any pension or National Insurance schemes’ (SR19).
Summary of the Mental Wellbeing During Covid-19 Survey Whilst individuals did not provide demographic details for this survey, we know from the demographics of the sample it was sent to that the participants are primarily female, aged 45-65 and living in detached properties, indicating a high socioeconomic background.
The data from this group shows increases in levels of worry, stress, anxiety, depression, panic attacks and mood swings. As a consequence of the pandemic people may be avoiding others, experiencing disrupted sleep and having intrusive thoughts.
People are turning to family and friends for support and also look after themselves with time in nature, hobbies, and personal wellbeing strategies such as meditation and mindfulness. In this group there was low use (less than three quarters of respondents) of professional services to support wellbeing. The respondents are not calling for additional professional support, rather, the continued support from family and friends, and clearer and more factual information from central government.
This survey hints at the impact of experiencing low level stress, associated with significant change and health fears, over a long period of time. The respondents may be considered a relatively resilient group, insulated by life experience (age), secure living circumstances (detached housing), and good personal awareness (high levels of personal wellbeing strategies). And yet, this group is experiencing high levels of mental wellbeing issues. These limited results hint at the scale of the mental health challenges facing people without such resilience or insulating factors. Further research should be undertaken with representative samples to fully understand the mental wellbeing load created by the Covid-19 pandemic and associated control measures. This is particularly important in order to inform an equitable mental health support plan rather than an equal one – people are very likely to have very different needs. Medicine varies its approach depending on the biology and needs of the individual, and so the psychological supports should also work in this manner.
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Student Wellbeing During Lockdown Survey Edukit administered their 10 question online survey via schools to all pupils from year 1 (aged 5-6) to year 13 (aged 17-18). They have received 11,275 responses to date. Student Ages
A full range of ages was present in the sample and the most frequent ages were between year 6 to year 9 (11-14 year olds). Student Genders
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There was a mix of genders in the sample, but a higher percentage of females (60%) to males (39%) completed it. A small percentage identified as ‘other’ or did not state their gender. Life Satisfaction
The most frequent answer was eight, indicating an overall satisfaction with life, although the full range of scores was utilised. The scores are arranged in a classic ‘bell-curve’ distribution as would be expected for any range of scores, however, the peak of the curve is situated to the right of the graph indicating a trend of generally more satisfied than not satisfied students.
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The majority of children felt happy about being home educated (n=3999, 35%), although a large percentage (n=3075, 27%) were unsure how they were feeling and 1756 students (16%) were feeling unhappy. This indicates students are having very different experiences of being in lockdown, perhaps due to their existing levels of life satisfaction but other factors such as socio-economic status may also be relevant. Time in Home Education
The majority of the respondents spent between three and five hours a day on home education (n=3929, 35%). Again, a bell curve distribution of answers is evident, with its centre towards the greatest amounts of time home educating. Of significance, however, are the 962 students (9%) who are doing less than one hour (n=894). In total, 5494 (49%) of students were doing less than the recommended three to five hours of home education a day. This indicates a steep inequity in the volume of home education received.
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Time Doing Exercise
The majority of children were exercising and most frequently for between 30 and 60 minutes a day (n=4242, 35%), however 703 students (6%) were getting no daily exercise, and 3909 (35%) were getting below the daily recommended 30-60 minutes of exercise. Over time this could have a negative impact on their fitness and health. Access to Healthy Food
Most students thought they were getting plenty of healthy food (n=4575, 40%) or just about enough healthy food (n=4308, 38%). Very few students gave negative answers to this question (n=1149, 10%). This is encouraging, suggesting that students are receiving adequate or good nutrition, supporting their wellbeing.
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Daily Exercise
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Boredom
Students were generally feeling bored. The frequent answers were being a bit bored (n=4222, 37%) and being bored very often (n=3453, 31%). There was no option for ‘not at all bored’ which may have presented some skew in the data, however, only 1113 students (9%) said they were bored very little, suggesting extended time at home is under stimulating for them. General Wellbeing
There were mixed responses to the question how do you generally feel? The most frequent feeling indicated was ‘mostly okay’ (n=4126, 37%) although feeling ‘so so’ (n=3165, 28%) was also a frequent answer. Some students were ‘not really okay’ (n=1571, 14%) or ‘very upset’ (n=613, 5%), indicating that whilst most students are coping, the school closure and pandemic is affecting them in very different ways.
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School Support Received
There was a wide range of answers to the question of support from school for mental health issues. The most frequent answers were ‘getting plenty of support’ (n=4050, 36%) and ‘somewhat supported’ (n=3072, %). Some children, however, also felt they didn’t really get support (n=1192, 11%) or got no support at all (n=605, 5%), again reinforcing the theme of inequality and inequity arising from this data. Summary of the Student Wellbeing During Lockdown Survey Findings The 11,275 respondents were all aged 5-18 years of age, and mostly of secondary school age. There was a mix of male and female respondents but mostly female. Overall students were satisfied with their lives although respondents experienced all levels of satisfaction. There were mixed feelings about home education but most students felt happy about it. Most students spent 3-5 hours studying at home, took 30 – 60 minutes exercise a day, and ate healthy food, but this was not the case for all students, and many got too little home education, exercise and nutrition. All of the students were bored, but some to only a small extent. A full range of feelings existed about their lives during the pandemic. Most felt okay or ‘so-so’, but many felt unhappy too. Most students felt supported by school but a minority did not access support either. This data indicates that most students are doing well on many if not all aspects of wellbeing, however, some students are also struggling with many if not all domains of wellbeing. It is not possible to understand the key variables in these different experiences from the data set but we do know that significant variation exists for a significant number of young people and this should be addressed through equitable educational and social care provision.
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Conclusion This mixed method report contains the findings from 305 respondents to the narratives of covid-19 survey, 36 respondents to the mental health during covid-19 survey, and 11,275 respondents from the Edukit student wellbeing during lockdown data. This gives a total of 11, 716 views. Participants The narratives of covid-19 survey and 36 respondents to the mental health during covid-19 survey were predominantly aged 35-65, female and of unknown ethnic background. Psychologically, 16% of people indicated pre-existing mental health issues may have placed them at greater risk from the psychological impacts of Covid-19. The social characteristics of the respondents were complex and diverse encompassing relationships, living arrangements, housing, employment, hobbies and sports. The majority of respondents were, however, living with a spouse or partner in a detached house with some outdoor space creating an innate bias in the data set. Having a support network rather than supporting people in too much proximity, sports and hobbies, all featured in the respondents lives and may have insulated them from psychological impacts as meaningful forms of occupation. The bias in the data does not undermine its value, but means it cannot be directly generalised to society as a whole. Rather, this data gives an insight into the covid-19 experiences of a particular group of people who are relatively rich in assets and protective factors. Seeing this ‘side of the coin’ does not directly tell us what other people’s experiences are, but hints at what the flip side might be like and how challenging that experience could be as summarised below. Biopsychosocial Findings Respondents were experiencing a range of impacts including: contracting Covid-19, bereavement, shielding and isolation, worsening health conditions, changes to health choices and access to food. Some of these are significant and immediate impacts, whilst others will have significance later in life as cumulative effects. The psychological impacts of Covid-19 identified in the narrative survey were wide ranging and experienced, on the whole, by most people regardless of other characteristics. They included deteriorations in overall mental wellbeing, negative emotions, a wide range of worry and stress, loneliness, poor sleep and reduced self-efficacy. These were perhaps caused by living under moderate stress for a long period of time. Despite this, people had strategies in place to support their own mental wellbeing. This data was corroborated by the second mental wellbeing survey. This data showed increases in levels of worry, stress, anxiety, depression, panic attacks and mood swings. As a consequence of the pandemic people may also be avoiding others, experiencing disrupted sleep and having intrusive thoughts. Coping strategies were again evident in this survey and included; family and friends, time in nature, hobbies, and personal wellbeing strategies such
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as meditation and mindfulness. Again, the survey hints at the impact of experiencing low level stress, associated with significant change and health fears over a long period of time.
The respondents highlighted a wide range of social impacts including; substantial losses, new caring responsibilities, educational impacts and employment impacts. Some new activities were highlighted and online platforms were instrumental in maintaining social contact. Generally, the social impact of Covid-19 was negative, although a few instances of improvements were noted by 2% of respondents. The analysis using three strands of biological, psychological and social characteristics and impacts enables us to take account of a complex range of different types of factors which might otherwise be obscured or overlooked. The characteristics can be seen to predispose people to certain types of impacts and are therefore both useful. An example of this would be underlying health issues increasing the likelihood of shielding. Such impacts can then establish on-going characteristics themselves, in an ongoing cycle of cause and effect, for example as shielding causes loneliness. This encourages us to take a longer-term view, looking beyond immediate effects and onwards to later life impacts, for example, loneliness decreasing life expectancy. Support Needed Support needs spanned the biological, psychological and social domains, but were most prevalent in the social domain. These supports, however, could be seen as cross cutting. Increased financial aid, for example, would ease psychological distress and social issues such as overcrowded housing. Equally, community support could be seen to decrease loneliness and increase access to prescriptions and food. 10% of the respondents said they needed no support at all, reinforcing the finding that they have lots of coping strategies and helping make them relatively self-sufficient as an experienced (45-65) and socio-economically privileged (detached houses, gardens, stocks and shares) sample. Learning from the Pandemic Dissatisfaction with and anger at the government was palpable from the comments people made to the questions ‘what should we learn from this’. Many people focussed on the issues of governance in the short term, others indicated the changes that needed to be made and innovations that should be capitalised on in the realms of health, education, social care, and employment per se. Other people took a wider and more existential view, considering what the large lessons are for everyone in this pandemic. It is clear that people want this to be over, want future pandemics to be handled better, want reinvestment in services, further use of online technologies, and a refocusing on the importance of people and the planet.
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The Student Wellbeing During Lockdown Survey Findings The 11,275 respondents were all aged 5-18 years of age, and mostly of secondary school age. There was a mix of male and female respondents but mostly female. Overall, students were satisfied with their lives although respondents experienced all levels of satisfaction. There were mixed feelings about home education but most students felt happy about it. Most students spent 3-5 hours studying at home, took 30 – 60 minutes exercise a day, and ate healthy food, but this was not the case for all students, and many got too little home education, exercise and nutrition. All of the students were bored, but some to only a small extent. A full range of feelings existed about their lives during the pandemic. Mostly felt okay or ‘so-so’, but many felt unhappy too. Most students felt supported by school but a minority did not access support either. This data indicates that the impact of Covid-19 is not limited to adults, but is also affecting children and young people. Most students are doing well on many if not all aspects of wellbeing, however, some students are also struggling with many if not all domains of wellbeing. It is not possible to understand the key variables in these different experiences from the data set but we do know that significant variation exists for a significant number of young people and this should be addressed through equitable educational and social care provision.
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Recommendations A range of recommendations flow, by implication, from the findings of the different data sets. As we are not economists we are unable to suggest how these might be afforded nationally, however we would also like to pose the counter argument – how can we afford to neglect the wellbeing of thousands of people. Indeed, economic recovery might rather depend on people being well enough to be at work in the immediate and longer-term future. Biological
• Encouragement and freedom to support own wellbeing through everyday lifestyle choices such as a nutritional diet, exercise and time outside.
• Access to health resources, whether this is electronically or face to face. • Capacity to catch up on the backlog of appointments cancelled during lockdown. • Community support and ‘check ins’. • Reassurance that it is safe to attend medical appointments again, remotely for some. • Flexible modalities such as ‘pop-up’ clinics, telemedicine, and postal prescriptions to
enable equitable access to health care. • Increased resources for people in the greatest inequities.
Psychological
• Encouragement and freedom to support own wellbeing through everyday activities such as time with loved ones and time outside.
• Access to a range of holistic therapies such as mindfulness. • Community support, ‘check in’s’ and socially prescribed solutions. • Access to therapeutic interventions such as IAPT CBT, CAMHS, psychological and
psychiatric support. • Multi modal support such as face to face, online, telephone sessions, as well as
online resource packages. • Increased resources for people in the greatest inequities. • Support for staff who have been traumatised by the pandemic. • Increased esteem, pay and terms and conditions for all health care staff.
Social Education
• Continued access to home education support for children unable to return to school (excluded, school refusers, underlying health issues).
• Additional wellbeing support for all children via home education and school-based curriculum additions.
• Increased access to professional wellbeing support through charitable, community and statutory provision face to face, online, telephone and app based.
• Additional teaching support for the children who have fallen the most behind during the lockdown.
• Encouragement and freedom to support own wellbeing through everyday activities such as time with loved ones and time outside.
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• Increased resources for children in the greatest inequities. • Improved resources for home education (hardware and connectivity).
Social Care
• Encouragement and freedom to support own wellbeing through everyday activities such as time with loved ones and time outside.
• The ability to be cared for within one’s home for as long as possible. • Community support, ‘check in’s’ and socially prescribed solutions. • Multi modal support such as face to face, online, telephone sessions, as well as
online resource packages. • Individual and family voice and choice in care related decisions. • Flexible care packages to meet a diversity of needs. • Increased resources for people in the greatest inequities. • Support for staff who have been traumatised by the pandemic. • Increased esteem, pay and terms and conditions for all social care staff.
Given how interrelated biopsychosocial factors can be, integration of solutions across disciplines and sectors has to also be a key aspect of the solution. Whilst they are under, arguably, the greatest stress, research with people who are shielding, living in poor housing, unemployed, recovering from Covid-19, and other such challenging circumstances are needed to inform the next level of recovery planning. Next Steps People are completing the research in whatever format they prefer and it is enabling the development of a biopsychosocial framework for Covid-19 exploring different individual characteristics, the impact of the virus, the support needs people have and what they feel should be learned for the future. We continue to collect data and publish updates to enable timely actions in local authorities and national government. As such the next steps for the research project are to:
• Continue to invite responses to the call for stories and wider mental wellbeing issues • Seek stories from wider demographics, particular younger, male, socio-economically
deprived demographics • Analyse 300 data sets on the health needs emerging from the pandemic from
partner Healthwatch Cumbria • Analyse the 20 stories, poems and interviews collected.
Thanks We would sincerely like to thank all respondents for their invaluable time and support.
