Mums Need Hugs: The Contradictions of Public Health

Just before COVID-19 led us into a national lockdown in March 2020, I learned that my mother’s cancer had advanced and that she will die soon. It is hard to know how long she has left. There is no further treatment and she is feeling less well as the weeks pass. I wanted to write about how COVID-19 has changed my experience of family, care, and society; and how my own experience has enabled me to understand the conflict that faces many of us as we try to do the right thing.

I am a Public Health Practitioner. COVID-19 has provided me with the opportunity to apply my skills and knowledge in a fight (from the safety of my own home) to keep my neighbours, friends and families safe and to enable our communities recover and rebuild.

In Public Health, it is part of our job to assimilate and communicate national and local guidance. It is a bit of a sales job—we are trying to persuade individuals, organisations and society to take action to improve the health and wellbeing of themselves, and of others. There is general agreement, however, that the national COVID-19 guidance is currently somewhat ambiguous. What clarity it lacks on the page becomes even more apparent when it is applied in real life, in the messy context of society and family. I personally do not think that we could produce national guidance that would work for every eventuality in this complex society, but we could probably do better than we are doing now. The problem is that lives, families, loves, memories and even generations are on the line. Losing someone to COVID-19 is a bad thing, but so is spending your final months in a care home with no contact from the people you love, or dying alone without the people who have accompanied you through this life, or not being able to hug your mum when she tells you she is dying.

In my professional role I promote official guidance, trying to make it as easy as possible for others to follow the rules and keep each other safe. As a daughter, I can’t help but review the guidance, checking what it means to me personally, while searching for any loophole that would justify hugging my mother. This helps me to understand the conflict and confusion that we are feeling as a society. For me, it is a conflict between doing the right thing as a professional and the need to do what you know is best to care for the people you love. All over the world, people are facing conflict between their need to be a good citizen (or just as importantly, their need to appear to be) and their need to earn a living, or care for someone that needs them.

Public health policy, by its nature, takes a ‘population’ approach. Universal guidance from central government need necessarily be adapted as individuals apply it in their own work or personal situation. An individual or worker will have to weigh up relative harms and benefits of a hug, or decide whether it is better to ignore a relative’s removed mask at a moment of great distress. National public health policy cannot account for the complexity and nuance of real human life and the decisions we are all making every day. These decisions will fall to individuals and will be hidden or not depending on how badly the rules have been broken and how this reflects on the image we wish present to the world as good citizens or professionals. I imagine many people are building a list of secret “transgressions”. Perhaps they squeezed past someone in the supermarket, received a drunken hug or physically comforted someone who really needed it. This is why I smile when I see someone post a “rant” on social media about other people not adhering to the guidelines. I imagine that this might be more about coming to terms with your own decisions, and valorizing oneself as a good citizen. We are trying to navigate complex challenges while finding a balance between being seen as “good” (conforming to the rules), and feeling or doing good.

The decisions I make over the upcoming weeks or months will live with me for the rest of my life. Many people are facing the same dilemmas, and, worse, and I think the collective guilt and irreversible harm this causes may live with us for generations. In addition to the list of broken rules, there will be a list of hugs that were not given, and can now never be given. It may be true that in order to overcome this pandemic, we need a collective of good citizens who follow the rules, but we also know, in our hearts, that mums need hugs.