Mixed messages from experts have left us all more fearful than during the lockdown

People seemed to welcome the slower pace of life, and while it was inconvenient and at times intrusive, people accepted it as a necessary encumbrance. To the surprise of medics, the numbers of people attending the emergency departments dropped to a trickle. The compliance with the lockdown was high and everybody knew the rules.

Then the lockdown began to ease and, now in phase three, the emergency departments are again functioning at full throttle. People are returning to work but the fear has intensified and the threat of a second wave has become a reality in some countries that thought a victory lap was in order. Their optimism has been crushed.

We are still supposed to social distance yet in urban coffee shops we see young people, in hordes around tables, sipping their chia-seed frappe, as if invincible. While it seems we will be able to travel abroad for holidays, many are ambivalent. The appeal of the sun and sea is tempered by the ever-present threat of a second wave. The difficulty of social distancing on the beaches of southern France or Spain or in the nightclubs of Ibiza will be challenging as the lockdown eases.

Our anxiety levels are further heightened by the delay of phase four and by the mixed messages concerning the wearing of masks in shops and in non-hospital settings. In March, on the advice of the World Health Organisation, we were advised this was unnecessary and even dangerous but now we are told they will be compulsory in shops and in situations where social distancing can't be maintained. Others say they give a false sense of security. Such contradictory views are still aired daily in our media.

It is easy to forget Covid-19 is a new virus which nobody had heard of seven months ago. The knowledge base is limited and while there is a vast amount of research taking place, there is a danger that in panic situations mistakes may be made in the rush to find a treatment and a vaccine. It will take time to study whether immunity is enhanced if one has had the infection and if vaccines are sufficiently potent to protect against the virus. Then due attention must be paid to the adverse effects a vaccine may have. Are they mild or serious? Are there any late-onset side effects?

The second problem is that of interpreting the scientific findings themselves. This has come to be known as the replication crisis which means similar studies on a specific issue produce different results. This is because humans and statistics are central to medical research and both are fallible and individual interpretation of findings also plays a part. So it is possible there are contradictory findings regarding masks. This is one of the reasons why some studies of the drug hydroxychloroquine, usually used to treat malaria, have arrived at different conclusions regarding its effectiveness in Covid-19.

Adding to the woes of the public is the fact that some charlatans seem to be taking advantage of people's anxieties.

For instance, we learned a few days ago that some home-testing kits available online were fake. But the greatest scam was discovered in early June when the 'Lancet' and the 'New England Journal of Medicine', the world's most prestigious medical journals, retracted two papers examining the impact of hydroxychloroquine and chloroquine on the virus. The results showed these had no effect on the infection but the death rate and impact on blood pressure was increased. Several global trials of the drug were stopped immediately. However, a journalist at the 'Guardian', and subsequently experts, began to ask questions. The company that compiled the data from almost 700 hospitals worldwide refused to share the data for an independent review and the authors accordingly called for the studies to be retracted. This happened speedily. It was one of the most serious breaches of scientific ethics in these journals' history.

People are now admitting their heightened level of anxiety and fear as being much greater than during lockdown. This is typical of the impact uncertainty has on the human psyche. We all need a structure to our lives, we are averse to uncertainty and we require a degree of predictability. Life became very predictable, almost monotonous, during lockdown. We knew what was expected and we adhered to it.

Now people have to make their own judgments regarding safety and general well-being against a background of lack of knowledge, mixed messages and even deliberate falsification. No wonder people are confused, fearful and uncertain.

Patricia Casey is consultant psychiatrist in the Mater Hospital and Emeritus Professor of Psychiatry at UCD