It was an unexpected twist in what already felt like an excessively dramatic disaster movie. On 6 April, the British prime minister was admitted to the intensive care ward at St Thomas’ hospital in London, after contracting a new and potentially deadly virus. Donald Trump said he was “praying for his good friend”; the French president, Emmanuel Macron, said all his wishes were with the prime minister, his family and the British people in “this difficult time”. The Labour leader, Keir Starmer, described it as “terribly sad news”.
Boris Johnson pulled through, of course, surviving to witness the birth of his son, Wilfred – given the middle name Nicholas, after the doctors, Dr Nick Price and Dr Nick Hart, who saved Johnson’s life. But more than eight months later, could the country still be feeling the impact of this dramatic turn of events?
Just two weeks after the UK was ordered to “stay at home”, Johnson’s hospital admission with Covid-19 underscored the severity of the situation. “Boris was somebody who never got ill, didn’t understand illness, he just sort of blathered on straight through it,” says Prof Matthew Flinders, the founding director of the Sir Bernard Crick Centre for the Public Understanding of Politics at the University of Sheffield. Flinders shadowed the PM during his time as London mayor: “When people realised that Boris had got it, it was like: ‘Bloody hell, this is really serious’ – and when he was moved to intensive care, this concern intensified.”
Johnson’s diagnosis ramped up the fear factor, which may have boosted people’s compliance with the new restrictions. “It also made Boris seem like, dare I say, like a ‘normal person’; the Eton education, Bullingdon club and Oxford Union suddenly mattered less if he could catch the virus like you or me,” Flinders says.
In the short term, this public sympathy benefited the PM. After his hospital admission, the proportion of people with a favourable opinion of him rose from 54% to 60%, a YouGov poll revealed. Social scientists refer to this as the “rally around the flag” effect. “In any period of uncertainty or crisis, people tend to associate criticism with disloyalty and being unpatriotic, so he had a bit of a ‘Boris bounce’ due to the illness,” says Flinders.
Sadly for Johnson, this quickly dissipated. Since returning to work, Johnson has faced criticism over his handling of the pandemic and rumours that he has lost his mojo. By the end of September, his public favourability rating had dropped to 33%. “Lots of cabinet colleagues have complained that he’s not his old self, he’s a bit below par and hasn’t got that energy, that buzz, when he walks into a room,” says Flinders. Of course, Johnson disagrees: “I could refute these critics of my athletic abilities in any way they want: arm-wrestle, leg-wrestle, Cumberland wrestle, sprint-off, you name it,” he argued in October in his party conference speech.
Without medical assessment, it is impossible to know if his illness has left a psychological mark on the PM, says Prof Neil Greenberg, a consultant occupational and forensic psychiatrist at King’s College London. But it wouldn’t be surprising if it had. For many people, being admitted to an intensive care unit (ICU) means confronting your own mortality for the first time. They may see other patients dying around them, be heavily sedated and confused, and struggle to communicate because they have a breathing tube in their throat – although Johnson didn’t require the tube.
Studies suggest that roughly one in five ICU survivors go on to develop post-traumatic stress disorder (PTSD). “We don’t quite know that’s the same for Covid patients, but I don’t see any reason why it should be any better, and in some senses, you could argue that it might be worse, because there’s this whole long Covid thing, where no one quite knows what’s going to happen to them,” says Prof Greenberg. “Even for those who don’t develop a formal illness like PTSD, it’s likely to be a significant, life-changing moment.”
Certainly, Johnson appears to have been humbled by his hospital stay – unlike Donald Trump, who used his brush with coronavirus to rip off his mask and pose for photos in a supposed display of his resilience. Johnson warmly praised the NHS staff who cared for him, and has talked openly about his efforts to lose weight and improve his fitness since recovering from the virus.
Such positive psychological changes also aren’t uncommon among ICU survivors, says Greenberg. The phenomenon even has a name: post-traumatic growth (PTG). Sometimes, PTSD and PTG can even coexist within the same individual.
PTG could explain the zeal with which Johnson has embraced the government’s new obesity strategy.
“Losing weight is hard but with some small changes we can all feel fitter and healthier,” Johnson tweeted at the end of July. “If we all do our bit, we can reduce our health risks and protect ourselves against coronavirus – as well as taking pressure off the NHS.”
This was a dramatic turnaround for the PM. In the years before Covid, Johnson openly scoffed at the idea of slapping health warnings on food and alcoholic drinks, and opposed “nanny state” interventions in people’s daily lives. And although the government proposed a series of measures to help curb childhood obesity in July 2018 – including banning “two for the price of one” deals near supermarket checkouts for food high in sugar, fat or salt – very little progress had been made since then. Campaigners such as Caroline Cerny at the Obesity Health Alliance had almost given up hope: “The policies had been totally kicked into the long grass at the start of the year,” she says. “Things like the 9pm watershed on junk food advertising, we just thought were never going to happen.”
However, the added plot twist of Johnson being hospitalised with coronavirus – possibly related to his being overweight – brought the issue sharply into focus. “He has been reported as saying: ‘I’ve changed my mind on this,’ and various advisers that we’re close to have told us he briefed Matt Hancock to come up with a new strategy as quickly as possible,” says Cerny. “I think the combination of his own experience, together with the evidence about the impact of obesity on coronavirus complications acted as a catalyst.”
Whether Johnson has the energy to push these changes through remains to be seen. “At the moment it’s talk, but what we need is action,” says Cerny. If he does, it could be a rare silver lining to what has otherwise been a gloomy 2020 – an example of PTG from which the whole country may benefit.