The Physical Pandemic: What Has The Last Year Done To Our Bodies?

Some months ago, my friend and I began sharing images that have become known as Our Agonies. We documented our letting-ourselves-go outfits: tracksuit bottoms tucked into socks and Crocs; fleeces; holey jumpers. Then we zoomed in. "Look at my eye bags" became "Behold my dandruff" or "Look at my sad, bloated stomach" or "Gaze upon the parched earth of my eczema-y hands". In the foreground, medicated shampoo, IBS medication and tubes of squeezed-to-death hydrocortisone cream sit by the bathroom mirror. They go unmentioned. 

For us, this is catharsis. Some people may be thriving. But who, three lockdowns deep, doesn't look in the mirror and see the imprint of this last year somewhere on their body? Weight gain or loss, deteriorating eyesight, sore backs, headaches, disrupted menstrual cycles, digestive issues, thinning or greying hair and skin conditions are just some of the ways our bodies tell the story of this pandemic; the pervasive stress, the ennui, the total rupturing of our normal routines. 

"From what I am seeing as a GP, not many people have used the last year to focus on their health. Most have been trying to get by under tremendous stress," says Sarah*, a GP partner in a busy London practice. Many of these physical ‘symptoms’ may be a function of changed set-ups. 

"Inactivity is leading to more musculoskeletal issues, particularly back and neck pain. Just losing the daily commute (a walk to the Tube, the cycle to work) has an impact on health. Many people sit in one position all day, on chairs that are not designed to be sat on all day," she says. 

Without a pricey ergonomic desk set-up, it figures that the spine might begin to suffer, along with screen-tired eyes. If we are legally bound to our homes, it makes sense that less movement might lead to weight gain. Constant hand-washing or sanitising may have a predictable outcome for those with sensitive skin. But even if we can rationalise these adaptations – or the flaring up of underlying issues – it doesn’t mean they're comfortable. 

A common complaint is strained eyesight. In a survey of 2,000 people conducted between eye health charity Fight for Sight and YouGov, 38% believed their eyesight had worsened during the pandemic. Respondents reported headaches, difficulty reading and poorer night vision. Last summer, the UK Ophthalmology Alliance and the Royal College of Ophthalmologists calculated that at least 10,000 people in Britain had missed out on essential eye care through a fear of contracting COVID. It may be the case that many are struggling but putting off seeking treatment. 

Kamini Scott is 26. She works in PR and lives in Bristol. After eight months of working from home, she felt her eyesight was changing. "I noticed myself sitting closer and closer to the laptop screen, squinting to make out what I was reading or typing," she says. Having always had 20/20 vision, it took a while for Kamini to realise she should see an optician. "In the end it became too uncomfortable. We were given a free eye test through work so I went on one lunch break. The optician failed to get a reading initially because my 'eyeballs were too stressed' and had to use muscle-relaxant drops. I now have a minor prescription but really didn’t expect to need glasses so soon."

There is not enough research to definitively confirm that increased screen time can lead to deteriorating sight. But it is sensible to be mindful of the risks – particularly a lack of natural light. Professor Jeremy Guggenheim specialises in myopia (short-sightedness) research. "Research has shown convincingly that insufficient time spent outdoors is a risk factor for myopia," he says. "Excessive time viewing electronic devices may pose an additional risk." Indeed, Kamini attributes the change in her eyesight to working with a smaller screen at home and "only being able to connect with people digitally". She feels she is on "emails or WhatsApp for 90% of the day" with minimal time outside. Many will relate. 

I have two hours outside with my dog each day. Then, with my neck bent forwards like a heron, my eyes are fixed on a screen. I have worn glasses for long-sightedness and astigmatism since I was seven and usually get a new prescription every two years. This month, nine months after my last visit, I returned. Headaches were tormenting me. The optician said my astigmatism is marginally worse and that my eyes were "terribly dry". Unsurprising, really: I’m lousy at drinking water and my screen time notifications are an existential embarrassment. 

The optician also told me that more people have presented with headaches in the last few months than she’s ever seen before; a reflection, she suspects, of that perfect storm: increased screen time and less natural light. Not all of these people have needed glasses, she says, but most have had dry eyes, which can cause headaches. I don’t need new glasses yet but am instructed to use eye drops, drink more and follow the 20-20-20 rule: taking a screen break of at least 20 seconds, every 20 minutes and to look at something at least 20 feet away. 

Even with pandemic-related bodily shifts which feel spooky or surprising, there is probably a reasonable explanation. My feet have grown, for instance. Hear me out: I started running again for the first time in a year and my smugly bought trainers felt too small. When I tweeted about this, others reported having a similar experience. People mooted that wearing proper shoes less often might be to blame because the feet have a chance to 'spread out'. Also, that weight gain can make feet go up by half a size. I may well be carrying a little extra lockdown timber but there is credence in the other theories, too. 

"Our feet do change over time and with certain life events," says podiatrist Emma McConnachie, a spokesperson for The College of Podiatry. "Weight gain and pregnancy can change our feet, as can ageing. I frequently have patients comment that their winter shoes feel tight or start to cause problems after months in sandals or more open footwear." The physical structures of the foot can start to shift. "With 26 bones, 33 joints and over 100 ligaments, muscles and tendons in each foot, it is easy to see why," says Emma. 

Many women have noticed that their menstrual cycles have changed, becoming longer or shorter, uncharacteristically erratic or with worse premenstrual symptoms. This can be a confusing and distressing experience. There is not yet any formal data to reflect any patterns in cycle changes during the pandemic but, although any significant changes should always be discussed with a GP, stress is a likely driver. 

Prolonged stress can keep us in fight-or-flight mode. The evolving threat of coronavirus transmission, home schooling, working from home (or living at work), loneliness and grief are enormous  stressors. If high levels of cortisol and other stress hormones are sustained, they can make a body feel wretched. These hormones can also inhibit the normal levels of reproductive hormones, which can suppress ovulation. If ovulation is affected, the whole cycle can be. The good news (but far from a simple answer) is that periods should go back to normal once stress is reduced.

It may be that some behaviours we have identified as coping mechanisms for stress are having a cumulative effect on the body. "Most people have drunk more alcohol than they would usually, along with eating more, particularly more sugar and carbs," says Sarah. "Baking cakes or bread to relieve stress, or having cocktails over Zoom with friends, is perfectly understandable. But for some people, these changes in habits might have become detrimental to health. Many of my patients have gained weight in the last year. Most people I care for with diabetes have had a worsening of blood sugar levels and are requiring interventions." 

As a society, it seems we easily forget how embodied stress and, more generally, emotion is. That is, until it shows up in a physical symptom or state we don’t recognise. To an extent this is normal; our bodies are designed to be relatively stable machines. But Sarah tells me she has noticed "an increased pattern of patients presenting with tiredness, weakness and generalised aches and pains" which she suspects speaks to "a physical manifestation of the stress of the last year". She feels there is "suddenly a motivation in patients to 'get healthy'," now that they can think about taking care of themselves in a recognisable way, like visiting the hairdresser or going out to buy skin products. "This sounds trivial in the context of a pandemic but has a huge impact on self-esteem," she explains. 

Could it be that the erratic messaging we have received about risk over the last year has compounded an inevitable degree of high-alertness people would have towards their bodies during a global pandemic? Noticing and ruminating on every sniff, mark or tingle as something potentially significant? Dr Esther Murray, a health psychologist and lecturer at Queen Mary University, believes so. "Human beings are pretty bad at conceptualising risk, which hasn’t been on our side with the pandemic," she says. "We have an optimistic bias and may be inclined to think, Oh it won’t be me. It is unsurprising that our relationships with our bodies have changed, given how conflicting the information we have received has been." 

How so? "Well, in the beginning we were told not to worry, weren’t we? The message was, ‘Unless you are old or obese, it won’t get you.’ Then the counter message was, ‘No, it really might be you. Not only that but we don’t know what will happen to you.’ So vast numbers of previously fit and healthy people have had the stuffing knocked out of them by realising they need to notice what is happening in their bodies in a way they may have taken for granted before. People with chronic illness will be used to this but so many of us aren’t." 

Twenty-seven-year-old Ruby Elliot, a London-based illustrator known as Rubyetc, says the invisible threat of the virus has made her hypervigilant. "It has heightened my feelings of vulnerability in my body and given me this exhausting energy, where I notice every ache or twinge or new sensation," she explains. "Being this anxious makes you move differently through the world. I strongly believe that living in a more sedentary way with fewer external stimuli cannot be good for me or anyone else." 

Ruby, who says she "doesn’t know anyone who isn’t crumbling like old shortbread at the moment", has had a "pretty extreme and unremitting flare-up" of her eczema during the pandemic. She attributes this to stress and increased use of soap and hand sanitiser. Last year, she was losing "up to three hours' sleep a night" due to discomfort and itching and, at one point, she couldn’t bend her fingers without being in pain. She is getting specialist treatment now and beginning to draw about her experiences, which she finds helpful. She hopes her body has a chance to rest in the next few months but is dubious. "As ever with this virus and the government's diabolical mismanagement of it, nothing feels guaranteed." 

At a time when we are turning to science and medicine for treatment, answers and hope, Dr Murray makes the point that medicine has "also worked hard to divorce us from our experiences of ourselves" by giving us a label and a perceived solution for everything. "The belief system is: that’s weird, you want to be fixing that. That our bodies have changed and played up and felt uncomfortable during the pandemic is actually not weird, though. As grown-ups, we’ve lost that intuition children have with emotion. They might put their hand on their tummy and say it hurts, when they actually mean they’re sad or angry. There is an instinctive understanding that emotion is felt." 

As adults, perhaps embodying such strong emotion makes us panic. The idea of not being able to stop those feelings in the near future is worrying, too. But maybe not completely returning to who we were before doesn’t have to be such a frightening concept. "People talk about how we will recover and get back to normal, but we won’t," says Dr Murray. "We’ll never be the same and that is okay. That is life. We change all the time. To try and stay the same is the aberration and where the torture is, because it’s not possible."

That isn’t to say we are all irrevocably broken. "Absolutely not," says Dr Murray. "We have to be careful of what our big narratives are. For example, there are people suggesting that the whole population has post-traumatic stress disorder (PTSD). This is wrong. It is actually dangerous to imply that everyone is broken. Some people will be terribly affected, of course, but we adapt. That is what makes us human." Thankfully, there are psychologists who are publicly countering the 'tsunami of mental health problems' message with more nuanced, considered narratives of human resilience and the structural inequalities that inform profound distress. 

Scrolling through the images of my friend and me, our grey-streaked hair, tired skin and purple eye bags, I do not see people who are thriving. Like most, our bodies are carrying the anxiety, loneliness, apathy and sheer boredom of the year that has passed. I also see two people whose bodies will, as things evolve, adapt once again. Because that’s what bodies do. I see people who are just about managing. Perhaps just about managing is all we can expect of ourselves.