Lucy Stewart never used to enjoy doing the laundry.
But pulling children’s socks out of the machine and gently tugging them back into shape, she found herself stretching out each action, fearful of reaching the last handful of freshly-washed cotton.
“Anything like that reminds me that they’re not here,” she says. “I can’t even do the washing without crying, because they should be here.”
As Covid-19 began to sweep the UK, Stewart made the difficult decision to move her children, eight-year-old Kitty and Casper, aged 10, out of the family home, sending them to live with her ex-husband.
An advanced nurse practitioner at a rural doctor’s surgery in the east of England, she didn’t want to take the risk of catching the virus and passing it on to her children, one of whom is asthmatic. Visiting patients in their homes is a key part of her job, bringing her into close contact with them and their relatives.
“As health professionals, we will all say to you: We know we are going to get Covid-19 at some point. Fact,” she says.
Hundreds of healthcare workers in the UK have contracted coronavirus; government ministers say 69 UK health workers and 15 social care workers have died as a result of the virus
Like many frontline healthcare workers around the world during the pandemic, Stewart is caught between doing her job and protecting her family.
“The general thought from their father and me together was: ‘No matter what we have to do, I have to keep working,’” she says. “I have to keep nursing because I have to keep trying to help other people.”
Lucy’s family isn’t alone. The need for healthcare workers like her to live away from their families has been recognized by the UK’s National Health Service, which has promised to refund the money staff who are forced to move out of their homes during the Covid-19 outbreak have to pay for accommodation.
But the cost has been more than financial.
A new normal
Stewart’s ex-husband, Rob, who is now caring for the children day-to-day, says that – outwardly at least – they are dealing well with their new normal.
“They sort of just brush everything off, don’t they?” he explains. “I see it very much as a period of making the children more resilient for the future.”
“They play, they mess around,” says Stewart. “They seem to be pretty resilient, pretty versatile, flexible.”
Even so, she and Rob are keenly aware that the enforced separation, coupled with the confusion of life under a pandemic, may be affecting their children more profoundly.
Tips for separated families
Stay connected: Find creative ways to stay in touch remotely. Establish new routines, perhaps at bed or mealtimes. Provide age-appropriate information: Remind children that people get sick, and then they get better.If possible, give a timeline to your child that helps them understand when you’ll be reunited. Time-tracking tools (such as sticker charts) can make this easier.Offer reassurance: Remind your child that they are being looked after, and that lots of people (like health workers and scientists) are working to resolve the situation.Empower your child by reminding them that there are things they can do, such as washing their hands, to help fight the disease themselves.Self-care is important: The calm presence of an adult goes a long way to help children deal with uncertain times.
A Chinese study published in the British medical journal The Lancet highlighted the increased potential for children separated from their caregivers by the Covid-19 outbreak to develop mental health problems. It found that 30% of children quarantined or isolated away from their caregivers met the clinical criteria for post-traumatic stress disorder (PTSD).
Professor Tovah Klein, director of the Center for Toddler Development at New York’s Barnard College, says children can blame themselves for their parent’s absence.
That’s a familiar concern for Laura Woods, a consultant nurse working in forensic mental health in a prison in the south of England. A single parent, she moved her son 200 miles away overnight, sending him to stay with her sister in north Wales.
“My worst fear is that he will feel abandoned,” she says. “So, I remind him every day that I’m here and I’m thinking all the time of when I can come and get him. I think he also recognizes that it’s not me kind of pushing him away … you know, everything’s out of our control.”
For Stewart’s children, her job itself is the root of much of their anxiety.
“My work has become life-threatening to me, and the children are facing a reality that mommy is in danger now,” she explains.
“I think that there will always be an element of uncertainty and worry about [their] mother’s health now,” she said. “Before, there was a naivete, which was lovely for them.”
Parents: The ultimate protection
Nim Tottenham, professor of psychology at Columbia University in New York, said that when children can be looked after by another parent or close relative, the risk of them finding the separation traumatic is much reduced.
“Close family relationships are so important for infants and children, especially under times of stress, when the world is so strange as it is right now,” she says. “Parents can be a really effective buffer of children’s emotions and stress.”
When a parent is living away from the rest of the family, it is particularly important to consider how to foster a sense of normalcy and reassurance, she says.
Drawing a parallel with military families, who frequently have to deal with separation and fears for a parent’s safety, Tottenham says technology can be invaluable in maintaining a regular relationship.
The Stewarts’ Easter Sunday video call is filled with chatter about the new routines and oddities that mark daily life. They pretend to throw Easter eggs to one another, and Kitty falls off her chair as she catches hers, making them all laugh.
Before long, though, Casper asks when they’ll be able to see each other in person.
It comes up every call, Stewart says.
“I’m not sure at the moment,” she answers truthfully, careful not to offer false hope.
“Oh,” he says slowly, his gaze slipping down off the screen.
“We’ll see how things get on,” she says. “We’ll take each day as it comes.”
Given the emotional fallout that such video calls cause, Stewart says she only video calls her children a few times a week at most.
The pain of separation
More accustomed to the noisy hubbub of family life, Stewart now wakes up to a silent house. She comes home to silence, cooks and eats in silence, and hurries out to work in the morning to avoid it.
As a nurse, she has always looked to her family for support, but for the first time in years she is facing the stresses of work alone.
Normally, she would spend her evenings reading the children bedtime stories, but recently she’s been writing essays to them in case she dies, pouring out on paper advice on how to best live their lives.
“This underlying nag is that I’m not going to see them again,” she says. “That’s my fear.”
She worries, too, over what the fatalism that has washed over her professional life will do to her children. She knows they can sense the difference in her.
“I have this internal battle as a mother and a practitioner that I’m putting myself at risk to look after other people’s families,” she explains, “When, actually, my children may lose their mother.”
Tottenham, the psychologist, knows that guilt, isolation and fears for their children can be an overpowering mix for parents who are away from their families.
“The same rules really apply whether you are three or 43,” she says. “Social support is probably one of the most important things in terms of our emotions and well-being right now.”
“By the parent taking care of themselves emotionally, they are at the same time taking care of the young children,” she adds
Tottenham recommends using a calendar to physically mark the approach of a reunion, helping both children and parents remember that their separation is temporary.
But in the UK, where the government has extended the lockdown for a further three weeks, with few clues as to when the country will be ready to reopen, such definitive countdowns are currently impossible.
It’s this uncertainty that eats away at Stewart.
“I’ve got Easter eggs here. I can’t give them. I don’t know why I bought them, actually, but I just went crazy … It’s normality, isn’t it?”
Even if the timing of her longed-for reunion with Kitty and Casper is still uncertain, for Lucy, there’s one thing she’s looking forward to above all else.
“I’d just like to go for a walk with my children. In the sunshine, holding hands,” she says, struggling to hold back tears. “Three shadows, not one.”