COVID-19: the great equaliser or magnifier of inequality?
I am a second year PhD student at the Royal Veterinary College, researching infectious diseases. I am interested in zoonotic pathogens which of course are very topical right now. The following blog has been adapted from my essay which was highly commended in the RSTMH Student Essay Prize: "COVID in an inequitable world".
The subject appealed to me as I feel passionately about platforming the myriad inequalities that affect people’s lives, and how they do so in an intersectional way.
I hope it can offer a different angle on how using a "one size fits all" approach to solving a global problem can in fact be more damaging to many people than the pandemic itself. To me, this highlights just how inequitable our society is.
The great equaliser?
2019 saw the outbreak of the coronavirus disease (COVID-19) pandemic, during which many countries subsequently have adopted “lockdown” measures in an attempt to contain the spread of the virus.
Various famous figures referred to COVID-19 as "the great equaliser", insinuating that it affects everyone the same.
Can a world with staggering socio-economic inequality suddenly become equal as a result of a global pandemic? Or does the pandemic magnify the pre-existing disparities and vulnerabilities across the world?
Gender in the UK
Women are disproportionately impacted by the effects of the virus and the methods implemented to stop the spread.
From a financial perspective, women represent the largest demographic of single-parent households and part-time employment, which is generally lower paid, more precarious and often illegible for government support such as the furlough scheme, forcing women into financial conundrums like having to choose between purchasing food or paying energy bills.
"Stay home. Protect the NHS. Save lives" was the UK government messaging during the first and third lockdowns. While social distancing minimises the spread of the virus, home does not necessarily represent a guaranteed place of safety.
The United Nations (UN) described a surge in domestic violence witnessed globally since the pandemic, and the UK charity Refuge claimed an 80% increase in calls to domestic violence helplines.
Within the UK, domestic homicides have doubled since the outbreak, highlighting that staying home does not necessarily save lives in the same way across genders.
Ethnic minorities in the UK
Evidence suggests that people from different ethnic minority groups were at an increased risk of COVID-19 complications and mortality. With people from South Asian communities and Black communities experiencing COVID-19 deaths 1.5 and 4.3 times higher than white British people respectively.
Racial genetics were quickly disproven, implying social and economic inequalities experienced within these communities. For instance, employment predominantly carried out by non-white workers, include transport, food and healthcare roles, which increase exposure.
Furthermore, structural racism has resulted in some communities being more likely to live in overcrowded housing with material deprivations, thus increasing the chances of spreading COVID-19.
Child poverty in the UK
Prior to the pandemic, people living in extreme poverty rose to approximately 4.5 million people with an estimated 1.9 million people reliant on food banks.
School closures meant children eligible for free school lunches went without the guaranteed meal families in difficulty could previously rely on.
As lessons moved online, children whose households lack internet access or sufficient laptops ceased to continue studying.
Education is one of the most important determinants of a person’s prospects, suggesting an increased widening of the rich-poor divide for future generations to follow.
The Global South
Many countries within the Global South experience economic disparities, inadequate healthcare infrastructure and a lack of access to clean water and electricity prior to COVID-19.
The pandemic has exacerbated these disparities, potentially causing more deaths than the virus itself as a further 8% of the world’s population will fall into poverty.
What is the effect on food security?
COVID-19 has reduced access to food for many people around the world.
Areas used for planting and harvesting crops have not been accessible during lockdown implementations causing food insecurity to increase by approximately 265 million people by the end of the pandemic.
Malnutrition can lead to more severe COVID-19 symptoms and a higher mortality rate, with 30 million people predicted to die from starvation during the pandemic.
Serious health conditions
The highest prevalence of infectious diseases such as tuberculosis (TB) and human immunodeficiency virus (HIV) occur within the Global South.
Access to preventative or treatment programmes has become more challenging during the pandemic as healthcare systems are under increasing pressure when dealing with the additional challenges of COVID-19.
Therefore, not only do HIV and TB infections pose an increased risk to COVID-19 susceptibility and mortality, incidences of HIV and TB are predicted to rise because of the inability to access adequate treatment and services.
Who are we forgetting?
Migrant workers represent a largely overlooked demographic. Within India, internal migrants live in overcrowded slums in large cities. The government’s travel bans and lack of work have led to limited finance, food and healthcare with many migrants having to walk several thousand kilometres on foot to return home. This poses numerous dangers such as diseases, starvation and exhaustion along their journey.
Approximately 250,000 migrant domestic workers live in Lebanon largely from Ethiopia, Southeast Asia and Sri Lanka. The fractured Lebanese economy exacerbated by COVID-19 pushed tens of thousands of people into poverty.
Several migrant domestic workers were dismissed and living on the streets outside their respective embassies, unable to access their passport and immigration papers leaving them stranded. This has increased their vulnerability to not only COVID-19 but harassment, deepening poverty and a decline in mental and physical health.
How do you stay at home when there is no home?
An estimated 2.6 million refugees are living in non-permanent camps worldwide.
While the fundamental advice from the WHO states "wash your hands, social distance, self-isolate", it is impossible within such camps to adhere to this advice due to cramped conditions and lack of running water.
Combined with limited medical access, this creates a situation where COVID-19 can spread rapidly within refugee camps.
Conclusion
COVID-19 has affected almost everyone across the world. However, it is apparent that the effects vary widely, demonstrating that the pandemic is far from being "the great equaliser".
Measures to reduce the spread of the virus have disproportionately affected many different vulnerable communities across the globe, highlighting that, when a society is treated as homogenous, blanket decisions can impact certain groups more than others.
The effects will continue to resonate for generations, and call for united action from the international community to protect those most vulnerable and to end the disparities experienced by so many.
Society cannot be truly free of the virus if those most at risk are not being supported.