Coronavirus and Marginalisation: A pre-existing condition?

Image Description: Doctor talking to a patient

From its very beginnings when emerging in Wuhan last December, to the current mistreatment of NHS staff, Covid-19 has brought to light and deepened the existing structural inequalities and prejudices of our society.

Recent statistics have revealed that the virus is having a disproportionate impact on those from a BAME background, the figures from New York City highlighting nearly two-thirds of deaths are either Black or Hispanic people – making these people twice as likely to die. This doesn’t correlate to population distribution – in Chicago only 30% of the population is made up by Black people,  while 72% of the dead are.

The cause for this isn’t new, it is found in the longstanding barriers to health care for African American communities in the USA, as well as higher poverty rates, and a higher proportion of key workers, or jobs that cannot be done from home. The New York Times has calculated that many neighbourhoods that are hit the hardest by the virus are also neighbourhoods with the lowest median income, as a product of historical healthcare disparities.

Most states, as it stands, do not report their coronavirus deaths with information on ethnicity and race, but those that do are exhibiting a pattern. New York City’s health commissioner, Dr Oxiris Barbot, suggested that Hispanic people affected by the virus may not be seeking medical care due to fear of backlash from immigration officials, exposing a fundamental flaw in society that pre-dates the virus. Ms Barbot puts it down to ‘the overlay of the anti-immigration rhetoric across this country’. However, the far-right and some European governments, rather than help solve this, are using the virus as anti-migrant propaganda, despite there being no evidence that the virus is being transferred by those seeking asylum.

With increased policing and legislation to control the virus comes an increase in mistreatment towards those of a BAME background.

This follows events such as the Windrush scandal, where Windrush elders who lived in the UK their whole lives, contributing to and creating the society we live in, were deported in the middle of the night with no warning.  This week hundreds of Romanian citizens are being flown to the UK for fruit picking after the UK voted to leave the institution that facilitates their coming.

At first, people from Asia were targeted as transmitters of the virus, and more recently the Chinese government is alleged to have a cure which it is withholding from the rest of the world. These conspiracy theories and rumours surrounding the virus have been spreading and allowing racism, sinophobia and xenophobia, taking away from the real threat because this path feels less threatening somehow.

A statement from the department of global communications reads: ‘As the spread of the coronavirus accelerates, the United Nations is working to ensure that the needs of the most vulnerable are reflected in its response to the emergency.’ Like with conflicts, it is the marginalised and displaced who will pay, and are paying, the highest price during the current pandemic. With increased policing and legislation to control the virus comes an increase in mistreatment towards those of a BAME background.

The first arrest in England was a black woman who had not broken any restrictions. Marie Dinou, a 41-year -old woman from York was fined £800 after British Transport Police claimed to have found her ‘loitering’ in a train station and failing to provide a reason for travelling. However, the fine was lifted after it was revealed she had been prosecuted under a new law for those who are believed to be infectious, despite the BTP having no such belief.  Since then, the overenthusiastic use of new police powers has been criticised and protested by the public, with allegations that the UK is becoming too like a ‘police state’.

Moreover, Medecins sans frontiers have called the conditions in overcrowded Greek islands: ‘the perfect storm for a covid-19 outbreak’.

Cities will have the highest density of homeless people, but will also have the highest Covid-19 rates, exacerbating the vulnerability of those without a home to isolate in. Those in immigration detention and prisons are at high risk, as they share a confined space, and NGOs argue that these people should be released, as the legal grounds for detention are made redundant by the closed borders at present. Moreover, Medecins sans frontiers has called the conditions in overcrowded Greek islands: ‘the perfect storm for a Covid-19 outbreak’, with poor sanitation and lack of access to medical care and testing.

Many people with disabilities will have underlying conditions that put them at higher risk from coronavirus. Yet social distancing measures, especially isolation, do not consider those who rely on others for day to day necessities, and the medical services they depend on are being limited if not suspended for the duration of the pandemic. Stockpiling has left the less able-bodied unable to access products that to them are a daily necessity, such as antibacterial wipes to clean prosthetics and wheelchairs.

We are only as strong as the weakest in our society.

Over-represented both on the frontlines of the response to the virus, and as a population group affected by the virus, BAME communities will be hit hardest by this crisis, and thus to overcome it we should be supporting these communities more.  Whether this is identifying disparities in government policy and addressing them or providing financial aid for those struggling in the new environment borne from the pandemic. This is necessary not only at a legislative level but at a grassroots level too –  we should be identifying the vulnerable around us ourselves and looking to help wherever we can. Supporting those who need the most support is an essential process for supporting the whole. We are only as strong as the weakest in our society.

Thousands of key workers are asking for the basic means by which they can continue their jobs, for our benefit and their own, and yet the government continue to deny responsibility, and to fail to provide sufficient amounts of PPE or testing. A review by Sky News has revealed that 70% of frontline workers who have died as a result of the virus in England and Wales have been people from an ethnic minority. Moreover, while only making up 13% of the population, 44% of our NHS doctors and 24% of nurses are from a BAME background.

Public health is a common good. We all benefit from it, and we will all suffer without it.

Every Thursday at eight we clap for the NHS, and this is undeniably a touching sign of thanks and acknowledgement, but this does not solve that doctors, nurses and key workers putting their lives at risk for us are dying, and are dying when there are visible and attainable options for prevention.

Matt Hancock claims this isn’t the right time to address the systematic underpayment of NHS workers, but if not now when?  The underpayment of key workers isn’t only disgraceful monetarily, but it shows a lack of respect for exactly how much they do for the country now, did for it up until now and will continue to do after this is all over. Public health is a common good. We all benefit from it, and we will all suffer without it.

The virus is unbiased, and so too should be our response.

Now is the time to address racial and social imbalance, when a coherent society is needed most, and when every small decision made by us and our government will lay the groundwork for a recovering society in the aftermath left by the virus. It doesn’t get better from here unless we make it so.

Image Credit: NIH Clinical Center