The misleading language surrounding Covid-19 such as the government’s suggestions that the virus can be defeated by showing fortitude ignores the circumstances faced by the poor and BAME communities. The large number of deaths of BAME people due to the coronavirus has quickly disproved the claim that the pandemic is a ‘great leveller’ and has instead brought to the fore the many social ills of the world. If coronavirus doesn’t discriminate, why are BAME people bearing the brunt? Why are one third of those dying in ICU wards BAME?
“Covid-19 as the great leveller is a myth that needs debunking.”
The Research
New research indicates that the coronavirus has an unequal impact on these communities - from the disproportionate death rates of BAME people to the ‘right to cough’ of South-East Asian communities. Research into the first critically ill patients in UK hospitals shows that Black and Asian people are more likely to be badly affected by the virus than white people (Guardian, 2020). The Intensive Care National Audit and Research Centre found that 35% of the nearly 2,000 patients studied were BAME, triple their 13% proportion of the overall population.
The Class divide
For many, the lockdown is not a time for reflection but is instead a time of hardship in a constant struggle for survival. Often likened to WWII, this crisis has led to furloughing and layoffs while the latter saw everyone who could work, work. For the middle classes, the lockdown has meant isolation with compensation, but for many this is not the case.
It has been 3 weeks since the UK was placed under lockdown and it has already highlighted the ever-increasing class divisions in our society. Gubbi Bola, public health expert, argues that what the virus has best illustrated is the relationship between inequality and health in Britain and the poor ranking of BAME people in socio-economic indicators, such as poverty and deprivation - an outcome of the longstanding institutional racism in government policies relating to immigration, housing, criminal justice, and social welfare. As most determinants of health are socially created, it logically follows then that the fact that socioeconomic deprivation disproportionately affects BAME people will be a precursor to the impact of the virus on those communities.
Self-isolation
The government has confirmed that overcrowded housing is more likely to impact ethnic minorities. Across all socio-economic groups, age, region and income bands (regardless of whether they rent or own), White British people are more likely to be under-occupying (at least 2 bedrooms more than needed) than all other ethnic groups combined. In fact, in the South West, they are twice as likely to be under occupying. In comparison, BAME people are four times as likely to be living in overcrowded housing in the South West than White British people – how does one self-isolate in overcrowded accommodation?
In the City of Bristol, Black people make up 24% of homeless households despite only making up 6% of total Bristol population (gov.uk). Self-isolation will for the majority of BAME people, and the poor, be very different to that envisioned by issuing the rules for lockdown. As a key social determinant of health, housing is central in understanding these health disparities. In the South West, 70% of White British households own their home versus 40% of BAME households (gov.uk), and BAME people are three times more likely to rent than White British people (gov.uk). While many of those who own will have paid off their mortgages or can apply for a mortgage holiday, those who rent are still expected to spend the majority of their (already limited) wages on rent.
With living space, gardens and local areas (or the lack thereof) dictating our wellbeing, the gap between the rich and the poor has never been more obvious. Those who live in Clifton for example, close to the Downs and the multitude of parks, will feel the sense of isolation very different to those in Lawrence Hill.
Power & policing
Black people are already nearly ten times more likely to be stopped and searched and four times as likely to be arrested than their White British counterparts (gov.uk) so at the risk of facing fines from the police, some of whom are taking advantage of their extended powers of social control, many will feel a very different sense of lost freedom to those of the majority white population. This is most recently illustrated by the black man who was threatened with spray and arrested by Manchester police for dropping off supplies to vulnerable family members and is representative of a repetitive narrative of using pandemic hysteria as a justification of violence towards socio-cultural minorities.
Essential workers are dying
Our experiences of the lockdown are shaped by race and class and this is glaringly obvious when essential workers are dying on the job.
In the UK, our health service relies heavily on migrant workers. NHS staff who are exposed to the virus are disproportionately drawn from minority ethnic group. The first 8 doctors who died were from Egypt, Nigeria, Pakistan, India, Sudan and Sri Lanka, which only confirms the dependence of the NHS on migrant workers (telegraph). It’s a sign of the systemic racism which permeates our society as white doctors dominate prestigious disciplines while foreign doctors find work on the front line.
The hostile environment
#CharitySoWhite issued a statement calling for action over the unequal impact of the virus on BAME communities and addressed the various ways in which ethnicity, race and immigration status play a part in these disparities. What we have is a benefits system designed to deter people from using it, particularly if the levels of melanin in your skin are higher than those ‘from here’. This is particularly true for the NHS Levy (£2200 p/a for a family of four) that all migrants, including those that work for NHS, have to pay on top of the taxes and puts the idea of equality of access in question. The government’s hostile environment (most recently illustrated by the Jamaica deportations in February this year, supposedly taking ‘violent’ criminals ‘back to where they came from’) allows and directly enforces racist attitudes toward migrants and people of colour.
A recent ITV News report in October 2019 indicated that racist abuse against NHS staff had almost tripled and showed that racist attacks against NHS staff had increased by 145% in 2018. Migrants, many of whom lack the language skills or knowledge to negotiate the complicated benefits system, are having to navigate an online system with no additional support and often poor access to the internet or computers - particularly as public libraries have shut. 30% of Lawrence Hill’s population in Bristol for example, do not speak English as their first language and 7% cannot speak English at all (bristol.gov.uk).
Poverty & health
BAME people face consistent barriers in accessing healthcare, are at a higher risk of developing serious and long-term health conditions and are therefore over-represented in those identified as vulnerable to Covid-19. One third of those analysed who were critically ill were BME. While there is little data on ethnicity and life expectancy, the link between deprivation and average life expectancy is indisputable. A higher level of deprivation is related to poorer health outcomes and reports consistently show that BAME people are far more likely to live in more deprived areas (gov.uk).
In 2011 for example, over 50% of people in the Bangladeshi and Pakistani ethnic groups lived in 20% of the most deprived areas in England. In Bristol, 45% of children in Hartcliffe are from low income families versus less than 1% of children in most parts of Clifton (bristol.gov.uk). With over half of Bangladeshi and Pakistani children living in poverty, the impact of school closures on low-income families who regularly rely on free school meals may be devastating, not to mention the impact of GCSE and A-level cancellations on social mobility, as poorer children and those from minority backgrounds are often predicted poorer grades than the grades they end up achieving.
Racial disparities have a history
Racial disparities have a history and we see this not only in the various responses to the virus around the world (such as the French discussion to test Covid-19 vaccines on Africans ) but also in the racial disparities in death rates all over the world, most obvious in the death rates in the US (Chicago has a 30% African American population who have made up 70% of the death rate, Louisiana has a 32% African American population with a 70% death rate, the list goes on). Policies cannot be race neutral and treating everyone the same will only embed inequalities.
Recognise the difference in circumstances
Thus, while it is important to come together in times of crisis, it is equally important to recognise the difference in challenges and circumstances. BAME communities are overrepresented in many vulnerable groups often with no recourse to public funds, and so addressing structural inequalities is essential to fighting the pandemic. As Guppi Bola argues, we need to suspend NHS charges, support detained migrants and overall, understand the significant racial disparities not only in the virus but in the government’s lockdown strategies. For example, BAME households are often multi-generational and self-isolation is therefore not the only answer to protect the elderly. The issue of race is central to tackling the virus and as #CharitySoWhite note, “without a purposeful, intersectional approach centring on BAME communities, the current outbreak will lead to severe consequences and further entrench racial inequalities in our society”.