Pandemic of inequality: Emergency measures must prioritize those most at risk

New coronavirus exposes deadly public health and social safety gaps
Photo: Tim Mossholder on Unsplash

“‘There is a rich man’s tuberculosis and a poor man’s tuberculosis. The rich man recovers and the poor man dies.’ This succinctly expresses the close embrace of economics and pathology.” – Dr. Norman Bethune, 1932

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There’s nothing like a pandemic to highlight the pathologies of our current social and economic system. The nature of the coronavirus outbreak means that an injury to one is an injury to all — but some are more vulnerable to suffering the most serious wounds.

That’s why the current extraordinary and emergency measures being implemented by the provincial and federal governments must prioritize those most at risk. Applying the principles of justice, equality and solidarity will help us minimize the damage from this pandemic and move us in the direction of a healthier, fairer and more sustainable society.

First and foremost, that means deploying public health resources where they are needed most, and doing so quickly. Canada’s response has been better than that of the United States, hampered as our neighbours are by their blustering and buffoonish head of state, but we have lagged behind South Korea’s exemplary implementation of broad testing.

There is nowhere to self-isolate if you don’t have a safe place to call home.

From all over the world come reports of the rich and famous jumping the queue to get tested. As Canada’s public healthcare system bends and strains under the current crisis, all options must be on the table to ensure the equitable distribution of resources for testing and treatment. In Spain, for example, the government has used its emergency powers to take over private health care facilities in order to better coordinate public care delivery.

Homes for health

Ontario and Quebec have announced short-term restrictions on evictions. Tenant organizers across Canada are demanding all governments ban evictions and consider moratoriums on rent in some circumstances.

In cities like Vancouver and Toronto, which already have acute housing crises, thousands of service and hospitality sector workers facing layoffs or sharply reduced hours simply won’t be able to make rent on April 1 without significant immediate financial support or a moratorium on rent. In addition to a rent freeze, moratoriums on mortgage payments and utilities need to be seriously considered.

Tens of thousands of people are experiencing homelessness across Canada. There is nowhere to self-isolate if you don’t have a safe place to call home. Earlier today, advocates for the Oppenheimer Park homeless camp in Vancouver’s Downtown Eastside held a press conference to demand action from local officials. An excerpt from their press release reminds us of the extraordinary vulnerability of the camp’s residents and all those in conditions of homelessness:

In Oppenheimer Park, there is no soap or hand sanitizer in the washrooms — and sometimes no washrooms at all. Running water is limited. Tent city residents, and other homeless people, often rely on crowded drop-in centres, food line-ups, and shelters with shared washrooms and showers. Many are immune compromised, with chronic disease and disability, and a high percentage are seniors. The vast majority don't have phones to call 811 for testing or help.

Existing resources are not equipped or prepared to meet pandemic-level needs and demands. Vancouver Coastal Health does not currently offer any formal services or outreach in Oppenheimer Park. Shelters and drop-ins are already overwhelmed and under-equipped to offer additional shower, laundry and washing facilities. Other Downtown Eastside programs are scrambling to pandemic-proof existing services, especially for those who are most at risk.

In California, the governor has announced the state will acquire hotel rooms and other accommodation to ensure the safety of the more than 100,000 people experiencing homelessness. Similar measures need to be implemented across Canada. In the short term, this will save lives and slow the spread of the new coronavirus. In the longer term, the precedent can pave the way for the provision of permanent housing for all who need it.

Child care and income supports long overdue

Provinces across the country have announced extended school and daycare closures, deemed necessary to reduce social contact and transmission of the virus. But none have provided anything close to an adequate plan for child care.

What are wage-dependent workers who must go to work in order to meet basic needs supposed to do with their kids? What about essential workers — ranging from medical professionals to health support workers to grocery store and pharmacy employees — who should not be stuck at home to care for children because they have been left in the lurch by government?

Canada has waived the standard waiting period for EI for COVID-19 cases. But what about gig workers and the self-employed — an increasing proportion of the workforce — who don’t qualify for EI? In the United States, Mitt Romney of all people has jumped in with a proposal for some version of a temporary universal basic income that would see $1,000 sent to every U.S. citizen.

Going forward we must interrogate the systemic inequality in our society and its manifestations in Canada’s beloved public health care system.

On Tuesday, Prime Minister Trudeau indicated details would be forthcoming later this week on plans addressing those not covered by EI. Will the federal or provincial governments in Canada match the measure proposed by Republicans south of the border?

And what about workers who do not have access to paid sick leave?

Canada should look to countries like Denmark, where the needs of the working classes have been prioritized. “During the next three months, the state will cover 75% of the wages of workers threatened by job loss, up to £2,800. Companies will cover the remaining 25%, while workers will give up 5 days of paid holiday time, in other words work five days for free,” reports Tribune magazine.

Denmark points in the right direction: securing the livelihood and well-being of working people, rather than no-strings-attached corporate bailouts. Going forward we must interrogate the systemic inequality in our society and its manifestations in Canada’s beloved public health care system.

A fight of collaboration and solidarity

Why has our health system constantly verged on not having enough sick beds — and in some cases even run out of them, leaving patients in hallways — even before this pandemic? What excuse is there for underfunding health care? The cracks are going to become apparent as COVID-19 sweeps the country.

In the North, particularly in First Nations and Inuit communities, people often live in overcrowded conditions, stuffed into an insufficient number of houses. In this situation, the virus could spread easily, and people will encounter challenges in self-isolating. Health care in such regions is limited, as communities may have one or two nurses, and people must be flown to places such as Iqaluit, Nunavut’s capital, to access hospital care. Tuberculosis, which also causes respiratory distress, is already a problem there. What will happen when COVID-19 is added into the mix?

We need the end goal to be treatment for all, based not on a profit imperative but on an understanding of the strength of collective solidarity.

While social isolation on an individual level is required to slow the COVID-19 wave, it’s certainly not what should be happening at the top levels.

We need more collaboration and solidarity to fight this pandemic.

We need governments coordinating the production and distribution of equipment and supplies — from ventilators to testing kits to face masks and other personal protective equipment for health care workers — to ensure all places in need have what it takes to face the virus.

We also need researchers sharing information across borders, working with one another to develop more efficient testing regimens and to create a vaccine, without governments trying to implement silos and monopolize vaccine development.

We need the end goal to be treatment for all, based not on a profit imperative but on an understanding of the strength of collective solidarity. Only then can we escape the pathological embrace of a system that threatens our health through the pandemic of inequality.

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