The inequities of reopening
It’s easy to say that COVID-19 doesn’t discriminate. But it’s not entirely true, is it?
Those who live in crowded spaces, who struggle with adequate income, housing and food insecurity, those with disabilities, and those who have poor access to health care are markedly more vulnerable.
As provinces across the country begin to reopen, what do we need to know about who is most at risk in our new normal and what can be done about it?
A recent Angus Reid poll shows that the majority of Canadians aren’t willing to resume life as it was before once restrictions start to ease. Seems like we’re all waiting for the numbers to really go down.
But as those who are enjoying some semblance of quarantine privilege get to think about which friend can come over for a porch hang first, others are worried about what reopening will mean for them and their health.
Frontline and low-wage workers bear the brunt of reopening
Sheila Block, a senior economist with the Canadian Centre for Policy Alternatives, has been closely watching the inequitable impacts of COVID-19 and says that “the reopening of the economy will shine a light on inequality just as the onset of the pandemic did.
“Higher-income individuals will be able to continue to work from home and, therefore, protect themselves and their families from potential exposure. Low-income workers whose workplaces reopen will likely have to return to work and take on health risks to put food on the table for themselves and their families.”
University of British Columbia professor Patrick Condon agrees, arguing that the pandemic reveals how deeply inequities are built right into our cities:
“We’ve basically boxed ourselves into a situation where the people with [essential] jobs [like grocery clerks, nurses, garbage collectors] usually are not able to live close to their jobs because they can’t afford to.”
Jammed commuter trains and buses no longer seem safe but are still the only option for many.
Without explicit protections for employees, things could be murky, forcing people to choose between getting fired, risking infection or infecting others.
This choice was already a reality for a lot of people before the pandemic. You’ll remember that we don’t have a lot of paid sick days in this country. And that’s by design.
But three days of unpaid leave, if you’re someone who lives in Ontario, won’t really cut it if you get COVID-19, a disease that takes at minimum 14 days to work through your system, during which time you’re also contagious to others.
We’re all in this together but we’re not all affected the same
The bits of data that are coming out are also showing a racial disparity. In the UK, data is showing that Black African Brits are tallying the most COVID-19 related deaths. There’s a similar story in the U.S., where African Americans make up a smaller part of the population but make up a higher percentage of COVID-19 deaths in some states.
COVID-19 data by race is not yet available in Canada, though some jurisdictions are beginning to collect this crucial information. Expect to see similar disparities here.
In Saskatchewan, for instance, the pandemic is spreading through its northern communities. Perry Bellegarde, national chief of the Assembly of First Nations says that “First Nations communities are more vulnerable because of overcrowded living conditions and a lack of hospital access.”
Gaps in the data cover up the real story
Gaps in the data for our northern communities have real consequences for people’s health and our ability to prepare for an onslaught of infections. Data collection and data sharing helps communities to make informed decisions. Without it, we don’t have a good sense of what’s happening.
Courtney Skye, a research fellow at Yellowhead Institute, says that the lived realities of First Nations people in Canada are not being captured or fairly represented. She says "if people aren't empowered with actual reliable data, stigma is a consequence." Collecting race-based data, in general, helps us to identify the gaps in our health care system to better address inequities at the source. Researchers in Canada have been calling on governments to fix the gaps in the data from the start.
“Collecting race and socio-demographic data is an essential component of the work of eliminating inequalities in healthcare,” said a letter signed by 190 public health groups in Ontario to the Premier and Minister of Health.
Without this essential piece, we can’t effectively and fairly address the pandemic and we also can’t predict or prepare for what will happen when we reopen and who it will happen to. A big consideration as jurisdictions begin to reopen.
Funding public health for our future
One thing that is abundantly clear is that what we’re collectively experiencing in the wake of this pandemic is the result of decades of underfunding our public health care systems across the country. COVID-19 exposes the decay of everything from our PPE supply chain to long-term home inspections to the abysmal pay for personal support workers.
For years, provincial governments across the country have been implored to reverse or freeze cuts to health care. If it isn’t political now (according to Alberta’s health minister), why would it have been before a (predicted) global pandemic? Ontario’s action plan includes $3.3 billion of additional resources for health care. But before this, the government was planning an annual cut of $200 million. Why would we ever starve this most essential of services?
We are only in the first wave of the pandemic. We should expect and prepare for more. We will have a second wave. We will have a future pandemic. But will we learn enough to be ready?
Whether it’s COVID-19 or something new, we need to be better prepared with robustly funded public health systems and social safety nets.
We need better data to make sure that everyone is getting what they need when they need it.
As restrictions start to relax, remember that we’re still trying to protect each other from infection. Continue to keep your distance and minimize your trips out and be generous with our front line workers.
Jo Snyder is a seasoned communications professional with expertise on the social determinants of health and health equity. Over her career, she's worked with think tanks, non-profits and big tech to deliver comms of all kinds.
This project has been made possible in part by the Government of Canada.