Viruses don’t discriminate, they can’t. They don’t have a brain, they can’t discriminate between people. So the current crisis is a special one, one in which we don’t have to think about inequality. COVID-19 as the great equalizer, for which we don’t have to talk about differences, inequality, discrimination. That saves another problem. Or isn’t it that simple?
Viruses don’t discriminate, they can’t. It doesn’t matter to a virus whose body it’s in. But people are different, people have unequal opportunities, people do discriminate. And that’s a problem, also, and maybe especially, in the current situation.
The differences between people also lead to differences in the consequences of this pandemic, now and in the future. The risks of COVID-19 are different, depending on who, what and where you are. For convenience’s sake, let me take my own situation as a starting point for the comparison. I am a middle-aged woman, live in a Western European country and have an office job.
1. Risk of infection
Viruses don’t discriminate, so anyone can get infected with COVID-19, including me. But the risk of infection is not the same for everyone. COVID-19 is transmitted from human to human, so if you have contact with a lot of people, for whatever reason, the risk of infection increases. I can choose whether I stay at home, where I only get in contact with my husband, or to go outside, but that doesn’t apply to everyone.
Sometimes people have jobs in which they don’t have that choice. Supermarket or shop employees, parcel delivery staff, tram and bus drivers, health workers, all those people who work in what we have come to call the essential professions, come into contact with other people a lot. By definition, therefore, they run a higher risk of infection. This is even more true for many people who work in the informal sector in developing countries, such as street vendors or drivers of moto-taxis. Not only do they come into frequent contact with other people, but they are usually unable to take protective measures because these are not (yet) available or not affordable.
Sometimes people also live under conditions that mean do not have a choice. Residents of a shack in a slum or a tent in a refugee camp cannot choose to stay inside because their place of residence is not suitable for that purpose. The same applies to many people without a valid residence permit who often rent an apartment with many people at the same time.
2. Risk of serious infection
People are different. Anyone who becomes infected can develop serious symptoms, but the risk is not evenly distributed among the population. Age is an important factor; children are hardly at risk of developing complications, older people have a much higher risk. This means that countries with an older population have a higher risk of overburdening the health system. Underlying medical problems or (serious) overweight also greatly increase the risk of complications. And someone’s gender also appears to be a risk factor; men are considerably more likely to have a serious course of the disease than women. As a middle-aged woman, with good health and without being overweight, I don’t run that much risk.
3. Risk of consequences of complications
People have unequal opportunities. What happens if I show serious symptoms and need professional medical care? Then I’ll go to a hospital. The hospital around the corner or, if that has reached full capacity, another hospital. I don’t have to wonder whether that care is available; although the occupancy in intensive care has reached a critical level in recent weeks, the speed with which capacity was scaled up meant that there has never been a real shortage. I certainly don’t have to wonder whether I can pay for the necessary care, as everyone in this country has compulsory insurance to be able to do so. Those certainties are not self-evident everywhere and for everyone. In a country like Mali, there are 20 ventilators for 19 million inhabitants, half of the population of Afghanistan doesn’t even have access to any medical care within two hours travel distance. I find it incredible though that a large part of the American population does not have access to the necessary care. Not because that care does not exist (although the availability of quality care is also much more limited than expected given the country’s level of prosperity), but because a large proportion of Americans cannot afford good care because they are not insured. So it is political choices that determine people’s unequal chances of survival, not medical choices.
4. Risk of consequences of staying at home
People have unequal opportunities. If I show symptoms of infection with COVID-19 I have to stay at home and I am not allowed to leave my house. Annoying, yes, but not much more than that, it has no major consequences for me. I have an office job that I can also do from home, I have a house where I can stay in a pleasant way, where I can work well. I have a partner who can take care of the groceries or if he’s not allowed to go out, I can order the groceries online and have them delivered at my doorstep. I can manage. It’s different for people who have to go out on the streets every day to buy their food, or who have to go out for work and have no income when they’re not working. That means being hungry.
Also for those who don’t have a house, a house that’s too small, a house that’s too crowded, the consequences are much worse. In addition, the forced stay at home, close to each other for days or weeks on end, combined with the extra tension of this pandemic, leads to an increase in the risk of domestic violence. This means that staying at home, intended as protection against one danger, ultimately leads to an increase in another danger. An impossible choice that no one should be forced to make.
5. Risk of consequences of measures against the pandemic
People do discriminate. Inequality of opportunity does not end at the end of the pandemic, inequality has been increasing for years. The measures that are being taken now also have far-reaching consequences that will affect people’s future in different ways.
I could lose my job, which is bad and undoubtedly has consequences. But I can manage, I live in a country where I am entitled to social services that at least offer me an income, I have a network of people around me who can support me. For many others that is not the case. Farmers cannot sow or harvest if they are not allowed to leave, factories that go bankrupt no longer have employees. And if you then live in a country without social services, where everyone in your network is in the same situation so that supporting each other no longer works, then you go hungry. A famine threatens that can be more serious than we have experienced in a long time and from which more people could die than from the COVID-19 virus itself.
The good news is that this does not have to happen, we have a choice and can prevent it. The bad news is that we have to make that choice. The virus doesn’t discriminate, but people do.