- Hannah Hassan
Inclusion and equality matter: Why are they missing from our approach to Covid?
Illustrations by Megan Le Brocq
The uneven impact of Covid-19 has shown the abject failure of our response to it as a society. It has caused immeasurable detriment to marginalised people, and yet our policies continue. The laissez-faire approach to Covid, its harms, and the increasingly libertarian policies that seek to erode social solidarity and replace it with personal responsibility, indicate the rampant disregard for minorities in policy and wider society. Covid has exposed complex, intersecting social problems and emphasised the multiple disadvantages marginalised people experience. Those of us with disabilities, low incomes, women and ethnic minorities have higher exposure and fatality to Covid, yet receive the least support from employers and social security. Removing protections means marginalised people will lose the remaining means of protecting themselves from Covid’s social and economic harms.
Covid policy already abandons the likes of me, a mixed race woman with an invisible disability, alongside countless others. I have Type 1 Diabetes, an autoimmune disease where my body attacks itself, likely caused by post-viral syndrome. While I have avoided Covid by limiting contact with friends, family, and my partner for most of the last two years, this will not be enough to escape Covid forever. Many regard this as an extreme personal choice. What they fail to see is that I’m not excluding myself, it is the environment that is excluding me and many others from participating socially and avoiding infection.
Increased death and illness in marginalised people are a combination of occupational, social and environmental factors. Insecure workers experience twice the mortality rate to others. Having no employment rights makes it unlikely that extra safety precautions or home working will be granted. Precarious work is predominantly carried out by women and ethnic minorities. Both represent a large portion of essential workers, in overwhelmingly public facing or caring roles. Black and South Asian people have three times the infection rate, have a larger average household size and more often live in deprived areas. Occupational exposure, increased household transmission and poorer socio-economic conditions together produce increased death rates.
The social determinants of health impact disproportionately on disabled people. We experienced the largest reduction in wellbeing through Covid. Our lower socio-economic status is due to poorer access to education and the labour market, discrimination, and the insufficiency of social security in meeting the increased costs of disability. Covid has strengthened barriers to healthcare, food, and practical support which continue to restrict independence and quality of life. This impacts on physical and mental health significantly more for disabled people. Disabled workers are also 17% more likely to be public facing, increasing exposure and Covid-related wage loss.
Failing to consider marginalised people in pandemic policy has increased existing social exclusion and inequality. Lifting protections will be an attack on vulnerable, marginalised and working people. Despite our rights to safe inclusive environments, institutions will further renounce their responsibility to protect people. The previous removal of protections termed “Freedom Day” further curtailed freedom and inclusion for disabled people, and upcoming changes will be no different. Only 2% of people felt safe and over half continued distancing, avoiding public transport and indoor places. It impacted disabled peoples’ incomes, with 37% suffering financially due to employers refusing reasonable adjustments. The narrative that Covid is no longer significant nullifies any concerns we try to raise. My own university’s lack of engagement with my concerns shows they are a mere inconvenience; that by asking for adjustments I am being abrupt, paranoid or embellishing my concerns. Disabled people are 46% less likely to discuss their increased risk to Covid with employers. Ethnic minority women are also likely to avoid reporting workplace discrimination, because they believe they will not be taken seriously. There is a culture of fear for marginalised people around raising legitimate concerns. The strength of the narrative is silencing and trivialising us. It is showing minorities they have no voice to protect themselves; that individual freedom to accept risks overshadows the suffering it causes others; that disabled lives matter less than non-disabled lives.
This also excludes non-disabled people who choose to avoid infection and Long-Covid. People who insist on continuing to avoid indoor public places and meeting outdoors are quickly presumed to be excessively anxious. Yet such indoor environments are not without risk, even with free testing and masks. Their removal ensures no setting will be able to guarantee low risk. The inevitable increase in infection will strain workforces, including NHS capacity to work through the many treatments postponed as a result of the pandemic.
Risk to Covid has been normalised despite a significant portion facing disproportionate harm. The retrenchment of Covid support payments, lack of sick pay and removal of free testing will prevent us protecting others. This undermines the message that returning to work and education is safe. Without informed choice and financial support, removing protections directly contradicts our ability to exercise personal responsibility.
The cost of living crisis means those who cannot afford any wage loss are likely to infect others within their occupational and economic class. Workplace and school infections will become inevitable by removing mitigations and online options. Without flexibility and support, many will have no choice but to be exposed to Covid. Inflexibility and disparity already create attainment gaps for disabled people and minorities; removing protections will deepen class inequality and intensify these.
Yet we have the tools to avoid this. Risk mitigation has long been woven into our culture. We accept that schools, workplaces, even homes must be risk assessed, audited and subject to occupational health interventions to minimise risk and liability. How then, have we become a society that wilfully accepts exposure to a harmful virus?
An inclusive new normal must be designed from the social model. Living with Covid can be safe through mitigations such as ventilation, well-fitting masks, and the basic protections we know work. A new normal must alleviate intersecting inequalities for minority and low income people through financial and employer support. It must accommodate people who cannot be vaccinated or whose clinical risk means Covid is a huge risk. It must reduce health inequality and protect multiple comorbidities. Planning that considers diversity will promote inclusion and reduce risk for everyone.
The discussion of Covid protections is not a binary choice between freedom and lockdown. It shows the narrative is polarised, dangerous and requires nuance. The intersectionality and depth of inequality makes Covid increasingly unavoidable for marginalised people. The freedom of one group will be the oppression of another and it should be nobody’s free choice to exclude or harm those with the least ability to protect themselves. An inclusive new normal is possible.