Are we really all in this together? | Cassandra Voices

Covid-19: are we really all in this together?

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Introduction

What I don’t find nice, and I really don’t need, is people clapping. I don’t need rainbows. I don’t care if people clap until their hands bleed with rainbows tattooed on their faces. I don’t even (whisper it) need Colonel Tom, lovely man as he clearly is…

The coronavirus crisis has shone a light on lots of good and bad things in this country. It is of course to be welcomed that key workers, including those for the NHS and social care, are being increasingly valued. I hope the reality is dawning that immigrants and BAME staff are vital to the NHS and we couldn’t manage without them.

But don’t feel you need to clap. Enough with the rainbows. When this ends, people need to show their value of key-working staff in practical ways; pay them enough to be able to live in our cities, and recognise, support and welcome immigrant staff who prop this country up. Listen to the views of NHS workers when they raise concerns, address the culture of blame and bureaucracy.
Anonymous NHS Doctor, 2020[i]

Mediated Isolation

Cocooned in state-imposed lockdown, many of us succumbed to media binges while absentmindedly doing the housework, feeding the kids or, my own personal bête noire, chasing the kids down to do their homework. For some this might entail spending a sizable proportion of their waking hours perched in front of flickering TV screens while others opted for being serenaded by the droning tones of radio heads defining their versions of a ‘national reality’, from which we were physically excluded.

Internet and social media platforms have also served to distract us from excess navel gazing by informing us of FB ‘friends’ consumption habits that day, conjectures as to when the ‘circenses’ of sport will return to lighten up our beleaguered days and the travails of celebrities struggling to survive their privileged lockdowns, while providing anodyne and impractical advice on how we too might achieve elevated states of consciousness.

However, no matter which media is our poison of choice, it is hard to escape the constant, mind-numbing refrain that ‘we are all in this together’, facing the same existential threat irrespective of our status in society, our relative wealth, cultural and religious ethos and any other distinguishing features, real or imagined. Only by sticking together will we be able to defeat our contagious foe, or so the story goes.

Never ones to let a good crisis go to waste, the advertising industry has swiftly conceived and produced a slew of adverts to hawk their clients’ wares by tapping into the positive sentiments of this catchphrase. Praising frontline workers or highlighting our newfound unity – separated but together – they strive to manipulate the emotions and purchasing decisions of their target audiences.

But are we really all in this together? Has the Covid-19 pandemic impacted us all in a similar manner? Or has it and the measures imposed to tackle it impacted upon different sectors of our societies?

Mortality Rates

The first and most obvious disparity of impact has been the varying mortality rates between different age groups. Amongst those diagnosed with Covid-19, people over 80 were seventy times more likely to succumb to the virus, than those under 40 and the death rate amongst males has been seen to be greater than amongst females. A Public Health England report revealed a higher mortality rate amongst members of Black, Asian and Minority Ethnic (BAME) groups than in White ethnic groups, those born outside the U.K. and Ireland as well as, unsurprisingly, ‘those in a range of caring occupations including social care and nursing auxiliaries and assistants; those who drive passengers in road vehicles for a living including taxi and minicab drivers and chauffeurs; those working as security guards and related occupations; and those in care homes.’[ii]

However, it could be argued that these facts should not be used to detract from the fact that we are all in this together. After all, Covid-19 resulting in higher mortality rates amongst certain age categories is surely just a characteristic of this virus, similar to how the second wave of the 1918 flu virus disproportionately resulted in deaths amongst young men and women in their 20s and 30s, ‘while often sparing the very young and the very old.’[iii] Similarly, there are obvious reasons why people on the frontline and who have been dealing directly with the public have experienced greater rates of infection and higher mortality rates. Although the higher rates of death amongst BAME groups is evidently concerning, it too requires greater examination to be able to determine its exact cause.

Socio-Economic Disparities

While one might claim pathogens are ‘democratic by nature’, [iv] in the sense that viruses do not consciously target potential victims or particular social groups, certain social and economic factors clearly influence their ease of dissemination and transmission.

In the United States, according to the epidemiologist Camara Phyllis Jones, the higher infection rates amongst African and Latin American communities can be at least partly attributed to their being at a greater risk of exposure and less protected. Other contributing factors include the existence of socio-economic and health disparities, themselves the outcome of historical segregation and endemic racism,[v] as well as the increased levels of contact with environmental pollution and lower rates of access to health care.[vi]

In many parts of the United States, people of colour make up a higher proportion of some low-paid professions that have elevated risks of exposure to the virus—those who staff grocery stores, drive buses and work at food plants, for example. Also, COVID-19 is deadlier for people with chronic conditions, including diabetes, obesity and cardiovascular disease. These have a higher incidence in many minority ethnic and racial groups.[vii]

In the U.K., considerations such as ‘crowded housing and working conditions’ have been advanced as reasons for the divergences in infection and death ratings between ethnic minorities and white people. For example, whereas only 2% of white people in the U.K. are living in crowded conditions, overcrowding is far more prevalent amongst minority ethnic groups with as many as 30% of Bangladeshi, 16% of Pakistani and 15% of black African households being overcrowded.[viii]

Social Determinants of Health

According to Dr. Enam Haque, a GP based in Manchester, while BAME groups, particularly from South Asia, are more prone to diabetes, heart disease and high blood pressure, which does increase their risk of contracting Covid-19, a more significant role is played by the social determinants of health.[ix]

As Farrell, McAvoy and Wilde explain

Health is not just the outcome of genetic or biological processes but is also influenced by the social and economic conditions in which we live. These influences have become known as the ‘social determinants of health’. Inequalities in social conditions give rise to unequal and unjust health outcomes for different social groups.[x]

About a decade ago, my wife Anna Datta, who is a doctor, and I prepared a couple of Thinkpieces for the Think-Tank for Action on Social Change, on the Socio-Economic Realities of Mental Health in Ireland and the Socio-Economic Realities of Health in Ireland as well as preparing an oral presentation on the Socio-Economic Realities of Health in Ireland for the 19th European Congress of Psychiatry. In researching and drafting these pieces the critical role played by social determinants in determining the health of different sectors of the population was clear. We concluded that

(i) Social determinants contribute to health inequalities between social groups. This is because the effects of social determinants of health are not distributed equally or fairly across society.

(ii) Social determinants can influence health both directly and indirectly. For example, damp housing can directly contribute to respiratory disorders, while educational disadvantage can limit access to employment, raising the risk of poverty and its adverse impact on health.

(iii) Social determinants of health are interconnected. For example, poverty is linked to poor housing, access to health services or diet, all of which are in turn linked to health.

(iv) Social determinants operate at different levels. Structural issues, such as socioeconomic policies or income inequality, are often termed ‘upstream’ factors. While ‘downstream’ factors like smoking or stress operate at an individual level – and can be influenced by upstream factors.[xi]

The social determinants which have placed minority ethnic groups at a health disadvantage already as well as other vulnerable groups – less economically secure white people, the homeless and so forth – have led to their members being at greater risk of falling victim to Covid-19. It is critical these factors are addressed, not just in a piecemeal fashion or through a short-term approach in response to this pandemic, but comprehensively with structures being put in place to reduce the health inequities experienced by BAME communities and other vulnerable groups, as well as ensuring equitable access to health services.

The 1% and the Rest

When celebrities die, we review their lives; when wage earners die, owners re-hire.[xii]

People around the world have been obliged to adapt to living in relative isolation, frequently separated from their loved ones due to stringent lockdowns. They have found themselves in straitened conditions on reduced incomes, with many worried as to whether their pre-Covid-19 jobs will still be there when the economy reopens. The vulnerable in countries such as India, South Africa or the Philippines, are faced with the Catch-22 situation of abiding by savage lockdowns, facing potential starvation and severe malnutrition for their families, or venturing forth at the risk of violent beatings or worse at the hands of the police for breaking state-imposed lockdowns.

As Joseph Natoli writes, the rich face no such dilemmas.

Those who live on dividends and interest from investments face no Catch-22. Private planes take them where they think they will be safer. Sheltering in place on your yacht with a serving crew is a safe sort of isolation. It’s in fact not much different than life before the pandemic. A cell phone and zoom keep you actively tending your horde. A top 20% meritocratic class has already been working from home, not bound by office or punching a wage clock. Life’s not much different for them. Nannies and tutors, daily tested, can handle, as usual, the offspring. Someone — not you — will cook and clean. Life’s not much different. No Catch-22 here…[xiii]

One of the most vocal advocates for the re-opening of the economy and ending the lockdown measures in place is the controversial billionaire Elon Musk. He even went so far as openly defying the local authorities in the US to reopen his flagship Tesla auto assembly plant in Fremont, California, which public health officials had ordered shut down some two months previously. Due to a complicated pay deal Musk had negotiated with Tesla, which could culminate in the ‘biggest executive pay windfall in global corporate history,’ opening this plant was critical to help him reach the required targets.[xiv]

While, it might be argued that Musk was right in his arguments about opening the country to business to prevent economic devastation, whatever his personal interest, this is not the issue here. If an ordinary U.S. citizen had defied the public health authorities as Musk did, publicly defying the civic authorities to arrest him as he joined his workers in the factory,[xv] would they have got away with it? Having got his way, Musk can now sit back in comfortable isolation, while his workers run the risk of contracting any circulating viruses, as he waits for his bonus to come home to daddy.

Rich Man, Poor Man

During Covid-19, the ultra-rich have managed to increase their already obscene share of the world’s wealth, as poor people around the world have struggled to survive. A report by Americans for Tax Fairness reveals that between 18 March and 19 May, in the midst of state lockdowns and business closures, the wealth of Jeff Bezos (Amazon), Bill Gates (Microsoft), Mark Zuckerberg (Facebook), Warren Buffett (Berkshire Hathaway) and Larry Ellison (Oracle) grew by $75.5 billion. The personal wealth of Elon Musk alone, grew by 48% or $11.8 billion.[xvi]

At the same time, the severe impositions of movement control and lockdowns globally have disproportionally affected the more vulnerable members of our societies. While things may be booming for the wealthiest, many of the poorest and most defenceless communities are subject to violent and humiliating punishments to ensure they stick to quarantines, leaving them at the risk of starvation. Alberto Ruíz, who sits on a resident’s social organisation in the deprived Tacumbú neighbourhood of Asunción emphasises the lack of support that has been provided to lockdowned families deprived of any income and how people have been instructed ‘to stay at home, to protect your family. But in poor neighbourhoods, you have to go out to earn a living: if you don’t, you die of hunger.’[xvii]

As Arundhati Roy writes, encapsulating the horrors of those most affected by the Indian lockdown, migrant workers and their families.

Many driven out by their employers and landlords, millions of impoverished, hungry, thirsty people, young and old, men, women, children, sick people, blind people, disabled people, with nowhere else to go, with no public transport in sight, began a long march home to their villages. They walked for days, towards Badaun, Agra, Azamgarh, Aligarh, Lucknow, Gorakhpur — hundreds of kilometres away. Some died on the way. They knew they were going home potentially to slow starvation. Perhaps they even knew they could be carrying the virus with them, and would infect their families, their parents and grandparents back home, but they desperately needed a shred of familiarity, shelter and dignity, as well as food, if not love. As they walked, some were beaten brutally and humiliated by the police, who were charged with strictly enforcing the curfew. Young men were made to crouch and frog jump down the highway. Outside the town of Bareilly, one group was herded together and hosed down with chemical spray.[xviii]

Philip Alston, the former United Nations Special Rapporteur on extreme poverty and human rights, accuses many states of having enacted policies reeking of social Darwinism, by prioritising the wealthiest to the detriment of the poor.[xix] Looking at how entire countries have been shut down by governments, many of whom have failed to make even minimal efforts to protect the most vulnerable members of their societies, it is hard to disagree.

Covid-19 and minority ethnic groups

From early May, New York City reported over twice as many deaths amongst the African and Latin American communities per 100,000 residents compared to white people. The Bronx, with the highest concentration of African Americans, had the city’s highest rates of deaths and hospitalisation.[xx] Data from early June indicates that Black Americans have been throughout the U.S. been 2.4 times more likely to succumb to Covid-19 than White Americans.[xxi]

This disparity of impact on black and Asian communities is also an issue of serious concern in the U.K. Harriet A. Washington writes how

In April, the UK Intensive Care National Audit and Research Centre estimated that 35% of people in intensive care with COVID-19 are black, Asian or members of other minority ethnic groups, nearly triple their proportion in the UK population. The first ten physicians in the United Kingdom known to have died from COVID-19 were also from black, Asian or minority ethnic groups.[xxii]

Racial Inequality in the U.K.

A Public Health England report, Covid-19: review of disparities in risks and outcomes, highlighted the role that deprivation can play in exacerbating infection and mortality rates.

The mortality rates from COVID-19 in the most deprived areas were more than double the least deprived areas, for both males and females… ONS analysis shows that between 1 March and 17 April 2020 the deprived areas in England had more than double the mortality rate from COVID-19 than the least deprived areas.[xxiii]

Given the relatively impoverished status of BAME groups, as evidenced in their far higher concentration in impoverished locales such as the most deprived 10% neighbourhoods, their vulnerability to Covid-19 is further aggravated.[xxiv]

Ethnic minority workers also tend to be employed in more insecure and more poorly regulated work with a Carnegie U.K. Trust, UCL and Operation Black Vote report noting that BAME millennials were some 47% more likely to be on ’notoriously unstable “zero-house” contracts.’ As a result, they have been disproportionately engaged as key workers in front-line positions, placing them at greater risk of catching the virus.[xxv]

The situation for migrants to the U.K. employed in front-line positions, necessitating direct contact with the public, is if anything even more precarious. A particularly tragic case was that of Rajesh Jayaseelan who succumbed to the virus alone in Northwick Park hospital on 11 April. Rajesh, who had come to London about a decade earlier to provide for his family, had starved in his rented accommodation for several days. He had informed his wife he did not want anyone to know of his condition, as he feared being cast out on the street, as had happened at his previous lodging where the landlord had evicted him due to the risk of his contracting the virus as a Uber driver. By the time he made it to the hospital where he passed away, he was already critically ill. He left behind a wife and two young children, to whom he bade one final farewell in a last video call from his hospital bed.[xxvi]

Exacerbating social and economic inequality

The situation in South Africa clearly illustrates the social and economic divisions that existed in society prior to Covid-19 and how they have remained in place during the virus and punitive lockdown. Rather than creating a national unity where everybody feels they are in it together, the pandemic and, in particular, the actions taken to combat it have in face served to reinforce the social schisms. As Patrick Bond writes:

The lockdown and social-distancing mandates simply won’t work in the overcrowded townships, which traditionally under apartheid were built merely as the urban holding cells of a reserve army of migrant labor… Many workers and most of the massive unemployed precariat were immediately without income as the full lockdown began on March 27, just as the state safety net was fraying… So as Covid-19 has struck, the country’s extreme inequality has been exacerbated, and the state’s long-standing delivery shortcomings stand exposed… For many people suffering what were already recessionary conditions, coronavirus seems the least of their concerns.[xxvii]

Bond quotes a local activist who explains that while people understand the potential threat of coronavirus ‘it is here for a short period, while we have been living under these dangerous conditions since 2000.’[xxviii]

Le coronavirus, c’est l’État (the coronavirus is the state) [xxix]

As she recounts issues of police harassment and oppression in the tower block estate of La Caravelle located in the commune of Villeneuve-la-Garenne, Malika points out a boy of 13, who looks younger, and relates how a couple of days previously he had frantically knocked on her door pleading for help as the police were around.[xxx]

Another resident, Taha Amghar, details how a body of police followed him home, entered his flat and beat him with their batons. They had then detained him overnight, and refused him access to legal representation. Rather than receiving any apology for this completely unnecessary detention, Taha was later issued with a deportation notice on the grounds of his Moroccan nationality, prohibiting him from working, despite having lived in France for 16 years. To add insult to injury, Taha has a medical certificate from a French doctor explaining the necessity of his remaining in France as he has a chronic illness for which treatment does not exist in Morocco.[xxxi]

It is for this reason that Malika states ‘Le coronavirus, c’est l’État.’ For the relatively impoverished residents of La Caravelle, Covid-19 is being exploited by the state and its’ servants, primarily through the brutality of police operations, to repress them. Whereas for Louis XIV, he was the nation (l’État, c’est moi), today the French state (ab)uses the coronavirus, by using it as a ‘veil’ to disguise its’ efforts to engage in targeted violence and discrimination, primarily against ethnic minorities.

As Assistant Professor of Sociology, Jean Beaman writes,

While everyone in France is subject to this decree, early evidence reveals it has been differentially applied. COVID-19 is not the equalizer or leveler some have suggested. Rather, this state of health emergency has disproportionately affected some populations compared to others, as some communities are more policed and surveilled than others. And these communities and populations are those that were already marginalized in France before COVID-19.[xxxii]

Plight of refugees and migrants

Similarly, it is hard to see how the almost 71 million refugees and forcibly displaced people worldwide[xxxiii] are being included as one of us, members of the ‘we’ fighting an implacable, infectious foe. As Cork-born Ettie Higgins, the UNICEF Deputy Representative in Jordan, warns previous experience has demonstrated “that a pandemic accentuates existing inequalities and makes life much more difficult for the most vulnerable.”[xxxiv]

Corralled in alarmingly overcrowded camps, the risk levels for refugees is greatly elevated for virus contraction and dispersion, not to mention the barriers, including language, they experience in accessing health services. Devoid of support, residents from many different countries in the Moria camp on Lesbos, where there are over 20,000 people living in a camp designed for less than 3,000, have come together to spread awareness of the virus to their fellow camp residents. A group of four Afghan women, one of whom had been a tailor in Kabul and who was willing to head the operation, volunteered to sew face masks for the camp’s population.

Writing in late May, Lorraine Leete from the Legal Centre Lesvos points out the continued movement restrictions on refugees in Moria were unjustified,

While people continue to be detained inside refugee camps in horrible conditions where there’s limited measures to prevent the spread of Covid-19, restaurants and bars will be opened this week across Greece. This discriminatory treatment is fulfilling the goal of local rightwing groups of keeping migrants out of public spaces away from public view, abandoned by the state.[xxxv]

Added to their immediate concerns regarding Covid-19, refugees are also impacted by the cessation of free movement and international travel between countries, with some countries also placing a hold on resettlement intakes.[xxxvi]

In the U.K., the sharing of patient information between healthcare services and the Home Office has resulted in highly negative health outcomes for migrants with an insecure migration status, as they have avoided going for treatment even for serious complaints such as tuberculosis, lest they be detained and/or deported.[xxxvii]

Indigenous Peoples’ struggles

Indigenous people’s face many challenges, similar to those experienced by refugees and other vulnerable groups. As the UN Permanent Forum on Indigenous Issues highlight:

Indigenous peoples often have much in common with other neglected segments of societies, i.e. lack of political representation and participation, economic marginalization and poverty, lack of access to social services and discrimination. Despite their cultural differences, the diverse indigenous peoples share common problems also related to the protection of their rights.[xxxviii]

Making up some 6% of the world’s population, 476 million people spread over 90 countries, indigenous peoples account for about 15 percent of the extreme poor and have a life expectancy some 20 years lower than that of non-indigenous people worldwide.[xxxix] Frequently deprived of good access to health care, higher rates of poor health and lack of access to adequate sanitation facilities and other preventive measures, the advent of Covid-19 was seen as a significant threat to these communities. However, the lockdowns implemented without adequate support measures, could create greater long-term problems.

As lockdowns continue, Indigenous peoples who already face food insecurity, as a result of the loss of their traditional lands and territories, confront even graver challenges in access to food. With the loss of their traditional livelihoods, which are often land-based, many Indigenous peoples who work in traditional occupations and subsistence economies or in the informal sector will be adversely affected by the pandemic. The situation of indigenous women, who are often the main providers of food and nutrition to their families, is even graver.[xl]

Even worse, some governments are using the cover of Covid-19 to implement policies and actions that indigenous people oppose. In Canada, Kate Gunn, a lawyer at First Peoples Law Corporation wrote in early April how the Crown had still not clarified how it would safeguard the title and rights of Indigenous People’s during Covid-19. The Crown had also failed to confirm whether it would continue to make decisions which might impact on First Nation rights, a particularly critical issue given the impossibility of the First Nations to participate meaningfully in consultations during this period.[xli]

The Choctaw nation and the Irish

Although the mortality rate during the 1740-41 Irish famine is estimated to be slightly higher,[xlii] the 1840s famine is generally remembered as the greatest tragedy to have befallen the island of Ireland. Fuelled by blight devastated potato crops and an, at best, callous British administration,[xliii] one million Irish died and over a million more emigrated between 1845 and 1852 out of a population of 8.5 million.[xliv]

One of the few positive memories of this famine was the wonderful humanity demonstrated by the native American Choctaw Nation who, moved by the plight of the Irish, donated $170 in 1847.[xlv] This was a highly significant sum of money in those times, particularly when you consider that in 1831, the Choctaws had been forced to walk from their ancestral lands in the American southeast to the new Indian Territory in Oklahoma. Along this ‘trail of tears,’ many Choctaw lost their lives.[xlvi] And yet a mere 16 years later they were sufficiently moved by the suffering of a people living in a distant land to dip into their meagre resources to help alleviate the plight of the Irish.

Choctaw ‘trail of tears’

Now, over 170 years later, the Irish finally had the chance to repay this debt to some extent. In response to a fundraiser established to support the Navajo nation, badly impacted by the Covid-19 virus and the lack of suitable health facilities and equipment, many people of Irish origin contributed generously. Several of these contributors left notes drawing attention to the solidarity and humanity displayed by the native American community during the Irish famine.[xlvii]

Solidarity in India

The current pandemic has been witness to acts of heart-warming human solidarity. In India, the transgender community were seriously impacted by the sudden imposition of the Covid-19 lockdown on 24 March. Frequently dependent on daily income to survive, many struggled to survive, dependent on whatever relief was made available by the state and NGOs. Despite their precarious situation, transgender people have established support and assistance scheme for other vulnerable groups.[xlviii]

In Porur, the transgender community helped some 40 members of eleven stranded migrant, Muslim families. Originally from Andhra Pradesh, these individuals did not have identity cards and were therefore ineligible to receive relief. Keerthana, a transgender sanitary supervisor helped feed sanitation workers in Puducherry. According to Srijith Sundaram, an LGBTQ activist, the transgender community was able with the help of patrons to distribute rations and other essential items to these workers.[xlix]

Moved by the frightful conditions and suffering of migrant workers travelling on the Shramik Special trains commissioned to ferry them home, Rasheeda who lives in impoverished circumstances in New Arif Nagar slum in Bhopal, decided she had to do something to assuage their misery. Leaving her house at daybreak, Rasheeda collects materials and food to prepare packages of food. Wasif, her husband, who works in a nearby junkyard as a rag-picker, helps her collect the food, firewood and utensils to prepare these packages. The children in their colony pack the food. Upon the arrival of a train, dozens of the children rush forward with packets of food and water. Between 200 and 250 food packets and 50 litres of water are distributed daily to the grateful passengers.[l]

Rasheeda and Wasif engage in this selfless work each day even though, according to Wasif:

There are days when we get to barely eat as well, but we try hard to feed the passengers because we at least are at home. However, the lockdown has not only made them homeless but penniless too.

  • Six kitchens are operated by their neighbours in the Blue moon colony and New Arif Nagar slums, despite the intense poverty and deprivation experienced by their inhabitants. Each kitchen prepares 20 to 25 kgs of rice daily to distribute to the passengers of two to three Shramik trains. They continue in their altruistic work, despite themselves having only received assistance of 5 kgs of flour and rice from government authorities over two months previously.[lii]

    Final Remarks

    I would argue that if there is one thing that Covid-19 has demonstrated conclusively, it is that we are not all in it together. At least, not in terms of our experiences, our levels of resilience and the impact the virus and state-imposed lockdown measures have had upon us. For vulnerable groups in the Global North or South, minority ethnic groups, refugees and indigenous people, the homeless or financially insecure, the negative impacts of Covid-19 and, in particular, the lockdowns, have been far more severe, resulting in serious economic stress, increased immiseration and deprivation, hunger and even death. Furthermore, as the Covid-19 infections decrease, economies reopen and people get back to work, the inequalities that pre-dated Covid-19 will still be here.

    Moving forward, we need to work together to ensure the most vulnerable groups amongst us receive the support and assistance they need to address these inequities, ensure they are provided with equal access to education, health and other social goods and are able to participate fully and equitably in our society and economy.

    [i] Anonymous-NHS Doctor, I’m an NHS doctor – and I’ve had enough of people clapping for me, The Guardian, 21 May 2020, https://www.theguardian.com/society/2020/may/21/nhs-doctor-enough-people-clapping

    [ii] Public Health England, Disparities in the risk and outcomes of COVID-19, Public Health England, June 2020, Page 4, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/889861/disparities_review.pdf

    [iii] Bryan Walsh, Solving the Mystery Flu That Killed 50 Million People, Time Magazine, 29 April 2014, https://time.com/79209/solving-the-mystery-flu-that-killed-50-million-people/

    [iv] Nidhi Subbaraman, How to address the coronavirus’s outsized toll on people of colour, Nature Magazine, 18 May 2020, https://www.nature.com/articles/d41586-020-01470-x

    [v] Ibid

    [vi] Harriet A. Washington, ibid

    [vii] Nidhi Subbaraman, ibid

    [viii] Harriet A. Washington, ibid

    [ix] Ashitha Nagesh, How coronavirus tore through Britain’s ethnic minorities, BBC, 2 June 2020, https://www.bbc.com/news/uk-52894225

    [x] Clare Farrell, Helen McAvoy & Jane Wilde, Tackling Health Inequalities: An All-Ireland Approach to Social Determinants. 2008, Institute of Public Administration & Combat Poverty Agency: Dublin, Page 11

    [xi] Justin Frewen and Anna Datta, The Socio-Economic Realities of Health in Ireland, TASC, December 2010, https://issuu.com/tascpublications/docs/socio-economic_realities_of_health_in_ireland-fina

    [xii] Joseph Natoli, Who’s in a Catch 22?, Counterpunch, 13 May 2020, https://www.counterpunch.org/2020/05/13/whos-in-a-catch-22/

    [xiii] Ibid

    [xiv] Sam Pizzigati, Civil Disobedience, Billionaire-Style, Counterpunch, 19 May 2020, https://www.counterpunch.org/2020/05/19/civil-disobedience-billionaire-style/

    [xv] Ibid

    [xvi] Bryan Kirk, The 5 Wealthiest Americans Have Gotten 75 Billion Dollars Richer While a Pandemic Guts the Economy, Newsweek, 22 May 2020, https://www.newsweek.com/5-wealthiest-americans-have-gotten-75-billion-dollars-richer-while-pandemic-guts-economy-1506044

    [xvii] Rebecca Ratcliffe, Teargas, beatings and bleach: the most extreme Covid-19 lockdown controls around the world, The Guardian, 1 April 2020, https://www.theguardian.com/global-development/2020/apr/01/extreme-coronavirus-lockdown-controls-raise-fears-for-worlds-poorest

    [xviii] Arundhati Roy, ‘The pandemic is a portal’, The Financial Times, 3 April 2020, https://www.ft.com/content/10d8f5e8-74eb-11ea-95fe-fcd274e920ca

    [xix] UNHR News, Responses to COVID-19 are failing people in poverty worldwide” – UN human rights expert, UNHR, 22 April 2020, https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25815

    [xx] Nidhi Subbaraman, How to address the coronavirus’s outsized toll on people of colour, Nature Magazine, 18 May 2020, https://www.nature.com/articles/d41586-020-01470-x

    [xxi] Marya T. Mtshali, How medical bias against black people is shaping Covid-19 treatment and care, Vox, 2 June 2020, https://www.vox.com/2020/6/2/21277987/coronavirus-in-black-people-covid-19-testing-treatment-medical-racism

    [xxii] Harriet A. Washington, How environmental racism is fuelling the coronavirus pandemic, Nature, 19 May 2020, https://www.nature.com/articles/d41586-020-01453-y

    [xxiii] Public Health England, Disparities in the risk and outcomes of COVID-19, Public Health England, June 2020, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/890258/disparities_review.pdf

    [xxiv] Ashitha Nagesh, How coronavirus tore through Britain’s ethnic minorities, BBC, 2 June 2020, https://www.bbc.com/news/uk-52894225

    [xxv] Ibid

    [xxvi] Robert Booth, Uber driver dies from Covid-19 after hiding it over fear of eviction, The Guardian, 17 April 2020, https://www.theguardian.com/world/2020/apr/17/uber-driver-dies-from-covid-19-after-hiding-it-over-fear-of-eviction

    [xxvii] Patrick Bond, Covid-19 Attacks the Down-and-Out in Ultra-Unequal South Africa, Counterpunch, 3 April 2020, https://www.counterpunch.org/2020/04/03/covid-19-attacks-the-down-and-out-in-ultra-unequal-south-africa/

    [xxviii] Ibid

    [xxix] Lameute Info, Violences policières à Villeneuve-la-Garenne : « Le coronavirus, c’est l’Etat », Lameute, 20 April 2020, https://www.lameute.info/posts/violences-policieres-villeneuve-la-garenne-le-coronavirus-cest-letat?fbclid=IwAR3WlWKvip4Ebm89kTLg3RNYoKp9wOuFyLD-hRzalEWw0DdL1yWKVDyGAd4

    [xxx] Ibid

    [xxxi] Ibid

    [xxxii] Jean Beaman, Living on the Margins in France: Before and During COVID-19, EuropeNow Journal: Centre for European Studies, 22 May 2020, https://www.europenowjournal.org/2020/05/22/living-on-the-margins-in-france-before-and-during-covid-19/

    [xxxiii] Adrian Edwards, Global forced displacement tops 70 million, UNHCR, 19 June 2019, https://www.unhcr.org/news/stories/2019/6/5d08b6614/global-forced-displacement-tops-70-million.html

    [xxxiv] Philip Bromwell, Irish aid worker’s Covid-19 fears for Syrian refugees. RTE, 15 April 2020, https://www.rte.ie/news/2020/0414/1130482-irish-aid-workers-covid-19-fears-for-syrian-refugees/

    [xxxv] Katy Fallon, Greece ready to welcome tourists as refugees stay locked down in Lesbos, The Guardian, 27 May 2020, https://www.theguardian.com/global-development/2020/may/27/greece-ready-to-welcome-tourists-as-refugees-stay-locked-down-in-lesbos-coronavirus

    [xxxvi] UN News, COVID-19: Agencies temporarily suspend refugee resettlement travel, UN, 17 March 2020, https://news.un.org/en/story/2020/03/1059602

    [xxxvii] May Bulman, Pregnant and ill migrants going without medical care as Government intensifies NHS immigration policy, The Independent (UK), 23 October 2017, https://www.independent.co.uk/news/uk/home-news/pregnant-and-ill-migrants-going-without-medical-care-due-to-hardline-government-immigration-policy-a8011351.html

    [xxxviii] UN Permanent Forum on Indigenous Issues, Who are indigenous peoples?, UN, accessed 10 June 2020, https://www.un.org/esa/socdev/unpfii/documents/5session_factsheet1.pdf

    [xxxix] World Bank, Indigenous Peoples, World Bank, 24 September 2019, https://www.worldbank.org/en/topic/indigenouspeoples

    [xl] UN Department of Economic and Social Affairs (UNDESA), COVID-19 and Indigenous peoples, UNDESA, accessed 10 June 2020, https://www.un.org/development/desa/indigenouspeoples/covid-19.html

    [xli] Kate Gunn is a lawyer at First Peoples Law Corporation, Indigenous Peoples and COVID-19: Protecting People, Protecting Rights, First People’s Law, 8 April 2020, https://www.firstpeopleslaw.com/index/articles/449.php

    [xlii] S. Engler, F. Mauelshagen, J. Werner and J. Luterbacher, The Irish famine of 1740–1741: famine vulnerability and “climate migration”, Climate of the Past, 28 May 2013, page 1174

    [xliii][xliii]Frank Nally, How workhouses contributed to the misfortune of the Famine, Irish Times, 13 August 2019, https://www.irishtimes.com/opinion/how-workhouses-contributed-to-the-misfortune-of-the-famine-1.3985180

    [xliv] Laurence Geary, Brutality of Cork’s Famine years: ‘I saw hovels crowded with the sick and the dying in every doorway’, Irish Examiner, 8 May 2018, https://www.irishexaminer.com/ireland/brutality-of-corks-famine-years-i-saw-hovels-crowded-with-the-sick-and-the-dying-in-every-doorway-470367.html

    [xlv] Jimmy Deenihan, Time to Recall our Famine Heroes, Irish Examiner, 31 March 2014, https://www.irishexaminer.com/viewpoints/analysis/time-to-recall-our-famine-heroes-263721.html

    [xlvi] Pranit Nanda, The Choctaw: Trail of Tears,  The Choctaw, accessed 08 June 2020, https://choctaw.weebly.com/trail-of-tears.html

    [xlvii] Naomi O’Leary, Coronavirus: Irish donate to hard-hit Native Americans to repay famine aid, The Irish Times, 5 May 2020, https://www.irishtimes.com/news/health/coronavirus-irish-donate-to-hard-hit-native-americans-to-repay-famine-aid-1.4245807

    [xlviii] Neelambaran A, COVID-19: Fighting Social Exclusion and now a Lockdown, Transgender Community Extends Help to Stranded Migrants, Newsclick India, 18 May 2020, https://www.newsclick.in/COVID-19-Fighting-Social-Exclusion-Lockdown-Transgender-Community-Extends-Help-Stranded-Migrants

    [xlix] Ibid

    [l] Kashif Kakvi, COVID-19: Unemployed for Months, Bhopal’s Slum Dwellers Still Feed Workers on Shramik Trains, Newsclick India, 30 May 2020, https://www.newsclick.in/COVID-19-Unemployed-Months-Bhopal-Slum-Dwellers-Feed-Workers-Shramik-Trains

  • Ibid

    [lii] Ibid

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    About Author

    Justin Frewen

    For over twenty years Justin Frewen has worked in the field of international development and humanitarian issues for the U.N. and others, including in Guinea during the Ebola crisis. His writing has been published by The Irish Times, Village, The Sunday Business Post, Politico.ie, Magill, Irish Medical Times, The Wanganui Chronicle (NZ), The New Shetlander etc.

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