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The unequal pandemic

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When COVID-19 first arrived, it was described as the great equaliser. Infection could happen to anyone. Your race, creed, or the balance of your bank account didn’t matter to the virus that was spreading. 

But after a summer of dodging the virus and hunting for rapid tests, it is abundantly clear this isn’t a pandemic of equals. Now we have the data which quantifiably measures just how Australia's socio-economic fault lines were exposed and exacerbated by COVID-19.

The research, commissioned by Catholic Health Australia and undertaken by Australian Catholic University, shows that how well you do in a crisis depends very much on your postcode, your family background, and even your sex.

The report reveals that far from society sharing the pandemic burden, factors such as the uneven application of stay-at-home orders, night-time curfews, testing regimes, vaccine accessibility, and enforcement measures all worked to magnify existing social and economic disadvantage including sharp declines in employment among more vulnerable demographics. For example, during the third wave of Winter 2021, COVID-19 cases were concentrated in suburbs where higher levels of socio-economic disadvantage, blue-collar workers, and culturally and linguistically diverse (CALD) residents lived. 

A one percentage point increase in blue-collar workers in a local government area led to one additional coronavirus case for every 183 people, while a one-point increase in the percentage of CALD residents led to an additional case for every 255 people. 

 

"It seems obvious that the pandemic would exaggerate the inequities that already exist within our society. What matters now is having the foresight to ensure our ongoing pandemic response and recovery aims to address disparity."

 

The residents of these LGAs were people who worked in construction, retail, transport, hospitality, and even health. They had to keep working to keep our cities running, but they were also dealing with added restrictions. 

At the height of the crisis, stunned citizens in areas such as Sydney’s 12 ‘LGAs of concern’ faced harsher lockdowns, curfews and Big Brother-style surveillance, while elsewhere in the city apparently more well-to-do people seemingly enjoyed greater freedoms. 

The social divide included vaccination rates, the great hope of ending the pandemic, with localities with the highest case numbers recording the lowest full vaccination rates, while the highest vaccinated localities were in relatively wealthy, affluent areas.

Compounding all of this, the social and economic impacts of extended lockdown policies fell disproportionately on women. As well as being concentrated in industries with high rates of job loss and insecure employment, women carried the burden of additional care and household-based work under stay-at-home orders, including the need to care for dependent children forced to home-school.

With hindsight, it seems obvious that the pandemic would exaggerate the inequities that already exist within our society. What matters now is having the foresight to ensure our ongoing pandemic response and recovery aims to address disparity, rather than entrenching disadvantage. 

So with that in mind what restorative policy fixes should we be thinking about, to repair the divisions and foster greater fairness? Catholic Health Australia believes there are a number of measures which could address suffering being felt in communities. Funding no-gap psychological support for identified vulnerable groups is a start. The Head to Health and Head to Help pop ups, which delivered greater access to mental health professionals, should be extended and expanded to areas most impacted by the pandemic. 

We should also get smarter about using existing networks. In Japan they have successfully used postal workers to spread information and resources. With some training, posties here could provide high-need communities with social service contacts. 

Centrelink offices could also be sites for accessing social services, not just government support. By co-locating providers with government services we can make sure there is a ‘no wrong door’ approach to welfare and support. 

In short, prioritising the most vulnerable, meeting them where they are, and making services accessible, rather than just available, needs to be the guiding principle of all policy. As Pope Francis says: ‘The measure of the greatness of a society is found in the way it treats those most in need, those who have nothing apart from their poverty.’

 

 

Brigid Meney is the Catholic Health Australia Director of Mission & Strategy.

Image: Lone woman is seen looking out the window of her apartment at the North Melbourne Public housing flats. (Asanka Ratnayake / Getty Images)

Topic tags: Brigid Meney, COVID-19, pandemic, CHA, ACU, socio-economic disadvantage

 

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Existing comments

I would so much like it to be not so; that the most disadvantaged did not have to struggle to live, that their inherent dignity was not constantly put to the test by a world intent on not seeing that what they offer is invaluable. Pope Francis articulates beautifully what privilege really entails: caring deeply about and giving ourselves to those who can make us ‘poor in spirit’.


Pam | 01 February 2022  

This is an extremely important article.
It’s clear that the pandemic has further divided an already unequal Australian society.
The quote from Pope Francis is deeply moving and a reminder of where our focus needs to be: “The measure of the greatness of a society is found in the way it treats those most in need, those who have nothing apart from their poverty.”
I really appreciated the restorative policy fixes you’ve suggested Brigid.
But I would like to add two more.
Firstly, Australians relying on Jobseeker and similar allowances need an immediate significant weekly increase to be able to live above the poverty line.
Secondly, those schools attended by low socio-economic students need huge increases in the number of teaching, pastoral, and wellbeing human resources.
You are right Brigid when you state that our nation needs, “the foresight to ensure our ongoing pandemic response and recovery aims to address disparity, rather than entrenching disadvantage.”
I sincerely hope and pray that our political, business, and religious leaders have that foresight and work harder to address and overcome the severe inequities that exist within our society.


robert van zetten | 01 February 2022  

It is a sad truism that the best medical services in this country are usually within the major cities and in middle class areas. I am in my seventies and glad to be triple vacced. The same happened to my wife in her excellent nursing home. I think, in the major cities, Melbourne and Sydney, there are problems with people in Housing Commission ghettoes who may not be fluent in English, not au fait with the system and suspicious of the government. A similar situation may exist with Aboriginal fringe dwellers. Here in Queensland the government has done a very good job. The answer to the problem is better funding. Catholic Health do a marvelous job.


Edward Fido | 02 February 2022  
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Interestingly, it is difficult to access GP services in Canberra regardless of one's income. It is just too hard to get an appointment. As well, almost none of them bulk-bill even for people on government benefits.


sheelah Egan | 03 February 2022  

In all societies inequality has many origins and these inequalities will be magnified regardless of the nature of the societal stress which is applied to that society. Viruses do not have any discretionary capabilities, do not select out those individuals which they choose to invade and are in no way influenced in their behaviour by the education, wealth, communication skills or place of residence of their victims. The fact is that people, disadvantaged according to the above mentioned indicators, are not singled out by the virus for invasion as a result of government or any other authoritative response to its presence but by their own response to the presence of the viral threat. Unfortunately such people suffer more, die more frequently, are plagued by long term effects and infect others who might well suffer the same fates. These incontrovertible facts negativate or discount the value of the research relied on in this article which, sadly, does nothing to enhance the academic rigour of Catholic Healthcare Australia and the ACU but rather tends to commit both to the 'dumbed down' basket.


john frawley | 02 February 2022  
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How people respond to a viral threat has everything to do with their personal and social context: past experience (especially with authority), heritage, access to education and their ability to receive it, the relationship between employment and financial need, access to health care generally, family structures, the ratio of services to population available nearby, and so it goes on. None of these things contribute to any sector of the population warranting simplistic victim blaming as your 'incontrovertible facts' suggest. I am very lucky to live on the northern beaches of Sydney and was in tight lockdown Christmas 2020. At a glance the restrictions imposed on us were very similar to those imposed on the 12 LGAs of Concern later in 2021 but because of vastly different social and economic situations the impact and outcomes were vastly different. For most of us in the north it was not much more than a temporary inconvenience, sad that Christmas was curtailed. What vastly different scenarios did those same strategies create elsewhere! So a strategy designed to fit one context ends up revealing severe inequities when applied to lots of completely different contexts. Complex problems require complex solutions. What do we do about it?


Donna Stimson | 02 February 2022  

‘but by their own response to the presence of the viral threat.’


You’ll need to explain this headscratcher given that we’re all agreed with the principle that pandemics (and tsunamis and bushfires and earthquakes and London blitzes and evacuations of Kabul) all affect people without alternatives more than those with the resources or foresight to have alternatives.


Those who can save save for a rainy day so they have alternatives although some people like the Aesop grasshopper don’t save for rainy days and others (presumably those here) can’t or are just starting.


roy chen yee | 03 February 2022  

Donna and Roy. The point I was making, perhaps not clearly enough, is that infectious disease is not selective. Rather, its success in achieving its devastating consequences is significantly affected by the protective measures taken by society as a whole such as social distancing, mask wearing, quarantining of infected persons and most importantly of strengthening the human body's natural defences against infection, ie, the immune system. Vaccination gives the immune system a head start in the battle to eliminate the virus in that it provides the body with a ready made army of antibodies capable of overpowering the virus. In the unvaccinated, the immune system struggles to provide an army of antibodies after the war has begun and in some people fails to produce antibodies quickly enough to eliminate the virus, thus exposing the infected person to the destructive advance of the virus which leaves death and long term disability in its wake. What I am suggesting is that people in societies seen to be disadvantaged for various reasons, it is their failure (not necessarily deliberate on their parts) to take these precautions that results in higher vulnerability. Such failure is not of governmental management but rather a matter of ignorance or distrust of science arising from such limiting factors such as poor education, language impediments to understanding, unfounded philosophical/religious beliefs regarding the nature of disease and its prevention and in others, nothing other than selfishness and lack of any sense of personal sacrifice in the interests of the greater good. The "research" quoted in this article simply describes this phenomenon but attempts to claim that the sufferers are in some way victims generated by the so-called "haves" in society - a completely invalid conclusion.


john frawley | 03 February 2022  
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The main article mixes the themes but there seems to be two questions. Does being poor make you more liable to be incapacitated from infection? Does being poor make you more liable to being economically/mentally stressed?


Most working poor don’t work in non-discretionary jobs that can be done from home, so, yes, they have to be out there if they want to be paid, where they might develop symptoms, but vaccination should protect them from becoming incapacitated. But nurses and doctors, among those who come into close proximity with the public, aren’t ‘working poor’. It depends on your job whether you have to be out there but, in general, ‘poor’ workers have to be out there.


Does being poor make you more liable to being stressed from the pandemic? This depends on whether the pandemic interrupts your cashflow. If you’re on the aged pension, it doesn’t. However, most plastic surgeons work in discretionary jobs that can be put off and their periodic bills are probably huge, what with the Merc and yacht and private school fees and so on. The usual image is of lockdowns, occupational hiatuses and economic slowdowns depriving lower-waged casual employees (waiters, musicians, thespians, etc.) in discretionary employment that can’t be done from home, but small business owners are bitten hard too, small business providing most private employment.



The mental and physical burden of home management on partnered women is a cultural thing which can be reversed by private countercultural initiative. The phenomenon of non-bereaved single mothers (or custodial fathers), is, by now, an ancient cultural fault arising out of the fact that one or both parties didn’t take the notion that love is for life as seriously as they should have. This has nothing necessarily to do with being poor although poverty and single motherhood do seem often to make a pair like Fred Astaire and Ginger Rogers, the woman having to keep up while backwards and in high heels. But needs to relieve stress from loneliness by some kind of service are as much driven by cultural choices (although not necessarily only by the persons suffering) as by poverty.



At the end of the day, the pandemic extends the concept of saving for a rainy day. People have now been instructed by life itself that if you want to self-insure against downsides of the future, apply some traditional foresights when making your life cycle choices now. As you say, fault lines magnify the effects of blind adversarial forces. You should try to avoid living in one. Economic fault lines are hard to avoid (plastic surgeons being an example) but personal psychological fault lines (the hypothetical high life of our hypothetical plastic surgeon, or the spouse who made an unwise choice of partner) are often a product of moral choices, and of very early moral choices at that, perhaps not at the point of infant baptism but not very long after that.


roy chen yee | 06 February 2022  

Firstly, most would agree with “prioritising the most vulnerable.” But let’s remember what happened to eminent epidemiologists like Jay Bhattacharya of Stanford and Sunetra Gupta of Oxford who proposed just that, instead of lockdowns. They were subjected to smear campaigns and banned from the Internet. But new research from John Hopkins University shows lockdowns “are ill-founded” and reduced Covid mortality by 0.2% in the US and Europe while “imposing enormous economic and social costs where they have been adopted”, such as here in Australia. The poor got hurt most. But tribal loyalties trumped reason, and policies that hurt the poor were supported by people dedicated to the poor.
Secondly, most would agree with “address disparity, rather than entrenching disadvantage.” But countless studies have documented the disadvantages wrought by family breakdowns. Children suffer most. Children from broken homes make up 80% of the population of Britain’s psychiatric institutions; in the USA, 77% of black births are to single mothers; and in Australia, youth homelessness is exacerbated by family breakdowns.
Certainly, help the needy first. But radicals have been intent on destroying marriage and the family for decades. To ignore, or fail to address this issue, is to “entrench disadvantage.”


Ross Howard | 03 February 2022  
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Thanks, Ross. Good post. I think we might all have been sucked in by the inadequate use of statistics. And by technical experts for whom any attempt to think beyond their specialisation would have been all downside for their careers. Can a CMO be expected to advise anything other than locking down? What can a CMO say about ripple effects on the economies of poorer nations? A CMO is only one of a range of advisers. A cabinet as a whole should be thinking about the issue, not just the premier/pm and a health minister.


Public health management is a political art because politics includes the weighing of respective harms, all of which are very significant, not all of which are medical, and even within the medical domain, there are different kinds of medical harms. This is not to say that after weighing the different harms, there isn’t implemented a one-size-fits-all approach, but the range of different harms should be considered.


Florida is getting a bad rap but perhaps it shouldn’t.


http:// www youtube com/watch?v=zG7XZ2JXZqY - interview with Bhattacharya


http:// www youtube com/watch?v=t6kmm70ji5c - speech by Atlas


Now the kids are back at school, the most important thing they can learn is how to do proper statistics. Then they can teach their parents to question whether all of the applicable statistics are being considered.


roy chen yee | 05 February 2022  

the media reporters who put pressure on the LNP and ALP membes of parliament and the medical science who cheered on the lockdowns were never going to suffer the effects of the health orders which do not pass the pub test. CHildren were not allowed to go to school but bulding workers were allowed to move around the city. childrens education was not essitental but building workers were - this sounds hypocrisy


Stuart Lawrence | 04 February 2022  

Thank you Brigid for this article which documents something that has been very apparent to many of us. Social disadvantage takes many forms - larger numbers of people living together but also people living alone and disconnected from society. As a grandmother I had grandchildren remote learning while their parents worked from home. A difficult situation but it pales in comparison to those families living in crowded apartments without backyards and care givers working in casual jobs with the financial insecurity that entails. When libraries and playgrounds closed, bottleshops remained open. An increase in alcohol consumption alongside a deterioration in mental health was only to be expected and the effects I suspect will be long lasting.
Yes, it is human behaviour not virus characteristics that cause the discrepancies in infection rates but those of us with comfortable homes, a family network and financial security should always be aware that we have so many more choices than those less fortunate and consequently insist that our political representatives prioritise the disadvantaged when developing economic policies. As Pope Francis reminds us - as Christians it is our obligation!


Mary Holland | 06 February 2022  
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It's not only our obligation Mary, it's in our own interests.


Ginger Meggs | 07 February 2022  

I am one of the "rich" people in that I own my home; self funded retiree. I am one of those who "have more resources."
I also am seeking to get psychological help. I am struggling with the impact of what happened. I have chronic insomnia.
My two sons are struggling. One is a doctor, overwhelmed. And when he finishes his shifts, he signs into the Covid ward to hold the hands of the dying. He is always pale faced.
The other son is my main worry. A casual worker. His mental health has deteriorated. He sees no future.

Try getting a psychologist at the moment. Good luck.

Sorry if that all sounds grim. I tell you this for a simple reason. Do not assume this simple dichotomy. That the poor are most vulnerable and suffering. That resources are there to be tapped, that the resources are just not spread evenly. This virus showed up the flaws in our society but also the flaws in the way we think. The assumptions we make about each other.


John | 10 February 2022  

I think that pandemic has changed my life forever. I'm sure that I will not forget the years spent at home doing online school and not any sports. I hope that we do not ever have to experience all of the lockdowns and isolations again and I hope no one else ever does.


Evie Oldham | 07 February 2022  

I agreed with the author of this article and I think they correctly stated how Covid19 is going. I'm glad now we have the vaccinations so everyone can get it and Covid won't be around much longer.


Makenna | 08 February 2022  

In mean time disaster still unfolding in remote Australia, rains and floods and food insecurity added to concerns initially , lack of vaccines and medical supplies / NO PPE gear a reality. Demonising First Nations communities because of lack of vaccination but there has been NO lac culturally relevant and linguistically sound education which significantly contributes to situation. Governments telling people to get vaccinated when there were NO vaccines is appalling . People turned up to medical clinics to be vaccinated to be turned away -travelling many kms to get there. Lack of PCR / RATs a reality. Insituitional racsim rife, even in remote health settings The fact that as many as 20 First Nations people live in one house and many are homeless is a national shame.Isolation not reality. Response to Covid in remote NT very slow and poor. Today I was informed a remote school needed to close its doors for a deep clean - NT remote teachers had to clean the school without appropriate PPE and limited disinfectant /cleaning supplies! Remote schools and communities are grossly underfunded . A few communities had a some media . Now remote communities not notified of numbers - numbers go into regions!

COVID-19 patients in remote community of Palumpa isolate in an office amid claims of NT government neglect, 4th Feb 2022 https://www.abc.net.au/news/2022-02-04/nt-palumpa-covid-response/100802954?fbclid=IwAR1Qh_1wEfgyQ-7A7OfwwnkjyNlR-yAVa0wjowEpuZlUJ5wLLL1MxpfwaRA
Read also see also "Utopia region in remote NT battles COVID-19 amid floods, no phone service" https://www.abc.net.au/news/2022-01-31/utopia-region-battles-covid-19-outbreaks-floods-no-phones/100790440


George | 15 February 2022  

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