History is written by the rich, and so the poor get blamed for everything
— Jeffrey D. Sachs, economist
It is not news that poverty can make it impossible to follow health advice. The submission by The Food Foundation, the London School of Hygiene And Tropical Medicine and SHEFS made it clear that although the government has published sound dietary guidelines, many people are too poor to follow them. Under normal circumstances, this is one of the most serious problems of poverty, and as the Marmot Review points out one of the greatest health challenges of the country.
But right now, there is another pressing health issue: coronavirus. As the dashboard shows, around the world there have so far been over 81,000 cases, the vast bulk in mainland China. Around 2,700 people have died, and about 30,000 have recovered. And there are 13 cases in the UK.
How sound is the government’s advice in this case?
As with the dietary guidelines, it is sound in theory but if it collides with the reality of poverty, it may fail in practice – and the consequences would be even more dramatic than those highlighted by the Marmot review. So, as with food policy, the government must not stop with well-meaning advice, it must make sure that it supports all those who need to follow that advice.
Government advice seems good in theory
At the time of writing, the government’s advice in relation to coronavirus includes the following:
“If you have travelled from:
- specific lockdown areas in northern Italy as designated by the Government of Italy
- ‘special care zones’ in South Korea as designated by the Government of the Republic of South Korea
- Hubei province (returned in the past 14 days)
You should immediately:
- stay indoors and avoid contact with other people as you would with the flu
- call NHS 111 to inform them of your recent travel to the area.”
The point about staying indoors and avoiding contact with other people – otherwise known as self-isolation – is the government’s current quarantine plan. The Centres For Disease Control And Prevention explain what this means in practice,
“Quarantine is usually established for the incubation period of the communicable disease, which is the span of time during which people have developed illness after exposure. For COVID-19, the period of quarantine is 14 days from the last date of exposure, because 14 days is the longest incubation period seen for similar coronaviruses. Someone who has been released from COVID-19 quarantine is not considered a risk for spreading the virus to others because they have not developed illness during the incubation period.”
So, in principle, the government’s advice is sound, and if we follow it the disease will be contained.
Precarity may make it hard for people to follow this advice in practice
But self-isolation for two weeks may be very difficult for many people. According to a 2015 survey from CareerBuilder.co.uk.
“Thirty-one per cent of British workers say they always or usually live pay-check to pay-check to make ends meet, an additional 30 per cent are forced to live pay-check to pay-check sometimes, while only one fifth (21 per cent) of workers never find themselves in this situation.”
If you are living pay-check to pay-check in insecure, low-paid work, you may simply have no way of surviving if you take the self-isolation advice literally. So more than 30% of British workers may simply not be in a position to follow the government’s advice in relation to coronavirus, any more than they are in a position to follow the dietary advice.
And if the disease were to get out of control, and the ratios of death to recovery remained the same as in the dashboard, the consequences would be disastrous.
Both moral and medical considerations demand Government action
According to the BBC, the DWP has stated that, “People who are prevented from working because of a risk to public health are able to claim universal credit.” And it has suggested that there may be other allowances available. Given the track record of universal credit, it will be important that the government makes sure that those who need it can get support quickly and easily.
And even if they do this, that still leaves the bigger challenges highlighted by the Marmot report among many others. Fortunately, the problem is simply one of political will – once this is found, there are five, relatively straightforward, steps which will reverse the process of mass impoverishment. If we act now, we do not need to face this kind of problem in the future.
If you feel this is important, please do sign up and join the 99% Organisation.