Pandemics Aren't Fair: The Unequal Impact of COVID-19

Fatih Sekercioglu, Assistant Professor, School of Occupational and Public Health and Adjunct Professor in the Master of Public Health Program at Western University

The COVID-19 pandemic has been changing many aspects of our lives. However, not everyone is affected equally. The pandemic and how it has magnified many of the systemic inequalities embedded in our system should be of real concern for researchers, decision-makers, and community activists. Sadly, the COVID-19 pandemic has been introducing new challenges to vulnerable populations who already suffer a wide range of inequalities.

Several government reports and academic publications have pointed out that COVID-19 affects vulnerable people disproportionately. Social factors such as language barriers, poverty, fear of deportation, low health literacy, overcrowded housing, carpooling, presenteeism, and hazardous occupational exposures all play a role in COVID- 19 transmission. The collection of race-based data in Ontario has highlighted the unequal distribution of COVID-19 in the public. Other populations such as low income, homeless, transient individuals and Indigenous communities are also at greater risk of contracting COVID-19, experiencing worse health effects, losing their jobs, and having challenges accessing care.

One crucial challenge yet to be understood and addressed is the COVID-19 specific inequality. That is to say, not only are the vulnerable more likely to contract novel coronavirus, but the impact of the disease is greater. Everyone facing a positive test experience a well-established public health case and contact tracing process. The significant majority of the cases are fully cooperative with public health instructions and complete their isolation to prevent further transmission. Everyone faces the psychological aspects of being ill with a deadly virus, fears the potential to transmit the virus to their loved ones, (if not already transmitted unintentionally). These and other factors already put considerable stress on the cases. However, the disadvantaged, Indigenous, Black, and the poor face another level of challenge. Lingering positive tests after isolation will put challenges on those living precariously, those with multiple low paying jobs, those whose homes may evict for lack of rent. The real challenge starts for many of the COVID-19 cases as soon as their isolation period ends. Transitioning back to their lives comes with a hefty price tag for them. It can be as obvious as not being able to visit a dentist in the middle dental emergency or their coworkers, or social network looking down on them.

The fundamental question to the decision-makers is: What kind of mechanisms have been developed to support COVID-19 cases from vulnerable populations during their isolation period and, more importantly, after their isolation period, so they do not experience another layer of inequality?