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Opinion: The inequities in the health impact of COVID-19

ONE

Jef Vanhamel is a medical doctor and ONE Youth Ambassador in Belgium.

The COVID-19 pandemic is changing the lives of billions of people worldwide. The rapid spread of the new virus has caused devastating health effects. In addition, the measures taken to contain its spread are severely affecting the global economy and our daily lives.

Because this crisis is so deeply rooted in almost every aspect of life, it is also painfully exposing and exacerbating the existent inequalities on multiple levels and in many dimensions. Besides the fact that I would argue many of those inequalities are avoidable and unfair in the first place (and maybe should be called “inequities”), they are also contributing to the spread and deadliness of this new virus. As such, these inequities are doing harm to all of us.

And as a medical doctor, I have sworn an oath that first of all I would do no harm. While I can live up to this principle in my own practice during this pandemic, I am witnessing that there are larger systems in place that are harming the health of people, nations, and even the entire planet in an unequal way. And so we have to speak about those things as well.

First, while it is true that we are all susceptible to infection with this novel coronavirus, the impact of this crisis has been unequally distributed and skewed towards marginalized populations. This is because underlying risk factors for COVID-19, such as diabetes and heart disease, are known to cluster in groups belonging to lower socioeconomic groups. People living in poverty are indeed more likely to suffer from unequal access to healthcare because of financial, geographical, literacy, or other barriers. These barriers are unfair, especially as they are avoidable. That’s inequity number one.

On top of that, it is often those same marginalized groups that are hardest hit by the economic consequences of measures like social distancing and staying home. In countries where a majority of people work in the informal sector and therefore need to leave home to make money, staying at home will not feed the mouths of your family and children.

There are also health impacts of stay at home orders because of non-COVID-19 illnesses that tend to affect people living in poverty at higher rates. Transmission of other infectious diseases, such as diarrhoea, TB, and malaria, are not put on hold because coronavirus is around. Health systems and societies that are not equipped to deal with these consequences reflect the harm that lies in inequity number two.

To dive into inequity number three, let’s reflect on the conditions that brought about an outbreak of global proportions. In my view, the outbreak of COVID-19 was caused by an unequal fixation on a human-only concept of health, without having an eye for the health of animals, the broader environment, and even the planet. This, combined with an economic model seemingly stuck in a never-ending growth paradigm, pushed us over the boundaries of what can still be called responsible behavior.

While we are all eager to go back to our normal lives, some things should never go back to the way they were. For the better! In that sense, this pandemic reminds us of why we need to continue to fight these inequities all over the world. First, because health is a human right for all of us, without exception. Second, because none of us are safe until all of us are safe. And finally, because we owe it to the planet.

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