Too often progressive responses to Covid-19 are about showing that we are on the right side. By following lockdown guidance, we are doing the right thing for those most at risk of Covid — the elderly and the ill — and supporting the health professionals to work with them.
But responses to Covid need to move beyond virtue-signalling. The situation is more complex, and we shouldn’t assume that what sounds like the right thing to do actually is the right thing to do.
Take, for example, the issue of facemasks: on the one hand, supporters of masks claim that if you don’t wear a mask you are killing people. Opponents claim that mask-wearing denies liberty. This has become a deeply polarized issue between left-wing proponents of ‘care’ and right-wing advocates of ‘liberty’. If as a progressive you challenge the ‘care’ narrative, you are seen by your tribe as a callous libertarian.
Yet this position has little basis in the evidence, which is very mixed. If everyone wore masks properly, removed them properly, used them for the right length of time, and combined this with social distancing and hand washing then the risks of Covid would be significantly reduced. But here’s the catch: unless you have an obsessive personality, you won’t do all these things. The evidence is that mask use has made people more lax about social distancing, which is why infection rates have increased.
This is not – as the Thatcherite purveyors of social media shame insist – a matter of people taking responsibility: the fact is it is quite hard to follow the rules precisely, and at a population level, a recommendation will produce perverse outcomes.
Crucially, a culture of mask-wearing has a perverse social outcome: it lumps reckless libertarians with the most vulnerable in society: those who are unable, for a variety of eminently reasonable reasons, to wear a mask. They might, for example, be hard of hearing and need to lip read, or have autism or other invisible disabilities which make wearing a mask an impossibility.
There is a wealth of evidence that Covid has led to increased abuse of disabled people, 700 of whom are now in the process of legal action against supermarkets for denial of service because they were unable to follow Covid guidance.
Lumping irresponsible libertarians together with those most vulnerable to Covid is perhaps the most disturbing feature of the ‘progressive’ response to Covid, which can be seen across the board in countries – like Scotland – which have policies of eradication.
Take obesity, the biggest determinant of Covid risk. To prevent Covid, we need to encourage everyone to be active. During lockdown young healthy people exercised more. But research by the World Obesity Foundation found lockdown discouraged those with weight problems from taking exercise, while their consumption of unhealthy foods increased.
The social impact of lockdown has also fallen heaviest on another group at risk from the physical disease: old people now feel more isolated than ever before. The solution proffered by governments is video conferencing. This risks further exacerbating the digital divide between young and old. A large body of research over the last decade has shown negative effects of home working on productivity, innovation and mental health – for this reason, big tech itself invested massively in its physical locations.
Yet we are being told (again) that home working is the future. This move will penalise some of the most precarious members of society: those who live with abusive partners or children who live with abusive parents. It risks dividing further white-collar workers from those in other sectors and disadvantages those who do not have the space – or the broadband capacity – to work from home. In short, home working increases inequality while reducing productivity. Once again, the burden falls on the most vulnerable in our societies.
But this is not the worst of it: Covid has been used as an excuse to make swingeing cuts to health and social care. In Scotland (one of the worst offenders) routine NHS treatment is slowly returning to normal but community health care has disappeared, the care sector is in crisis. I regularly make use of NHS community services, but have been unable to gain access to orthotic care since March: my adapted shoes are quite literally falling apart. I have spoken to someone with an eating disorder who has not been able to receive any treatment – because his condition was not deemed urgent: he told me he has “given up” on the NHS. In April, a BBC Scotland investigation found that those who rely on regular home care have had it removed. Pupils with Special Educational Needs and Disabilities (SEND) – in mainstream and specialist settings across the UK – received only limited support during lockdown and, now they have returned to school, are not receiving the help they need, because of fears about social distancing.
So lockdown in its current form has not worked for everyone. And those — young, physically and mentally healthy, able-bodied, middle class, married or partnered — people who say it has, speak from positions of huge privilege.
Where once the left fought admirably against the discriminatory effects of legislation on women, minorities and the disabled, its inability to see beyond Covid risks creating a society which is blind to the effects of inequality.
We need to remember that all public health measures are, to a certain extent, arbitrary. We must be prepared to challenge those that are implemented, particularly if they discriminate against those who are at most risk from Covid.
There is a huge danger that those who challenge Covid measures in this way will be seen as callous, careless, libertarians: that is not the case. We are not claiming that governments should not have responded to the threat of Covid, but that there were fairer alternatives to the measures they have put in place.
Public health policy should not produce worse social outcomes for those who are excluded from society, who will feel the effects of social isolation more strongly than their peers. Not only does this risk placing the greatest burdens on those most vulnerable to Covid, but it will drive social exclusion in the long term.
In future, governments must put equality at the centre of public health policy. There must be a specific duty to examine the short- and long-term equality impacts of public health responses before they are implemented. And, right from the beginning, public health officials must work in concert with representatives of groups who are likely to affected.
As we move out of lockdown, we must put the needs of those in society who have so far been excluded from the one-size-fits-all approach to Covid, which creates rules first and works out exemptions and adjustments later. Covid doesn’t affect everyone equally, and nor do political responses to it.