The pandemic has unmasked America’s deepest inequities: Covid’s disparate racial impacts, by the numbers

‘Covid-19 doesn’t discriminate, but the havoc wrought by the virus—the deaths, economic devastation, and intergenerational trauma—has disproportionately affected Black, Latino, and Native American communities. The Trump administration’s feckless response didn’t help, yet even proactive steps have reinforced preexisting inequities: Stay-at-home orders protected people with the privilege to work remotely while frontline workers, disproportionately Black and Latino, took on greater risk of exposure. People of color have also experienced more unemployment and financial insecurity. As Mary Bassett, director of Harvard’s François-Xavier Bagnoud Center for Health and Human Rights, explains, none of this is caused by the virus itself: “It’s because of the social consequences of race in our society, which has been reinforced by decades, centuries of bad practices and policies.”

Read here (Mother Jones, Feb 12, 2021) 

Covid-19 pandemic has shown humanity at its best – & at its worst: WHO DG before the UNICEF Executive Board

‘Ultimately, our fight is not against a single virus. Our fight is against the inequalities that leave children in some countries exposed to deadly diseases that are easily prevented in others; Our fight is against the inequalities that mean women and their babies die during childbirth in some countries because of complications that are easily prevented in others;

‘And our fight is to ensure that health is no longer a commodity or a luxury item, but a fundamental human right, and the foundation of the safer, fairer and more sustainable world we all want.

‘History will not judge us solely by how we ended the COVID-19 pandemic, but what we learned, what we changed, and the future we left our children.’

Read here (IPS News, Feb 11, 2021)

Intellectual property cause of death, genocide

‘Refusal to temporarily suspend several World Trade Organization (WTO) intellectual property (IP) provisions to enable much faster and broader progress in addressing the COVID-19 pandemic should be grounds for International Criminal Court prosecution for genocide. 

‘Making life-saving vaccines, medicines and equipment available, freely or affordably, has been crucial for containing the spread of many infectious diseases such as tuberculosis, HIV-AIDS, polio and smallpox. 

‘Jonas Salk, who developed the polio vaccine, insisted that it remain patent free. Asked who owned the patent 65 years ago, he replied, “The people I would say. There is no patent. You might as well ask, could you patent the sun?”

Read here (ksjomo.org, Feb 8, 2020)

Covid-19 and the convergence of nations

‘Few, if any [government], have set out recovery strategies that include the goal to reduce inequalities as part of future pandemic preparedness. Yet an essential truth of this emergency is that stronger security depends on fairer societies. But that is not the whole story...

‘In a working paper published last week by the US National Bureau of Economic Research, the Nobel economist Angus Deaton concludes that, at least in terms of global income, inequalities have decreased. He claims that the views of several respected authorities, ranging from fellow Nobel laureate Joseph Stiglitz to the UN Development Programme, are plain wrong. His argument is that high-income nations have suffered higher rates of mortality than low-income and middle-income countries. These higher mortality rates have translated into larger falls in wealth. This is an important observation...

‘The reality is that health and prosperity go hand-in-hand. During this pandemic, the smaller the number of deaths, the larger the income of a nation. The result has been that incomes per person in wealthier countries have fallen more than those in low-income countries. International income inequalities have therefore decreased. Nations have converged, not diverged. As Deaton notes, the pandemic “has brought countries closer together, not further apart”.

Read here (The Lancet, Feb 6, 2021)

More Covid vaccine choices mean new equity challenges

‘More questions about priority are likely as the distribution effort matures, says Julie Swann, a vaccine supply chain expert at North Carolina State University. Soon, there should be more than three vaccines—shots from AstraZeneca and Novavax are likely next—and each will come with pros and cons. Even if shots are eventually targeted for one group or another, transparency will be key, she notes. “You can tell people that one is less effective but you wouldn’t have to come back, and the other is more effective but you need a second dose,” she says. Some people may have preferences between one or the other. Maybe some will seek out a different shot elsewhere. Maybe some will wait. But most, she hopes, will see little choice in the range of good options. In the middle of a crisis, a shot is a shot.’

Read here (Wired, Feb 5, 2021)

Political warfare, inequity, and insufficient data in coverage of the vaccine rollout

‘Ellen Ruppel Shell, a professor of science journalism at Boston University, told me yesterday that vaccine framing can be “schizophrenic—alarmism followed by sometimes misleading reassurance.” This is true, for example, of many stories warning about vaccines’ possible reduced efficacy against new variants of the virus, whose scary headlines often belie more nuanced expert assessments and key questions that have yet to be answered...

‘It’s hard to generalize, obviously, but it’s increasingly clear that much vaccine coverage is stuck in conventional journalistic rhythms that don’t serve the story well. Given that the pandemic is a “once-in-a-hundred-years event, it’s time for journalists to step back and think about what our priorities need to be,” Shell told me. “We don’t just take notes and put them out there. Almost every piece should have some analysis in it.” In the course of this reflection, we need to reckon, too, with the idea that vaccines may not be a magic bullet. Elena Conis, a science historian and journalism professor at Berkeley, told me yesterday that her biggest concern with vaccine framing is that “we have rushed to cover, talk, and think about vaccination all while failing to have much harder conversations about other things we can do to keep this epidemic in check.”

Read here (Columbia Journalism Review, Feb 3, 2021)

CommuniVax: A coalition to strengthen the community’s involvement in an equitable vaccination rollout

‘CommuniVax is a national alliance of social scientists, public health experts, and community advocates who seek lasting solutions to a serious problem: in the United States, historically underserved Black, Indigenous, and Latino populations have endured negative health and economic impacts from the COVID-19 pandemic at tragic and disproportionate rates. While these communities could benefit greatly from safe and effective COVID-19 vaccines, longstanding biases and barriers hinder their access to and acceptance of vaccination.

‘The coalition is strengthening national and local COVID-19 vaccination efforts in the United States by putting communities of color at the center of those endeavors. The coalition is listening to Black, Indigenous, and Latino/Latinx individuals on how best to promote awareness of, access to, and acceptability of COVID-19 vaccines in their respective communities; and developing longstanding, local governance systems that enable underserved groups to exercise collective agency over their own health and wellness, during this pandemic and going forward. Funding for CommuniVax is provided by the Chan Zuckerberg Initiative.

‘CommuniVax relies on efforts from 3 groups: local teams, a central working group, and national stakeholders.

• Local Teams are composed of resident researchers, grassroots leaders, and public health implementers. They will engage local communities of color to identify improvements needed to vaccine delivery and communication strategies in their communities.
• The Central Working Group includes experts in public health, public policy, medical science, anthropology, and public involvement. With input from diverse stakeholders, the working group will coordinate the local research processes and ensure the implementation of findings nationwide
• National Stakeholders represent groups with political, technical, cultural, and social justice perspectives on vaccine delivery and uptake. These associations will amplify information generated from local teams within their networks and provide feedback to the central working group.

Read here (John Hopkins Center for Health Security, Feb 2021)

Vaccine wars: The global battle for a precious resource

‘Armed guards are patrolling the perimeter fence of a sleek factory. Software experts are fending off hackers. Border officials are checking trucks and ferries, not for weapons or illegal immigrants, but for a mysterious biochemical soup, while spies and spin doctors are feeding social media with scare stories flaming one national champion or another. Welcome to the first great geopolitical battle of the 21st century. It may sound like something ripped from the pages of a dystopian sci-fi novel, but in truth we’re seeing the opening salvos in the vaccine wars.

‘Rather than co-operating with one another to roll out a global vaccination campaign to rid the world of Covid-19, the major powers of the world are instead descending into a fierce, increasingly nationalistic competition. The EU is threatening to hold back supplies from Britain, the Americans are scooping up supplies wherever they can, and the Russians and the Chinese are engaged in a form of ‘vial diplomacy’ reminiscent of the Cold War. It is all starting to turn very, very nasty. We are seeing how quickly our globalised world collapses when push comes to shove. The effect of all this on national security, on industrial policy and on the movement of people around the world will be felt for many years to come.’

Read here (The Spectator, Jan 30, 2021)

The year global health went local: Bill & Melinda Gates

‘As hard as it is to imagine right now while so many people are still suffering from COVID-19, this pandemic will come to an end someday. When that moment comes, it will be a testament to the remarkable leaders who have emerged over the last year to steer us through this crisis.

‘When we say “leaders,” we don’t just mean the policymakers and elected officials who are in charge of the official government response. We’re also talking about the healthcare workers who are enduring unimaginable trauma on the frontlines. The teachers, parents, and caregivers who are going above and beyond to make sure kids don’t fall behind in school. The scientists and researchers who are working around the clock to stop this virus. Even the neighbors who are cooking extra meals to make sure no one in their community goes hungry.

‘Their leadership will get us through this pandemic, and we owe it to them to recover in a way that leaves us stronger and more prepared for the next challenge. Over the last year, a global threat touched nearly every person on the planet. By next year, we hope an equitable, effective COVID-19 response will have reached the whole world, too.’

Read here  (GatesNotes, Jan 27, 2021)

More than 85 poor countries will not have widespread access to coronavirus vaccines before 2023

• The rollout of vaccines against the coronavirus (Covid-19) has started in developed countries, but mass immunisation will take time. 
• Production represents the main hurdle, as many developed countries have pre-ordered more doses than they need. 
• The costs associated with mass immunisation programmes will be significant, especially for less-developed countries that have limited fiscal resources. 
• Vaccine diplomacy will play a role in determining which countries get access to a vaccine in the coming months. 
• Russia and China will use the rollout of their own coronavirus shots to advance their interests. 
• With priority groups vaccinated in rich economies by end-March, The EIU expects global economic prospects to brighten from mid-2021. 
• For most middle-income countries, including China and India, the vaccination timeline will stretch to late 2022. 
• In poorer economies, widespread vaccination coverage will not be achieved before 2023, if at all.

Read here (The Economist, Jan 27, 2021)

Covid vaccine: WHO warns of ‘catastrophic moral failure’

‘The world faces a "catastrophic moral failure" because of unequal Covid vaccine policies, the head of the World Health Organization (WHO) has warned. Tedros Adhanom Ghebreyesus said it was not fair for younger, healthy people in richer nations to get injections before vulnerable people in poorer states. He said over 39 million vaccine doses had been given in 49 richer states - but one poor nation had only 25 doses. Meanwhile, both the WHO and China were criticised for their Covid response.’

Read here (BBC, Jan 19, 2021)

Dr Paul Farmer: Centuries of inequality in the US laid groundwork for pandemic devastation

‘As the United States sets records for COVID-19 deaths and hospitalizations, we speak with one of the world's leading experts on infectious diseases, Dr. Paul Farmer, who says the devastating death toll in the U.S. reflects decades of underinvestment in public health and centuries of social inequality. "All the social pathologies of our nation come to the fore during epidemics," says Dr. Farmer, a professor of medicine at Harvard University, chair of global health and social medicine at Harvard Medical School and co-founder and chief strategist of Partners in Health.’

View here (Democracy Now, Youtube, Jan 1, 2021)

Covid-19 has shown us that good health is not just down to biology

‘Of all the lessons we’ve learned from this pandemic, the most significant is how unequal its effects have been. Wealth, it turns out, is the best shielding strategy from Covid-19. As poorer people crowded together in cramped housing, the rich escaped to their country retreats. Two of the largest risk factors for dying from Covid-19 are being from a deprived background and being from a minority-ethnic background, pointing to the underlying role of social inequalities, housing conditions and occupation.

\‘Our society’s recovery from this disease should be centred on building more equal, resilient societies, where people in all parts of the world have access to both protection from the disease and access to research developments. It all starts with government. At the end of a gruelling 11 months, I’m left with Abraham Lincoln’s words in my mind: the pandemic has shown that we need “government of the people, by the people, for the people” – not just government for the wealthy elite. Perhaps that’s the strongest legacy of Covid-19.’

Read here (The Guardian, Dec 25, 2020)

Is mass vaccination the best strategy for all countries? A doctor's surprising view

‘COVID-19 is now the second-leading cause of death in the U.S. for 2020. The virus has killed more than 90 people per 100,000, reports Johns Hopkins University. 

‘But in other parts of the world, the virus hasn't been such a big problem. It's not a top killer. Some global health experts are beginning to ask whether immunizing large swaths of the population is the best use of resources for these countries. That's a question that Dr. Chizoba Barbara Wonodi of Johns Hopkins University has been thinking about as mass nationwide vaccine campaigns begin rolling out in rich countries such as the United Kingdom and the United States.’

Read here (NPR, Dec 14, 2020)

Has capitalism turned the COVID-19 emergency into a disaster?

‘Exploit it’ - Protect the People or the Profit? ‘We were in a crisis before COVID-19 - a crisis of capitalism. Join Ali Rae in this first episode of “Al Hail The Lockdown” - a 5 part series exploring the complexities of our global response to the COVID-19 pandemic. In this episode, Ali speaks with filmmaker and activist Astra Taylor, economist Aditya Chakrabortty and economic sociologist Linsey McGoey about disaster capitalism, philanthro-capitalism and how the structures of capitalism have left us ill-equipped to deal with the fallout of COVID-19.’

View here (Aljazeera, Nov 24, 2020) 

Human Rights Watch: “Whoever finds the vaccine must share it” — Strengthening human rights and transparency around Covid-19 vaccines

‘The Covid-19 pandemic has shown that the fates of people all over the world are interconnected: protecting one country’s people and its economy from the impacts a deadly infectious disease is impossible unless the people of other countries are also protected. Governments have a critical role to play in funding efforts to develop safe and effective vaccines. But no amount of funding will guarantee equitable access without decisive collective action and global cooperation to challenge the profit-driven and opaque systems that have determined access to lifesaving treatments and vaccines in the past.

‘Governments should continue to fund Covid-19 vaccines, especially to ensure access for low- and middle-income countries. While doing so, they should take all possible measures, including directing and conditioning funds in ways that are aligned with their human rights obligations to share the benefits of scientific knowledge and its applications widely, and ensure participation, transparency, and accountability in vaccine research, development, and manufacturing.’

Read here (Human Rights Watch, Oct 29, 2020)

Emerging humanitarian Covid-19 crisis in Sabah: Bridget Welsh & Calvin Cheng

‘Sabah’s Covid-19 situation transcends health. A crucial part of this is recognising the difficult economic circumstances on the ground. Many of these are the product of failings in policy in the past, with the crisis bringing deep vulnerabilities to the surface. Socio-economic conditions are worsening with the lockdown. Even before 2020, Sabah’s economy had been in a tight spot. The state’s relatively high reliance on commodity-related economic activity (roughly half of the Sabah economy in 2019 was derived from commodity agriculture and mining), along with a sizable tourism sector, means that a large share of Sabah’s economy is subject to the whims of the global economy.’

Read here (Malaysiakini, Oct 25, 2020)

Covid-19 has exposed the catastrophic impact of privatising vital services

‘The Covid-19 pandemic has exposed the catastrophic fallout of decades of global privatisation and market competition. When the pandemic hit, we saw hospitals being overwhelmed, caregivers forced to work with virtually no protective equipment, nursing homes turned into morgues, long queues to access tests, and schools struggling to connect with children confined to their homes. People were being urged to stay at home when many had no decent roof over their heads, no access to water and sanitation, and no social protection. 

‘For many years, vital public goods and services have been steadily outsourced to private companies. This has often resulted in inefficiency, corruption, dwindling quality, increasing costs and subsequent household debt, further marginalising poorer people and undermining the social value of basic needs like housing and water. We need a radical change in direction.’

Read here (The Guardian, Oct 19, 2020)

Offline: Covid-19 is not a pandemic -- It is a syndemic: Richard Horton

‘The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure. 

‘As Singer and colleagues wrote in 2017, “A syndemic approach provides a very different orientation to clinical medicine and public health by showing how an integrated approach to understanding and treating diseases can be far more successful than simply controlling epidemic disease or treating individual patients.” I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.’

Read here (The Lancet, Sept 26, 2020)

Covid-19 and health equity — Time to think big

To achieve health equity, we need to reach beyond the health care system — and think big. New social policies on a few key fronts could advance both health equity and the Covid-19 response.

• First, we propose establishing a universal food income.
• Second, we recommend reforming unemployment insurance.
• Finally, we need policies supporting investment in community development.

Read here (New England Journal of Medicine,  Sept 17, 2020)