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Anyone can get coronavirus – but how you fare depends a lot on who and where you are

Many of the measures being taken to stymie the pandemic will intensify existing health inequalities, putting parts of the population at demonstrably greater risk

Alexis Paton,Agomoni Ganguli-Mitra
Wednesday 08 April 2020 17:06 BST
Sadiq Khan suggests government is 'nowhere near lifting the lockdown'

As we head into week three of lockdown, coronavirus has made common knowledge Britain’s worst-kept secret: that where you live, what you do, how much money you have and your ethnicity directly affect how healthy you are.

Over the weekend, the government warned that it would introduce tougher lockdown measures if people continued to flout the guidelines. Such measures may be justified to slow the spread of the pandemic, but lockdowns do not affect people equally. Not everyone has a garden, a partner with whom to share childcare, or the money to compensate for the lack of supermarket choice that panic-buying has created.

Early on in the lockdown, women’s aid organisations warned of the effects of social distancing and home confinement on violence against women and children. Reports today suggest these warnings have proved true, and that domestic abuse has risen since the lockdown began.

The shocking data coming from the United States must also act as a wake-up call that many of the measures being taken to stymie the pandemic will intensify existing health inequalities, putting parts of the population at demonstrably greater risk. Disability, for example, has already been flagged as one area where patients may be inappropriately excluded from treatment; English language skills another. Acting to ensure these patients receive the same quality of treatment as everyone else is an ethical imperative.

Without a deep engagement with health inequalities, systematic discrimination is bound to creep into the system. Illness mirrors inequality, a fact which may make some lives appear more expendable than others. Instead, the starting point must be that every life matters.

Boris Johnson’s hospitalisation has shown that coronavirus does not discriminate. Anyone can get the virus, but its impacts are not equal. We are privileged in the UK to benefit from a national healthcare system. However, we cannot ignore the effects of inequality as a comorbidity in this and all countries. National guidance on treating coronavirus patients has yet to materialise. When it does, we urge that it consider how many lives could be needlessly lost if it does not account for the role of inequality.

Dr Alexis Paton is a lecturer in social science applied to health at the University of Leicester, chair of the Committee for Ethical Issues in Medicine at the Royal College of Physicians, and a trustee of the Institute of Medical Ethics

Dr Agomoni Ganguli-Mitra is a lecturer in bioethics and global health ethics at the University of Edinburgh. She is co-director of the JK Mason Institute for Medicine, Life Sciences and the Law, and chair of the board of trustees at Shakti Women’s Aid

Both write in a personal capacity

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