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April 06, 2020

The feedback loop of Covid-19 and inequalities - part 10 of our series

The Covid-19 pandemic hits some more than others. It will take years to find out why Italy's mortality rate was so much higher. We might never find out why young people without pre-existing medical conditions died. But the risks are not only confined to the short term. How societies emerge from this crisis will bring up new divisions, and politics will need to address them. 

In principle, the virus does not discriminate. It pushes people into critical health conditions no matter what their socio-economic status. But not everyone can protect themselves equally well against the virus. Masks and hand sanitisers were bought up quickly, leaving shop assistants, police officers and other workers unprotected while many white-collar employees can work safely from home. The Economist cites a study according to which about half of Britain’s highest-paid employees can work from home, but less than 10% of those in the four lowest-paid deciles can.

Socio-economic differences will also be a consequence of the lockdown. Mental stress and anxiety are likely to be higher in households where people are living cramped in small apartments without a secure income to go forward, or savings to fall back on. Low-paid employees in hotels, construction, restaurants or retail were the first to be let go in the lockdowns. They cannot work from home. How they will survive depends on the funding and design of government schemes, and on the length of the lockdowns. The entertainment sector will remain closed for an extended period, and travel will remain severely restricted. Leisure favourites like football games will be off for a long time. 

Angus Deaton took a historical perspective on earlier pandemics, writing that even if the virus itself might not discriminate, the gap between the rich and the poor will widen again after the crisis. People living in deprived areas are already facing higher mortality rates due to the death by despair. Expect the rate of domestic violence to go up, together with alcohol and drug abuse. All these costs are difficult to measure up against the daily death count from Covid-19. But they will matter for our societies in the longer run.

Compared to the financial crisis, the policy response has been markedly different this time. Boris Johnson and Donald Trump are acutely aware that they cannot win elections without the poor people' vote. The trillion-dollar package that the US congress adopted nearly unanimously contained not only tax cuts but also health care for those who cannot afford it. Every country rolled out its own package of stimulus measures. We expect campaigning in the post-Covid-19 era to be very different from what it was before. The 2008/2009 crisis was all about villains, this time it is all about heroes. To call for more money to invest into the health care system will be a vote winner. Favours for nurses and those who kept the country going under lockdown will come up under election pledges. This is not the time for austerity. 

The lockdown also unleashes structural changes for the economy, likely to the disadvantage the poor. While some countries have provided assistance to workers unable to perform tasks from home during the pandemic, certain categories of workers fall through the cracks of these programmes. There are also payment delays, for instance in Italy, meaning that people face a month or two without any income. This pushes casual workers into poverty and will leave huge scars in the tissue of the Italian economy. 

After the crisis is over, more business and education are likely to continue virtually. Universities may even reconsider their teaching programmes. Experts already warn that school closures will increase inequality. Under lockdown, teaching happens in virtual classrooms. The material available online will benefit the ones who know how to use it.  

All this will allow a new digital-savvy economy to emerge, to which the poorer people have less access to. Low-income households do not all have computers or high-speed broad band an the costs of internet services are non-negligible. Well-off people find it easier to adapt to this more digitised working world, which requires new skill sets. The gap between the poor and the rich is bound to widen.

So far the virus has hit mainly developed countries. Once the pandemic reaches the war zones in Syria or Libya or developing countries with high-density slums and poor health care systems, like India, we will see different impacts. EU countries have to prepare themselves to help developing countries by all means, including equipment and doctors. Otherwise they just pass the baton to China and Russia, both eager to show that they are there to help. 

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April 06, 2020

How confinement affects mental health

In France there is a first study of how the lockdown affects mental health, according to Journal du Dimanche. The study is led by two psychiatrists and based on over 11,000 online questionnaires. it shows that mental well-being has been declining for everyone but some professions are more resistant. Those working in the health care system do better than others, possibly due to a sense of purpose in this crisis. After health workers are senior managers and social workers, possibly also because they are still engaging in work remotely. Farmers are near the bottom of the ladder, ahead only of students who are confined to small rooms and with broken social relationships.

The survey also looks at addictions. It shows an explosion of screen time, raising concerns about over-consumption and what it means for mental health. Among those drinking alcohol, only a quarter drink more than before while smokers increased their tobacco use significantly. More details are yet to come out of these data, including breakdowns by sex, age and other conditions. 

According to one of the authors, professor Nicolas Franck, the mental health effects kick in after 10-20 days of confinement. He calls for a progressive exit strategy to give people a perspective rather than leaving them in the unknown.

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