Covid lays bare lies of austerity

The Government's "vaccine amnesty" is insufficient in addressing health discrimination against migrants

Tory hostile environment has deepened health inequalities during pandemic, says Farah El-Sharnouby

Covid-19 has forced us all to look inwards; but as well as teaching us about ourselves, it has also exposed and exacerbated existing inequalities in our society, coinciding with racism, classism and xenophobia to result in worse health outcomes for ethnic minorities and migrants in the UK. Our government’s response to Covid-19 has often mirrored these injustices, highlighting which lives they deem expendable, and which, to them, are worth saving.

Very early on in the outbreak, it became clear that black and brown people were dying at higher rates than their white counterparts. This has often been put down to overrepresentation in frontline jobs: they are more likely to work as taxi drivers, security guards, hospital cleaners, social care workers, nurses and doctors, with healthcare workers in particular three times more likely to die of Covid than the general population. But if it were simply exposure to the virus that increased mortality rates, one would expect healthcare workers of all ethnic backgrounds to have similar mortality rates; however, of the healthcare workers that have died of Covid-19, two thirds have been ethnic minorities. There must therefore be compounding factors explaining the poorer outcomes in ethnic minorities, ranging from biological – having more comorbidities – to socio-economic: ethnic minorities are more likely to live in cities and deprived parts of the country, which alone doubles their risk of mortality.

Structural racism and discrimination have been identified as potential root causes of the aforementioned risk factors, and one of the most blatant examples of discriminatory government policy predating Covid-19 is Theresa May’s “hostile environment” – the aim of which, the government makes quite clear, is to deter immigration to the UK by making it such a cruel and uninviting place that even those fleeing war and famine will not want to live here. In 2017, this was extended into the NHS, meaning those not “ordinarily resident” in the UK require ID checks and are charged for their healthcare upfront. For years this has jeopardised migrants’ health, as many have found it difficult to register with a GP due to lack of identification/proof of address, and avoided seeking medical help when necessary due to fear of deportation or getting into crippling debt, which the Home Office can use as grounds to deny their visa applications. Restricting access to healthcare based on immigration status is appallingly xenophobic in normal times, but in the midst of a global pandemic has had even more deadly consequences. There have been reports of undocumented migrants found dead after contracting Covid-19, their loved ones citing fear of deportation as a key reason for not seeking medical help, and many support organisations across the UK state that migrants and refugees have avoided seeking healthcare during the pandemic due to fear of charging and data-sharing with the Home Office.

In an apparent attempt to mitigate this phenomenon, Covid-19 was added to the list of communicable diseases exempt from upfront charging, and the government has created a “vaccine amnesty” to encourage undocumented migrants to get the jab. These measures are laughably insufficient in undoing years of justified mistrust, but also futile if those who need to make use of this exception are not aware it exists. As the pandemic has progressed and key information is now disseminated online, many migrants have been left out of the loop, often living in destitution without access to the internet, and dependent on support organisations to translate government guidance into their mother tongues. This renders discussions regarding “vaccine hesitancy” amongst ethnic minorities particularly tone deaf, as it masks the complex and varied reasons people feel unable to get vaccinated. It is, however, consistent with the government’s strategy of denying all culpability throughout the pandemic, instead shifting the blame onto the people, often using ethnic minorities as a convenient scapegoat. Muslims have been blamed for outbreaks, black people protesting police brutality were “flouting the rules”, but at no point has the government conceded that Eat Out to Help Out increased infection rates, or apologised for not securing sufficient PPE.

Covid-19 has laid bare the lies of austerity, confirming that there is indeed a magic money tree, but the government selectively decides who to adorn with its fruits. If they can afford to hand millions of pounds out in contracts for a failed test and trace system, they can afford to stop charging migrants for their healthcare, and end the hostile environment once and for all. The pandemic has affirmed what ethnic minorities and migrants in this country have always known: we are worth keeping around so long as we are willing to risk our lives driving buses and intubating patients, but our lives are only worth saving if they keep others alive too.

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