Coronavirus and inequality: a vicious circle

Over the last few weeks, epidemiologists and authorities have insisted that there are basically two risk factors that make people more vulnerable to the coronavirus: old age and suffering from previous pathologies. To these two personal circumstances must be added another economic one: poverty increases the impact that the pathogen can have due to the lack of health infrastructures or means of prevention.

This problem is not exclusive to the most impoverished societies. It also occurs in those countries with a high level of economic development. Within this group, those who suffer most are those with the highest rates of inequality. The United States is a clear example. Within the European Union, Spain is among the five countries where the income differences between rich and poor are greatest, according to Eurostat data.
 

The most obvious disadvantage is in relation of access to health care. Perhaps the clearest example to point out this reality is the United States. The American giant has one of the least open systems in the world, with almost no public health care. Many workers depend on expensive private insurance if they want to receive medical care. While it is true that the government is not charging citizens up front for coronavirus testing, things change once a person is proven to be infected and needs treatment.

It is not known what the total amount of medical care for a patient with choroanvirus in the United States would be. The available figures are based on estimates. An emergency room visit costs, on average, almost $1,900, an increase of 176% over ten years, according to a report published in late 2019 by the Health Care Cost Institute (HCCI). In the case of COVID-19, that amount could increase due to all the prevention and prophylaxis procedures associated with the virus. 

In addition, it is estimated that about 32 million U.S. workers-something more than a quarter of the nation's workforce-do not have paid sick leave coverage on their contracts. The figures are even more serious for those who earn less. According to the CLASP think tank, the percentage rises to 47% when looking at the first quartile of workers according to their income levels. The balance of part-time workers is even worse. It should be remembered that the United States is already the country that has officially recorded the most COVID-19 infections worldwide.
 

However, the differences in the impact of the virus are not simply reduced to the ease of access to health care. Research published in 2008 by the American Sociological Association suggests that those with lower incomes are more likely to develop pathologies such as diabetes or cardiovascular disease. Combined with the conditions of the health system, it can increase the probability of dying from the disease by up to 10 times, according to the Chinese Center for Disease Control and Prevention.

Workers in lower-skilled - and therefore lower-paid - jobs are often those who have been most exposed to the virus in those European countries where confinement has already been officially decreed, including Spain.

As Lara Contreras, head of advocacy and content at Intermón Oxfam, explains to Newtral, people with lower incomes are very often those who are least likely to opt for alternatives such as teleworking. For that reason, they are forced to keep going out on the streets to take up their jobs in person. This also means continuing to use the public transport system. The problem, according to Contreras, increases when there are children or dependents in these homes.
 

If economic inequalities can exacerbate the spread of COVID-19, the crisis arising from this global pandemic can similarly exacerbate the differences between those with more and less income. In macroeconomic terms, the International Monetary Fund (IMF) has already warned that the recession resulting from the dramatic decline in economic activity could be even worse than 2008.

The paralysis of the manufacturing system will have very negative effects, especially for the self-employed and small and medium-sized enterprises. In some cases, they may be forced to reduce their workforce or even close down. It is foreseeable that all this will have a negative impact on the living conditions of the most vulnerable sectors of the population.

To put it in context, between 2008 and 2013, Spain's gross domestic product also fell by more than 8% and nearly four million jobs were destroyed. All of this was reflected in the daily lives of the citizens, but those who had less income were the ones who lost out. Since the beginning of the crisis in 2008, Spain is the second country in the European Union where the difference between the poorest 10% of the population and the richest 10% has increased the most, only surpassed by Bulgaria, according to the report 'Inequality 1- Equal opportunities 0' published at the beginning of 2019 by Intermón Oxfam. If the forecasts made by the IMF are indeed fulfilled, the impact of the current crisis could prove to be at least as destructive.
 

In the future, the gap in education is another result of this problem, as it unfortunately means less equal opportunities and more inequality in the coming years. Distance education forced by confinement is not the same for everyone, since one in ten families in Spain does not have an internet connection. Under these conditions, many children are left behind in comparison to others because they cannot follow the activities proposed in the virtual classrooms.

There are, therefore, reasons to think that the spread of the virus and the unequal distribution of wealth in a society are two variables that are interconnected and feedback each other. Those with fewer economic possibilities are more exposed and, furthermore, in countries where there are no strong public health systems, they encounter great obstacles in treating the disease.

As the virus spreads, its economic impact becomes more severe and, in the long term, it causes a recession that, predictably, can magnify those same income differences between the richest and the poorest.