Vulnerable

Without a lockdown, we are told, new infections will grow very rapidly, with many people dying because the health care system will not be able to cope. On a graph, it would show a line moving upwards very quickly and staying high for some time before declining because infections are uncontrolled.

A lockdown — limiting people’s movements, initiating social distancing — is supposed to reduce the speed of transmission, so a curve showing the number of infections will be lower and flatter, not reaching a high peak. We are trying to buy time here, to keep the number of patients down to a manageable level.

Patients who receive medical care are also less likely to transmit the infection to the public (but put hospital personnel and other patients in the hospitals at greater risk).

In all the frenzy around creating walls and borders, we forget something important in relation to this flattening: the differences in people’s vulnerability or chances of getting a particular disease and, once getting the disease, of suffering from complications, and even dying.

An individual’s vulnerability varies for diseases, whether infectious or not. A person’s vulnerability to heart disease, for one, is tied to lifestyle (including diet, exercise, stress) as well as genetics.

With an infectious disease like COVID-19, one which is highly contagious, we tend to think mainly of the virus “treating” everyone equally and forget that there will be differences in people’s vulnerability.

We already know that children are less likely to be infected compared to adults. Among adults who do get infected, there is also a higher likelihood of serious and life-threatening complications in the elderly, people with diabetes and heart disease, and people whose immune systems have been weakened (for example, kidney transplant patients who are taking medicines to prevent rejection of the kidney, but which suppresses the body’s immune system).

COVID-19 shows how class creates brutal differences in vulnerability. In the early stages of the epidemic in the Philippines, vulnerability to COVID-19 was tied to exposure while overseas, which meant it was among the upper and middle classes (including overseas workers).

Now, with the disease entrenched in the Philippines and being transmitted locally, vulnerability is highest among lower-income Filipinos, foremost because they can’t just stay home, as the government keeps urging us to do. Hanap-buhay, the Filipino word for work, has the literal meaning “look for life,” yet those who need hanap-buhay the most have been the first to lose their livelihoods.

Ironically, the lockdown contributes to the vulnerability of lower-income Filipinos, because they have to battle large crowds in public transport and in checkpoints to have their papers checked and to have their temperatures taken. (I’m actually skeptical about the thermoscanners because a person can have COVID-19 and not be running a fever, and those with fever, well, they’re just told to go home.)

With the “enhanced” lockdown, the problem is there is no public transport. On one of the television channels, a woman vendor in Divisoria muttered, as she was packing up because the mall was going to close down, that her family was not going to die from COVID-19 but from hunger.

The class bias in the response to COVID-19 is global. One headline captures it all: “Bankers go home, tellers stay: Virus exposes office inequalities.”

The class inequities pop up in all kinds of situations. Planning for online learning systems at UP, we’ve realized many students don’t even have a personal computer, or don’t have Wi-Fi at home. Internet cafes are closed now so they have to buy loads for their cellphones to connect to Wi-Fi, the connections not always reliable. Their richer classmates are safe at home, with unlimited Wi-Fi to keep in touch with friends, roam the internet, play games.

Also under the radar is the situation of our thousands of prisoners, many from low-income groups, detained for months and years on end in horribly congested spaces, especially following the war on drugs. Spokesperson Fides Lim of Kapatid, an organization working with political prisoners, has urged authorities to release the sick, elderly, and “low-level” prisoners before disaster strikes, one which will spillway beyond the prison walls.

A final observation: We were due to have launched the Universal Health Care (UHC) in January, but that was moved to February, and now, who knows when. UHC would have provided much-needed safety nets for lower-income Filipinos to cope with this public health crisis. Without UHC, the government must quickly find other ways to deal with the financial inequities that could turn the COVID-19 crisis, lockdown and all, into an apocalypse.

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