Refugees, homeless and prisoners likely to be forgotten in the COVID-19 panic

Lara Hamidi
Researcher for ImpACT International

With COVID-19 now entrenched or putting down roots in over 200 countries and territories around the world, governments are, understandably, scrambling to contain the ravages of the pandemic or figure out how to prevent it from wreaking more havoc in even more areas. Governments and health care facilities/professionals are pushed to their limits.

However, regardless of how much strain is placed on governments and the extent of uncertainties that remain even as the pandemic expands, it is their explicit duty to provide security and direction to their residents—all of them, including the most marginalized. And while stimulus packages are being adopted to assist businesses and the traditional unemployed, three other types of people are being neglected: refugees, undocumented workers, the homeless and prisoners.
 

The risk of dying from COVID-19 among the homeless is 10 times more than those who are sheltered and financially flexible.

Refugees and the undocumented: no time for xenophobia

An estimated 66 million individuals have been forcibly displaced from their homes due to persecution, conflict, violence and/or or human rights violations. Some millions of them are undocumented, meaning they live in particularly precarious conditions due to the lack of official status (which also makes their number impossible to track with any accuracy). Too frequently, they live in crowded, not uncommonly unhygienic conditions, with limited access to adequate health care.

For example, in Lebanon, which is home to nearly 2 million Palestinian and Syrian refugees—many living in slum-like settlements—six to 10 people often share one living space, making isolation simply impractical. Water quality is poor, waste treatment almost non-existent and access to health care is often tenuous. An outbreak in camps or refugee settlements, such as the one in Lebanon's Bekaa Valley, would cause great strain on the weak national health system as well as risk a spread to surrounding communities.

Another potential hot spot are the Greek isles, home to an estimated 37,000 refugees and migrants living in facilities meant to house just 6,000. These camps also have very limited access to water, heat, bathrooms and food. And medical care is scant and basic.

Neglecting these individuals in any strategy to combat COVID-19 is immoral; however, it also endangers everyone since the virus does not respect income levels or legal status. Thus, the politics that swirl around these populations must be put aside, with governments accepting responsibility for their protection and wellbeing without judgement or penalty. This means access to free screening to determine who is a carrier, free treatment for those who are ill and assurance of safe, comfortable quarantines for those who test positive but are asymptomatic or only mildly sick.

The homeless population: flying below the radar

Citizenship does not guarantee safety, unfortunately. Many people in both developed and developing countries are without a stable source of income and support network, and thus have no home in which to live. The streets or temporary shelters are their homes.

This means they, too, often live in unsanitary conditions, do not have access to health care and suffer from chronic illnesses that leave them vulnerable. In contrast to the general public, people on the streets are six times more likely to have heart disease, 10 times more likely to suffer from chronic obstructive pulmonary disease and 2.5 times more likely to be diagnosed with asthma. The risk of dying from COVID-19 among the homeless is 10 times more than those who are sheltered and financially flexible.

Likewise, they often have no access to online or broadcast news and thus are not educated on how to protect themselves and others. The United States alone is estimated to have 4 million homeless on the streets and in shelters.

An extensive outreach campaign is needed in each country in which teams go to the homeless where they are; offer education on the virus and protective measures; conduct free, rapid testing; provide free treatment for those who are ill; and transfer those persons who test positive but do not require hospitalization to facilities offering safe, comfortable quarantine spaces, as well as other essential interventions (such as addiction therapy).

Paris is one example where the government has opened self-isolation centres with hundreds of beds to accommodate the needs of the homeless population who have tested positive for the virus but do not require urgent ICU care. 

The incarcerated: Don’t throw away the key

A similarly high-risk group are those locked up in prisons and jails, where overcrowding is the norm, many inmates are plagued with chronic health problems and poor hygiene is rampant. In fact, while experts recommend the use of disinfectant with more than 70% alcohol to disinfect surfaces, no alcohol-containing materials are allowed in most prisons. 

If the humanity of these individuals is not enough to justify their dignified and compassionate treatment, then the safety of the employees in prisons, jails and courthouses (and their families) should be convincing. Prisoners who are not a danger to society should be released during the pandemic, perhaps to home confinement or with ankle bracelets for tracking, and those still behind bars should be tested, treated and quarantined if necessary.

To ease the already deep isolation in prisons and jails that is exacerbated by halts to visitors, free phone calls to family members should be facilitated.
 

Governments’ financial responsibilities 

A government's key role is to ensure the security of its people, especially during emergencies. COVID-19 is subjecting governments to a significant financial strain; however, this is the time when as much money as needed must be invested into the healthcare system and the economy to prevent collapse.

The outbreak of this new virus is above all a health crisis; however, it necessitates extremely damaging fiscal remedies that will be felt for years. Least Developed Countries (LEDC) that are unable to spend on their healthcare systems must be given zero-interest loans. More economically developed countries must stand with those that are less capable of fighting the pandemic to ensure there is a united global front.

With the coming of COVID-19 in December, the world has seen a rapid decline in economic activities, leading to a rapid fiscal policy response by governments, triggering a significant increase in public borrowing. Debt will be among the biggest challenges that will linger long after COVID-19 dies out. In the UK, for example, it has been recommended in parliament that the government increase its contingency funds from 10.6 billion to 266 billion pounds over the coming year. However, significant borrowing is mandatory to prevent health systems from collapsing. 

Vladimir Lenin once stated, “There are decades where nothing happens, and there are weeks when decades happen.” This quote by the Russian political theorist is extremely fitting for the situation in which governments find themselves since the outbreak of the novel coronavirus that started in Wuhan, China. The world is changing by the hour. The financial, political and social environment in all 200 countries affected has shifted unrecognisably.

The UK is a case in point: The economy is projected to shrink by 5% this year due to the pandemic this year, causing the government to be invest 70 billion pounds (3.2% of national income) into its borrowing accounts.

However, governments exist to serve the people, and thus they must take steps to ensure the wellbeing of their populations. This will require cooperation from all segments of society.

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