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How does COVID-19 impact vulnerable populations differently and why is a human rights response to the pandemic necessary?

Those were questions explored during a Dalhousie University ‘Open Dialogue Live’ panel discussion on Thursday afternoon. The panelists included Alex Neve, Amnesty International Canada’s secretary general, and Dalhousie University professors Judy MacDonald and Ingrid Waldron. 

Neve kicked off the discussion, noting how in recent weeks he’s experienced pushback when Amnesty International or other human rights organizations and experts say the COVID crisis needs to be about human rights. 

Alex Neve, Amnesty International Canada’s secretary general. Photo: Amnesty International.

“People kind of scratch their head and say, well, it’s a public health emergency. It’s an economic crisis. It’s not really a human rights concern, is it? But obviously everything about this situation, absolutely everything, is entirely about human rights,” Neve said. 

“The virus itself. The economic collapse. Certainly the impact on the most marginalized and vulnerable communities. The ways in which a lot of existing human rights violations are exacerbated and made worse, and certainly the question of what kinds of restrictions are or are not permissible on other rights.”

He highlighted some of the human rights ‘dos’. These include things like the right to health, including safety of health workers, the right to life, rights to housing, food, water, livelihood, and social security. 

On the flipside of that are the human rights ‘don’ts.’ Those include racism, violence in the home, abandoning refugee protection, poverty and homelessness, and prisons and detention centres. 

“Groups that are marginalized and already experiencing serious, and in many instances deeply entrenched human rights violations going back decades, require extra or particular attention and responses because of that marginalization,” he said.

Among his many points, Neve also touched on government measures that have included a variety of policies, programs, and enforcements that limit and restrict other rights. Suspension of classes undermines the right to education, while shuttered businesses means people’s right to earn a livelihood have been impacted. Requiring people to stay home and not allowing them to gather in large crowds restricts rights like freedom of movement and freedom of assembly. 

While these are all vital human rights vigorously defended by groups like Amnesty International, Neve said they recognize that when faced with a major crisis or emergency, some restrictions will need to be imposed by governments. But he cautioned against a carte blanche approach. 

 “Those restrictions cannot in any way, shape or form, be marked either directly or indirectly by discrimination, so certainly they can’t be intentionally applied discriminatorily to one community and not to another,” he said. 

“But the governments need to very much be looking for the differential discriminatory impact, even if unintended, across different communities.”

People with disabilities ‘vulnerable right now’

MacDonald, director and a professor at Dalhousie’s School of Social Work, focused her presentation on disabled people and COVID-19, asking if they were a disposable group of people. 

Historically marginalized throughout society in times of war, economic downturns, or in times of pandemics like we’re living through now, MacDonald said people with disabilities continue to struggle for their rights. She shared heart-wrenching stories that included a young mother who had to fight for a “do resuscitate” order for her severely disabled son. 

She also pointed to several recent news headlines from across the country. Transit drivers refusing passengers with wheelchairs; parents of disabled children worrying their children will get low priority during the COVID-19 crisis; and fears for the safety of people with disabilities after funding for mobility and medical devices is deemed non-essential. 

Judy MacDonald. Photo: Dalhousie University.

“We get into a position where we’re making judgment on people’s lives due to their perceived abilities, and due to our assessment about how we think that they will do in relation to that medical treatment,” MacDonald said, adding that people with disabilities can be thought of as a reasonable casualty of the pandemic.

“’We can’t save them all’ is kind of the mindset. But I ask you what’s happened to the dignity of life, to our concepts of diversity and equity principles? We have the opportunity to rewrite our history, to do things differently this time.”

There are more than six million people in Canada who live with a disability, and MacDonald said COVID-19 will hit them hardest. She urged Canadians to look at what their experiences have been and continue to be within society, adding that it’s time we learned from them. 

“People with disabilities face social isolation on a daily basis, long before COVID-19 came along.  We’re all in society getting a little taste of what that experience is like,” she said. 

“But for them, it’s something that they deal with on a daily basis, not going outside or having restricted exposure to the social environments, not having transportation to go to the movies or to engage in some form of social life.”

She pointed to one disabled woman who said the current pandemic normal that has people distancing themselves in public and not interacting at all is how it’s always been for her. 

“She said, ‘That’s my life before COVID-19. I’m invisible to people. People look over me, they don’t make eye contact with me,’” MacDonald said. 

“People with disabilities fear that they’re going to get sick, and if they get sick and have to go to hospital or have to find a testing site, how are they going to get there, because they’re told not to take public transportation if they have any symptoms, and that’s their only mode of transportation.”

Another woman living with cerebral palsy told MacDonald that because she relies on caregivers for assistance, she’s fearful her workers won’t show up or that her hours will be reduced.

“This quote was striking to me. She said, ‘If I contract COVID-19, I may or may not die. If I lose access to care, I will definitely die.’ People with disabilities are vulnerable right now,” MacDonald said.

“They’re fearing that their exposure to COVID-19 is increased by caregivers coming in and out of the home. But their greater fear is that the caregivers won’t come at all.”

She also pointed to how so many people are now experiencing increased worry, anxiety, and sleeplessness as a result of the ongoing pandemic. But for those living with mental health disabilities, their normal life is far more intense than what most of us are experiencing now.

“All in all, I think we have a lot to learn from people with disabilities. When COVID-19 is over, I hope we step back and think about where we’re at as a society,” she said. 

“I hope we take a deep look into how we were made to feel isolated, and how that is the lived reality of people with disabilities on a daily basis. I hope it’s now time for society to truly become accessible.”

“Perfect opportunity’ for governments to collect race-based data

Ingrid Waldron. Photo: Dalhousie University.

Waldron’s presentation focused on why race matters when discussing the pandemic. The Dalhousie University School of Nursing professor said evidence from the US shows COVID-19 has been affecting more African Americans and they’re also dying at higher rates than white Americans. 

“Many in the African Nova Scotian community are now wondering if they too will be disproportionately impacted by the pandemic, given the long standing social, economic, and health inequalities they experience,” Waldron said. 

“There is an urgency in determining if the (African Nova Scotian) community…will be disproportionately impacted in light of comments made by Nova Scotia’s chief medical officer during a press conference that the Prestons is a hot spot where there’s community spread of COVID-19.”

Since late March, Waldron said the COVID-19 Preston Response Team has opened three testing sites in the Prestons. The Prestons include the communities of Cherry Brook, Lake Loon, East Preston, and North Preston

The team includes community organizations, clinicians, local clergy, and activist groups and is taking a grassroots approach to working with Preston residents and public health officials. 

Waldron said race provides an important analytical entry point for understanding and addressing the multiple social, economic, environmental, and political factors that create disproportionate exposure to the virus.

She also highlighted how the pandemic “provides a perfect opportunity” for the provincial and federal governments to begin collecting disaggregated data based on race, along with other social identifiers such as gender identity, sexual orientation, and disability. 

“The disproportionate location of African Nova Scotians in low-income, essential services jobs, as well as the legacy of racism, sexism, classism, colonialism, and intergenerational income insecurity and poverty in their community means that they will be more exposed to the social determinants that put them at risk for the virus,” Waldron said. 

“Intergenerational income insecurity and poverty also mean that African Nova Scotians are more likely to live in households with large multi-generational families, making it less likely for them to isolate or quarantine sick family members in separate bedrooms, or to use separate bathrooms.”

Waldron pointed to research conducted over the last several years pointing to structural inequities contributing to health disparities and mental health disparities in African Nova Scotian communities. Those include institutional racism, socioeconomic disparities, educational barriers, and environmental racism. 

These health and mental health disparities, she said, result in high rates of stress, cardiovascular disease, diabetes, high blood pressure, cancer, and respiratory illness in African Nova Scotian communities. 

“Conversations are also taking place about the mental health impacts of the pandemic, particularly how social distancing has exacerbated feelings of powerlessness, fear, anxiety, and stress for African Nova Scotians in the Prestons and across the province,” she said.

Among her recommendations to help reduce community spread of the virus in the Prestons, Waldron called on provincial and federal governments to collect disaggregated health data based on race and other social determinants of health.

She said this will determine if and how the virus is impacting African Nova Scotians in the Prestons and Black communities in other parts of the province and country, “as well as identify rates of COVID-19 infection in these communities across gender, age, income, education, disability, employment, housing, and living arrangement categories.” 

While highlighting the importance of conducting studies that identify and address social determinants of health that create exposure to and a risk of COVID-19 in Black communities, Waldron announced that she and her team learned on Wednesday that they’d been awarded a grant to look at culturally-specific COVID-19 response strategies for African Nova Scotians in the Prestons.

“We also need to use the pandemic as an opportunity to increase the education, training, recruitment, and employment of African Nova Scotians and other people of African descent at all levels of the health system, which would enhance health services utilization among this population group and other racialized groups,” Waldron said.

In wrapping up the event, Neve said it was important that when we emerge from this pandemic, we don’t slip back to the new normal being what he referred to as “the old normal.”

“If we don’t effect some meaningful change that addresses the disgraceful inequities long known and long existing, and perhaps in some respects now much more apparent in a very raw way to all Canadians, then we have lost an incredibly important opportunity to advance some really meaningful social justice change,” he said.

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Yvette d’Entremont is a bilingual (English/French) journalist and editor who enjoys covering health, science, research, and education.

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