Increased awareness of Covid-19 and accurate information about how to prevent its spread are no doubt essential in initiating behaviour change. However, we cannot ignore the inequalities in living and working conditions that can make it difficult to take the necessary steps. Let’s first consider the working conditions. Those who spend long periods working in overcrowded conditions where they cannot practice physical distancing or regular hand-washing are at increased risk of infection than those who can work from home. 

Furthermore, a critical gap in our societies is the lack of financial safety nets for large segments of the population; this means that they have no income from their employers or the state if they are unable to work due to illness, family caring responsibilities or physical distancing requirements. In practice, what we are saying is that we expect a daily wage earner (such as a factory or food delivery worker) to stay at home for up to 14 days without income if unwell with Covid-19 symptoms. Is this realistic? If not, then we must accept that we, as a society, have not enabled people to be able to take measures necessary to prevent spread of Covid-19. A similar point can be made about hygiene behaviours at home. As long as we have communities living without adequate access to clean water and sanitation facilities, there will always be a risk of infectious disease outbreaks. I hope the Covid-19 situation leads to a realisation that inequalities in living and working conditions put everyone at risk – the rich and the poor.

-Mishal Sameer Khan

Associate professor at the London School of Hygiene and Tropical Medicine