This week in the House of Commons, Matt Hancock referred three times to a group of patients in Bolton hospital being treated for Covid-19. He seemed particularly keen to point out that of these 19 patients, the majority were eligible for a vaccine but “had chosen not yet to have it”.
Hancock’s use of this information raises several important questions. How did the health secretary know such detailed clinical information about these individuals? How accurate were these numbers? And was it appropriate to suggest that a small number of people currently battling a deadly infectious disease in hospital had brought this illness upon themselves?
The act of pointing the finger at people who apparently fail to do what they are told to and therefore become ill is known in public health as “victim blaming”. Hancock’s ill-judged comments about people suffering from Covid-19 suggested that they were responsible for catching this illness. Of course, some would argue that pointing out the risk of serious illness to unvaccinated people is an important means of helping them stay safe and get vaccinated. But by singling out those who had not received the vaccine and who were suffering in hospital, Hancock’s comments were all too reminiscent of those made in the early days of the pandemic, when commentators often reiterated that people who had died had “underlying conditions”.
People who are seriously ill need help, not personal criticism. No scientist would deny that vaccination uptake is key to controlling the virus. But the programme, just like test, trace and isolation, is a collective, not an individual, issue. Its success ultimately depends upon the direction and leadership of the government and health authorities. Ministers have been roundly criticised for England’s floundering test-and-trace service and the failure to provide sufficient support to those quarantining, both key parts of keeping the virus under control. They were warned that their half-baked approach to managed quarantine, where about two-thirds of people who apply for self-isolation payments are refused them, was bound to fail. It’s therefore no wonder that they are tempted to try to transfer the blame and responsibility for Covid-19 cases on to individuals.
During the middle of the last century, health education campaigns directed at the general public became the favoured approach for encouraging people to change their behaviour. Public service broadcasts on radio and TV imparted medical advice about the risks of smoking and sexually transmitted diseases, accompanied by exhortations from authoritative figures to follow that advice, and dire warnings of potential health risks.
But placing the responsibility for good health squarely on the shoulders of individuals ignored the myriad reasons why it was easier for some people to live healthier lives than others. For example, pointing the finger at smokers by telling them to quit and warning them of the consequences was easier for politicians than tackling influential tobacco companies’ addictive and dangerous products. This approach also ignored the reasons why many people living in difficult social and financial circumstances choose to seek what solace is immediately available to them, whether tobacco, alcohol or drugs.
Even before the pandemic, England was experiencing an unprecedented public health emergency. Life expectancy has stalled, and for some groups, particularly women and people living in poverty, has started to fall. The virus has magnified these health inequalities and taken the heaviest toll on those who are least able to cope with its effects. Like many other factors that affect people’s health, the uptake of Covid-19 vaccines varies significantly across different sections of society, according to people’s household tenure, ethnic group, religion, English language proficiency and level of deprivation. Pretending that each individual has an equal choice to make about vaccinations ignores the whole range of social and cultural factors that shape these decisions.
The spread of the B.1.617.2 variant, first identified in India, in some areas in the north-west of England seems to be what is driving Hancock’s remarks. By blaming people for Covid-19 cases, the government can divert attention from its failures to suppress the virus through, for example, instigating firmer border controls. This new variant has unfortunately created another opportunity for finger pointing. Naming it by its assumed country of origin emphasises its “otherness”. In the US, the former president Donald Trump’s repeated use of the term “the Chinese virus” was linked to an increase in racist attacks on Asian Americans.
As lockdown measures are lifted in England, we need local communities and their leaders to work together to suppress the virus. To step into the gaps that have been left by the government’s woefully inadequate support, these communities will need resources and help. Blaming people when they become ill or scapegoating particular groups or populations does the opposite of this and will only make the urgent task of keeping everyone safe and suppressing the virus more difficult.
This content first appear on the guardian