Published in Croakey, 27 August 2020

Wherever it goes, COVID-19 shines a light on injustice and inequality embedded in each society and community it touches. The COVID pandemic has exposed just how vulnerable people in residential aged care facilities are to being infected. But two other groups don’t get the same policy attention: prisoners, and people in overcrowded housing.

The design and nature of prisons mean that people are in close proximity to each other, making social distancing impossible. Outbreaks are likely to spread quickly if COVID-19 infects some prisoners. The only way to slow this spread is to isolate, which is harder in older facilities, and keep prisoners in their cells for most or all of the day, or to make room for social distancing by releasing low-risk prisoners.

Prison outbreaks

There have been major outbreaks of COVID-19 in prisons around the world. In the UK, health authorities put prisons into pre-emptive lockdowns after identifying the risk. All 80,000 prisoners in the UK remain locked in their cells for 23 hours a day, which has limited the spread to about 500 cases. Prisoners in the US have fared worse: there have been more than 70,000 cases, and 700 deaths, reported in prisons since April.

Prisoners tend to have poorer physical and mental health than the general population. One-third of prisoners in Australia have a chronic condition such as cancer, heart disease, diabetes, or asthma. The risk of outbreaks in prisons is starting to be realised in Australia. In Victoria at the end of July, six prisons were placed into lockdown – similar to that implemented in the UK – after a corrections officer tested positive to COVID-19.

The risk of incarceration, and so the risk of being exposed to COVID-19 in the prison system, doesn’t fall on all Australians equally. Aboriginal and Torres Strait Islander are enormously overrepresented in Australian prisons. Children as young as 10 – who are just as likely to contract COVID-19 as young adults – are imprisoned, unable to have visits from their family since March.

The National Aboriginal and Torres Strait Island Legal Services has made clear that, although there was fast preventative action by the community, the pandemic has ‘highlighted the drastic under-resourcing of health, education, legal, and social services, safe and secure homes, and community infrastructure for Aboriginal and Torres Strait Islander communities’.

Immigration detention facilities – which are densely populated and require sharing of facilities – are also high risk for COVID-19 outbreaks. People in these facilities have also been without visitors since March.

Overcrowded housing

Overcrowded housing has been shown in the US and Singapore to be a significant risk for the spread of COVID-19. Severe outbreaks in a public housing tower in Melbourne, where 11 percent of residents were infected with the virus, illustrated this risk in Australia.

There were 8,000 people living in public housing in Flemington and North Melbourne at the most recent Census (in 2016). A third of those were in homes that required more bedrooms. People who live in these public housing towers were the only Australians to be subjected to lockdowns without the option of leaving their accommodation for any reason. With no prior notice, in early July police placed at each floor of the towers to enforce the lockdown.

Overcrowded housing is not limited to public housing towers. Census data shows that about 1.5 million Australians live in homes with not enough bedrooms; 50,000 live in homes that need four or more bedrooms. Newly arrived migrants to Australian often room-share – where two or more adults not in a relationship share a bedroom.

It’s impossible to social distance or self-isolate if you live in overcrowded housing. In the US at the height of the pandemic, people living in wealthier neighbourhoods sheltered at home earlier, and for longer, than people living in poorer neighbourhoods. These risks were identified by healthcare workers before the June outbreaks in Victoria.

People who live in overcrowded housing are more likely to work in jobs that require close physical proximity to others, such as retail and foodservices. Many of the same people who are unable to socially distance at home are also required to have close interactions with others during their working day or night. This creates a vicious cycle of COVID-19 transmission in the community.

Vulnerable at risk

The Victorian Department of Health identified that the outbreak continued because people were not self-isolating when they felt sick or were waiting for COVID-19 test results. But for some, skipping work isn’t an option. They don’t have the savings to miss their casual work hours. These people feel they have little choice but to continue working – and hoping that COVID-19 doesn’t head their way.

Australian governments have failed aged care residents during this pandemic – leading to unnecessary deaths – and they are failing prisoners and people who live in overcrowded housing. There have been no announcements of special programs to reduce the risks for people in these two vulnerable groups.

For prisoners, it might mean bringing forward parole a few months so that a custodial sentence doesn’t become a death sentence.

For people in overcrowded accommodation it might mean extending JobSeeker so that they can return to their previous living arrangements. It might mean more targeted testing programs in these neighbourhoods to catch outbreaks earlier, and information programs – in multiple languages – so poor people know about pandemic leave provisions.

The lesson from the tragedies of residential aged care is that governments must do much more to protect other vulnerable groups. Because in the fight against COVID-19, protecting the most vulnerable means protecting us all.