LNOB amid COVID-19: Emerging from Survival Mode

08 October 2020

As many countries around the world experience a resurgence in COVID-19 cases, decision makers face the dual challenges of containing new outbreaks, while addressing the enduring consequences of the economic lockdowns imposed to contain the first wave. COVID-19 acts as a generalized shock to the economic and social fabric of societies, reducing their resilience to other crises. It is time to prepare a more complex response to the pandemic and its economic and social consequences.

The coming months will be crucial to prevent casualties for those at elevated risk of contracting the virus, and most affected by the measures to contain it.

In September 2020, during the 75th high-level debate of the UN General Assembly, world leaders stressed that swift action is needed to prevent a broad reversal of progress towards the SDGs, especially regarding poverty, food security, and health. The impacts of the pandemic have been highly uneven, often hitting people who were already struggling the hardest and pushing vulnerable populations even further behind.

The coming months will be crucial to prevent a rise in casualties among those who are both at elevated risk of contracting the virus, and most affected by the measures taken to contain it. While the headlines are dominated by news about case numbers, social distancing fatigue, and fear of lockdown relapse, experts and decision makers are beginning to discuss how we can ensure that no one is left behind in the time of a pandemic.

Leaving No One Behind While Adapting to COVID-19

On 30 June 2020, over 50 experts in health and development gathered for a virtual roundtable hosted by the UK Government’s Wilton Park center in partnership with Development Initiatives. Occurring just a few months into the unprecedented times we were all living through, the event challenged experts to identify ways to ensure that no one is left behind in policy responses to the crisis.

Even at that early stage, experts agreed that COVID-19 will be with us for some time, predicting that localized or widespread outbreaks will be common throughout the years ahead. It is therefore crucial that societies learn how to react to new outbreaks, while rebuilding their economies and ensuring that no one is left behind. The knowledge, ideas and concerns shared during the event can be summarized in two themes.

Understanding Unequal Impacts of Lockdowns and Social Distancing 

Lockdowns have harsher consequences for some groups of people than others. Why is this? Because social distancing is harder when your job requires physical work with many colleagues in confined spaces, when you depend on public transport to get to work, and when you share a small apartment with many family members or fellow migrant workers. Quitting your job to care for children at home or to protect high risk family members is impossible when you depend on your daily income to buy food and pay rent. This means that the cost of social distancing is higher for people with lower incomes, leaving poor people with insufficient means to protect themselves.

According to the Household Environment for Protection Index, globally only about 6% of the poorest 40% of people have adequate means to self-protect against infection risk. In sub-Saharan Africa, the number is almost zero. Almost half of the population in these countries requires external support like subsidies for personal hygiene and food to implement COVID-19 safety recommendations.

In addition, low income groups face a daunting trade-off between protecting themselves against the virus and worsening household poverty, leading many to slip into food insecurity or lose access to essential services. Poor households face deteriorating health on both sides of the social distancing equation.

The consequences are worse for groups facing additional vulnerabilities. For example:

  • For the elderly poor and disabled poor, essential services are limited. One told our roundtable that 80% of persons with disabilities already live in poverty, and now their barriers have grown: communication, access to hygiene facilities, and lack of their usual services. Moreover, with public budgets stretched by pandemic response efforts, some expect financial support for persons with disabilities to be cut.
  • The crisis affects women and girls through surging gender-based violence, unwanted pregnancies, and other events with long-lasting effects on their lives.
  • Measures aiming to contain the spread of COVID-19 can restrict access to services and medication needed to prevent the spread of other diseases. The most vulnerable will be affected by a dual impact of COVID-19 and HIV/AIDS.
  • The shut down of social service infrastructure leads to the collapse of social safety nets and other measures designed to protect the most vulnerable.

Anticipating Future Impacts and Compound Crises

In the initial stages of the pandemic, lockdown measures had to apply to large parts of the economy and social life to ensure that the curve of COVID-19 spread could be successfully flattened. But businesses and institutions learned to adapt and developed protocols for social distancing that allowed a careful reopening. Hospitals increased their capacity to treat COVID patients, restaurants reopened with spaced out tables, cultural events moved into the open air, and school children study in “bubbles” with a limited number of friends. Enabled by close monitoring of case numbers, contact tracing, and staged measures to control new outbreaks, many areas of social and economic life have safely restarted, albeit at reduced levels.

However, other sectors like tourism or densely populated urban areas remain closed or are at higher risk of lockdown relapse than others. Countries, areas, and populations depending on these sectors continue to be impacted disproportionately and risk suffering more in case of repeated waves of new infections.

These vulnerabilities can be compounded by other crises like locusts spreading in sub-Saharan Africa and India, wildfires, or hurricanes, floods, droughts, and other extreme climate events. Most disaster events make social distancing all but impossible, leading to a rapid increase of COVID-19 on top of disaster distress.

Emerging from Survival Mode

Societies, like individuals, respond to unknown shocks by focusing all available resources on immediate survival. It is likely that early lockdowns and restrictions  saved hundreds of thousands of lives. However, as the pandemic continues, it is imperative to move beyond emergency response to ensure stabilization and plan for longer-term recovery. The lessons shared during the event are evidence of the ability of societies to learn and adapt to a global pandemic and manage its spread, while waiting for a vaccine as a long-term solution.

Experts suggested:

  • Cash and food transfers and subsidies for personal hygiene are effective and should be utilized;
  • Community-based organizations should be supported, as they work closest to the people affected and know what support they need; and
  • Better real-time data will make support more effective, especially in countries where marginalized groups are underrepresented in official statistics.

With these lessons taken into account, decision-makers can regain the ability to address the needs of the poorest.

We can learn from our instincts to “survive” during the first round of this pandemic. We focused on containment, flattened the curve, and have been able to open our eyes to the resulting impacts. Now we must take a more measured response. Decision makers should begin longer-term planning for future waves of infections, to respond in a way that protects the most vulnerable. In this way we can prevent an even greater setback to shared long-term progress.

This article will be cross-posted at the global SDG Knowledge Hub of IISD as part of a series of publications from the Leave No One Behind partnership.