Social disparity in magnifying glass: the inequality among the
vulnerable people during COVID-19 pandemic
Keywords: COVID-19; SARS-COV-2; social disparity; vulnerable
people
The editorial written by Stein and Ometa, (2020) [1] about the
dilemma between health system and socioeconomic conditions created by
the Covid-19 pandemic has called our attention as a very appropriated
topic. Indeed, there are different repercussion in all aspects in
unequal societies, which goes from financial issues to the chances to
adhere of the current recommended measures of the WHO. For instance,
social distancing and basic personal hygiene without proper social,
economic and healthcare support may contribute to exacerbate disparity
in fragile societies.
In Brazil, the virus SARS-COV-2 is spreading fast and crashing our
healthcare system and economy. The government is struggling to pay the
financial supporting defined by the congress of 600 Brazilian real per
month (about 100USD) for all the living costs and only reached around
15% of the population.
Demographic data show that 48% of Brazilians live in places without
sewage and 35 million do not have access to running water in their homes
[2]. Furthermore, 5-10% live in slum-like areas known as
“favelas” [3], where most residences accommodate an average of 5
individuals per room with a housing density 10x higher than the rest of
the city [4]. Finally, 40.6% of the Brazilian working-age
population are in the informal economy, living without social protection
[5]. Keeping these in mind, how can these vulnerable people protect
themselves in times of COVD-19? How can they keep basic hygiene without
regular running water and sewage? How to accomplish social distancing
living in over-crowded places?
If the COVID-19 wasn´t challenging enough, Brazil still struggles with
other important infectious diseases, such as Dengue fever, Zika e
Chikungunya. These viral mosquito-borne infections (Aedes aegypti
mosquito) are endemic in Brazil and can show initial similar signs and
symptoms to COVID-19. The rainy season is the most favourable time for
mosquito proliferation and disease spread [6], which this year the
seasonality (usually peaks in April) is coinciding with the spread of
SARS-COV-2 in Brazil [7]. Socially vulnerable people are more prone
to acquire Aedes aegypti-related infections due to poor housing, poor
sanitation and high-density population housing in “favelas” [8]
[9].
Current recommendations for people with COVID-19 mild illness is to stay
at home. However, the panic-state created by the COVID-19 pandemic is
taking these vulnerable people, which may be suffering of mosquito-borne
infections, to health units and exposing them to SARS-COV-2. Thus, the
overlapping of infections is overburdening even more the health system
and increasing the transmission rate of COVID-19 in Brazil. Furthermore,
many people in the informal market don´t have bank accounts and are
agglomerating in huge lines in bank branches to get the financial aid.
While many developed countries have struggled to give assistance to
COVID-19 patients, Brazil must battle against two powerful enemies. So,
the hard question to answer is: how many extra souls will be lost due to
Brazil´s chronic problems?
Brazil was used as an example we know well, but many other non-developed
countries, especially the African ones may be struggling with some of
these problems as well.