The infamous Typhoid Mary was first brought to public attention when a private investigator attempting to track down the source of multiple outbreaks of typhoid fever discovered the Irish cook had taken employment with multiple families over five years, leaving when they became ill and finding new posts elsewhere. Unwilling to stay in confinement and quit her job, Mary Mallon was forcibly quarantined from 1907 until 1910, when as an asymptomatic carrier of the bacteria she was released after signing an affidavit agreeing not to work in food preparation again. Now working as a laundress, Mallon earned far less than she had as a cook, so she changed her name and renewed her old duties, infecting at least twenty-five more people and killing two. In 1915, she was arrested again, and imprisoned in a sanitarium until her death after starting another outbreak.
Authorities in the United Kingdom are now facing conundrums similar to the bodies that dealt with Mallon in New York a century earlier as they attempt to prevent coronavirus deaths: how do you stop people going to work when they might be sick if doing so is financially prohibitive for them? In the UK, statutory sick pay is paid after three days of unpaid leave, and often requires a doctor’s note. Immediately after announcing public health advice urging people to self-quarantine for two weeks upon coming into contact with a coronavirus carrier or exhibiting symptoms, the government was asked how they expected people to follow the advice when for many people on low pay, and zero hours contracts, doing so will have a massive financial effect on their household’s ability to meet rent, keep food on the table, and pay the most basic utility bills.
Speaking to several people working in Parliament and government buildings, workers employed through outsourcing companies all told me if they felt symptoms were mild, they would still come to work. If they met a carrier and their employer did not know, they would not self-isolate. One cleaner in Parliament told me “If I’m sick, I will have to come in or the company will just cut my shifts. People are really, really scared. Nobody knows if they will have a job to come back to if they get sick for just one day, two days, it’s really serious if it is two weeks. I will just pretend I feel fine, take paracetamol and keep working.” Another outsourced contracted worker in a government department said “the government haven’t been giving us any good advice. Will they stop those companies from punishing us if we catch coronavirus? They just say we will get paid but if I don’t know if I will have a job in one month, two months, I will not take the risk of [self-isolating] unless I need to go to the hospital I am so sick. The risk is too much.”
Boris Johnson announced shortly afterwards that the government would . Going back to the same people, their answers to me remained the same: money was part of the problem, yes, but their contracts meant they could easily be sacked and let go, since each hour and each day they worked was at the whim of the company, and taking any time off sick often resulted in people being replaced.
Coronavirus has threatened to act like a brick removed from the foundation of a poorly built tower. The structure has remained standing so far, but if precarity is built into every layer of infrastructure, everything can easily come tumbling down with an unexpected impact. Stripping back workers’ rights and legislating to quash union organizing mean millions of people don’t feel able to risk taking time off sick, including the people cleaning the buildings politicians work in every day.
Cuts to the National Health Service (NHS) mean a system already struggling with waiting times, with overworked and exhausted doctors and nurses and a failure to recruit new staff, is now expected to absorb a huge influx of patients with an illness we still know little about. The Conservatives’ contingency plan for coronavirus, which the Chief Medical Officer in England , is to force retired doctors and nurses to return temporarily to the profession, which means the use of much older medics who have long been away from the field, but also increased risk of exposure for people in an age group that is particularly vulnerable to death when they contract the virus.
Quarantine is also nigh impossible for many people: the vast number in shared accommodation, whether younger people who can’t afford their own home or those in temporary housing due to homelessness, will struggle to properly isolate themselves with shared kitchens and bathrooms. Those on the street are often so ill they would miss early signs of the virus if they noticed at all, and it is hard to picture rough sleepers, many with substance abuse problems, following government guidance on regular hand-washing and self-isolation. In the past, tuberculosis and typhus have spread rapidly through : many big cities across the UK have myriad small encampments of rough sleepers in the safest, most sheltered spots. The thousands of “hidden homeless” people, couch surfing and in temporary rooms will also find it impossible to self-isolate, and the lack of a strategy to enable all homeless people to access somewhere static if they fall ill is a public health disaster.
If schools close too, problems remain for parents: if they’re forced to take two weeks off to stay at home with their children, if they come down with the virus themselves later or come into contact with the contagious, many people on insecure contracts will be unable to cope with a month on statutory sick pay and are more likely to send at least one parent to work or leave their kids with family members. The poorest will also then lose out on free school meals for their children, and, for many, the breakfast clubs set up to combat food poverty among children from the ages of three to eighteen.
For a decade, the Conservatives have pursued austerity ideologically, committed to gutting the infrastructure of public services, spending the bare minimum to keep services operating. They’ve allowed companies to exploit workers and squeeze living standards, so millions of families are in poverty or just about managing. Allowing capital to profit while leaving workers in situations where they’re just scraping by means the smallest personal disaster, from getting ill to losing shifts, leaves you homeless and financially destitute. British people are lucky the NHS ensures that access to health care is not dependent on earnings; but the way the NHS has been managed for a decade means it was at breaking point before coronavirus hit. Now, millions of people are facing the possibility that they could lose their jobs or homes because of illness, and will try to work no matter how sick they become.
The Conservatives have repeatedly tried to calm the public and convince them that public health is not at risk. But gutting vital services and leaving millions of people just about managing financially has created a precarious society, socially and economically, and coronavirus looks set to cause the fine threads holding everything together to snap.
On “one of the theories is you could perhaps take [coronavirus] on the chin, take it all in one go, and allow the disease as it were to move through the population without taking as many draconian measures. I think we need to strike a balance.” This wasn’t the response of a prime minister seeking to calm the populace; he could have done so by stating there were scientifically backed public health plans in place, and he was happy to fund them. This was clearly an attempt to limit expectations, to tell the public the government wouldn’t adopt many of the measures followed by China and Italy, because pressure from business has more value than people’s lives.
Those most at risk remain the most vulnerable — older people and people with preexisting serious health conditions. But also the poorest, the homeless, people who are already struggling with health, finances, and housing: the government have already made their lives intensely difficult, and now a decade of austerity will make it almost certain lives will be lost unnecessarily as a result.