This blog originally appeared in the BMJ Opinion on April 30th:
Photo by Gustavo Fring via Pexels.
As more countries and US states move to lift lockdown orders and re-open businesses and other public spaces, many people around the world—including health professionals and other essential workers—are still being quarantined, hospitalized, and buried.
Public health experts have warned that lifting “shelter in place” and physical distancing measures too early could lead to a second, potentially greater, surge in infections and deaths in the summer or fall. However, some politicians have revealed how their immediate priorities rest on the health of the economy rather than human life. As a physician and social anthropologist, I think it is clear that while we must take “physical distancing” very seriously, we need the opposite of “social distancing” to survive this pandemic. We must develop social solidarity to survive the summer and beyond.
In the social sciences, we understand solidarity to be the feeling and practice of interdependence between individuals and groups, which can change the ways in which societies are structured, as well as how each individual views themself and acts in relation to other people. Solidarity can occur across categories of social difference in the form of coalition building, which recognizes the connections between different forms of inequity and highlights the need to stand together for the good of all. Yet, this collective aspect of wellbeing is difficult to achieve in societies where individualistic understandings of health and freedom prevail.
As we approach another month of the covid-19 pandemic, we need social solidarity to protect our mental health. Some people are sheltering in place alone, and some people will be feeling depressed or isolated. Other people are avoiding their homes to protect loved ones at high risk. Some people are far from their families due to travel restrictions and border closures. Other people are continuing to carry out essential work despite their intense fears. In this time of isolation, we need the healing properties of social cohesion—from a distance. Perhaps that means engaging with social media—or avoiding it. Perhaps that includes sending letters, setting up virtual hangouts, or talking by phone. For many, this includes sharing a kind word or smile with neighbors, strangers, and essential workers—from a distance.
During this pandemic, we also need social solidarity to avoid the harm of anti-social practices, such as stigmatization. At a time when politicians make free use of racist language, other people are committing hate crimes against anyone perceived to be related to the entire, diverse continent of Asia. President Trump and other politicians have stoked ethno-nationalism and xenophobia, violating UN conventions, global compacts, and the basic human rights of immigrants and asylum seekers. As we approach the summer, we must resist division, come together, and learn to see ourselves and our health in relation to one another. We must confront politicians and corporate executives attempting to benefit from the crisis.
As we debate how we should live in the coming months, we need solidarity to build systems that benefit the health of all. What scares many frontline physicians and nurses in this pandemic is not so much the highly infectious virus itself, nor even the severe respiratory condition it causes, but rather the lack of essential equipment necessary to curb the pandemic and care for patients safely. There have also been reports of the US government previously disbanding roles that are critical to epidemic responsiveness. If we want to survive the summer, we must understand how critical our public systems are for all of our health. As global health expert Paul Farmer explains, an effective epidemic response requires “staff, stuff, space, and systems”—including protection for frontline key workers, accessible testing, and contact tracing. We must build robust health systems to avoid thousands more avoidable infections and deaths in this and future pandemics.
While in the US, it’s been primarily white Americans with support from conservative groups who have been protesting shelter in place orders, systematically more people from black and minoritized ethnic populations have died. Well into the second month since the pandemic was declared by the World Health Organization, we need social solidarity to protect the health of all—including the people most marginalized by society. Many hourly workers, including those who plant and harvest produce, have been left out of protections. While we are ordered to physically distance, others have been separated from their families and locked in overcrowded detention facilities and prisons that are ripe for viral spread. And while we are told to “stay home,” an unprecedented number of people lack any kind of safe housing, with nowhere to “shelter.” For all of us to survive the summer, we need to acknowledge and work to improve the social determinants of health for all in our societies.
While covid-19 is more dangerous for certain groups, for any of us to be healthy in a pandemic, we must make sure that all of us are healthy. If we learn anything right now, we must learn that we are all in this together. We must stay connected. To survive the summer and beyond, we must fund public health and social care systems. We must confront racism, xenophobia, and division. Instead of allowing politicians and corporations to benefit from this crisis, we must provide people with safe places to live and healthcare for those who need it most. Stop raiding, detaining, and deporting immigrant communities. Avoid causing chaos for those on whom our system relies—including those who provide us all with food.
This pandemic reminds us that each of us is dependent on the health of everyone else. As we enter the summer, we must have what physician scholar Frantz Fanon referred to as a “solidarity of fact, a solidarity of action, a solidarity concrete in men, in equipment, in money.”
Seth M Holmes is a physician and social anthropologist at the University of California, Berkeley and University of California, San Francisco. He is also the author of Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States.