How do we live today in the age of COVID? One answer is that, of course, there is no “we,” other than for our leaders who proclaim that “we will beat it together” and who misguidedly believe that “we can send the virus packing” in 12 weeks.
At a national level, the pandemic threat is sharply exposing underlying tensions within society: about the role of the state in managing the economy and protecting workers; the value of science when experts and expertise have been derided; and the difficulty in balancing the benefits of collective action to protect public health with the rights of individuals. But the impact of coronavirus, real and perceived, varies widely across our country and an important dimension is the spatial variation of the effects of the virus upon different communities.
My rural community can feel a world away from the rolling news cycle inside the beltway, mainly as metropolitan areas, the centres of the epidemic, have understandably been the focus for news coverage. But, sociologically, rural communities are significant. Often (justly) caricatured as insular, culturally homogeneous, lacking diversity but with heightened levels of compliance and conformity, rural communities are also vital as unsettled sites of turbulence, discord and social struggle.
An ethnographic study of coronavirus in rural communities would reveal how the virus has brought into the open and accentuated local anxieties. These concerns include the impact of austerity on rural areas and how a widespread distrust of government has contributed to a sense of rural beleaguerment. It would illuminate the consequences of the never-ending burden-shifting that occurs when the prime policy responses to an epidemic are the responsibilisation of the individual and a call for volunteerism.
Government regional strategy over many decades has relied upon an emphasis upon self-government and localism, devolving responsibility without resources as a lever of austerity. As a result, local government is almost absent in rural communities: self-help groups have taken on responsibility for everything from planning to policing. In parallel, NHS reforms driven by concerns for efficiency have resulted in the reduction and centralisation of services far distant from many who live away from cities.
We know, for example, that coronavirus is already having a disproportionate impact upon the poorest communities, those with the oldest populations. In my area, where 30% are aged over 65, 35% are, in the language of the government, “economically inactive” and the district has the second-lowest household income in the UK, the need for help now is clear.
Local support groups have emerged but are no more than a kind of improvised scaffolding constructed rapidly to supplement a faltering safety net. Statutory bodies have been largely invisible as the crisis has developed. There has been no support from district or county councils to coordinate support; no link to the NHS to identify the vulnerable; no resources from Whitehall to enable a local response. For all the years of talk about integrated care, joined-up working between health and social care when it could make a difference in identifying the vulnerable remains as illusory as ever.
Critically, in establishing our COVID-19 support group we sought advice and support from Public Health, now based in local government, about local testing, building a community response, and contact tracing, but none was available. Whereas public health as a discipline used to be based around community development, reforms such as the 2012 Health and Social Care Act have undermined the public health speciality and centralised communicable disease control within Public Health England.
These changes are essential because, as critiques of the government’s approach have shown, top-down public health campaigns that fail to account for structural inequalities create challenges. From the evidence, we know that national campaigns to change behaviour are less likely to be effective than local campaigns. For example, requesting people to work from home and socially distance, assumes neighbourhoods are homogeneous spaces; national campaigns assume austerity has not impacted, and believe that social and cultural capital is evenly distributed in our society.
So, in the absence of meaningful public health messages and statutory support to address coronavirus, communities fall back on volunteerism. But even this has been to a great extent overtaken, and subsumed, by the national campaigns. Matt Hancock has proudly announced the recruitment via an app, GoodSAM, of over 500,000 volunteers to a new NHS army. The spirit of the Blitz, although this can be remembered by very few, has been invoked to encourage everyone to get involved but also dilutes or contradicts the government’s central messaging for people to stay at home. But where will this, primarily elderly, workforce come from? How does it support and complement the work and action where it is needed, within local communities?
There is a broader point here. Motivations for volunteering vary widely, and at this time, it would be churlish to criticise the spirit that compels people to get involved. But it is important to understand both the context and the political value volunteerism provides to the government. Local volunteerism fulfils vital functions but, in effect, fills gaps which should be delivered by statutory agencies. It distances government, local and national, absolves them of accountability, and perpetuates the illusion that “Big Society” initiatives are a genuine alternative to organised, equitable services. It works both to widen spatial variation – social capital is not evenly distributed – embeds territorial injustice and undermines any sense of national or inter-regional justice. It undermines the historically important role of local authorities in creating and sustaining safe and healthy environments and ensuring population wellbeing.
It is too early to say how this epidemic will be remembered. The bitterest folk memory in this community is of the Foot and Mouth crisis (2001) and the vivid imagery of the burning and burying of thousands of animals around our village. Less striking, but equally destructive to this community, and unfortunately evocative of Foot and Mouth, may have been the quote attributed to Dominic Cummings on the government coronavirus strategy: “herd immunity, protect the economy and if that means some pensioners die, too bad.”
About the Author: Adrian Mercer is currently assisting in organising a COVID-19 support group in mid-Devon. An occasional contributor to the ‘Cost of Living’ blog, he can be found on twitter @adeindevon