Social Change During the Covid-19 Pandemic: ethics, norms and how the vulnerable cope

Stories and Culture

DSC02054

A consideration of how the Covid-19 pandemic is requiring rapid change in social norms to protect vulnerable members of society, and how these norms are being reinforced. This article focuses on the realities now being faced by United States homeless populations.

Someone is walking toward you, but slowly. You’re the only two on the sidewalk. As you approach each other, the person avoids eye contact; as you get even closer, you see him step to the side. He circles around you, keeping a wide berth. What you don’t see is how he closes in behind you, rejoining the path he had strayed from just before. You both continue away from each other.

You’re walking home from the grocery store, and you are watching the people milling in the bike path when you notice a man walking away from a window close by. An elderly woman sees you and greets you, loudly. She’s behind the screen, but she’s asking you how you’re doing – you tell her you’re all right, and she hopes you stay healthy! You tell her the same, and you keep walking home.

Your friend has invited you to dinner, but your living situation is complicated. You have a roommate who’s insisting that all trips out of the house are discussed before anyone leaves. You’re supposed to tell them where you’re going and who you’re thinking about seeing, and you have to vet the person. It feels like you’re sharing your sexual history.

People are telling you that now, you must restrict yourself. You, and everyone else, are responsible for other’s lives. You must change for the good of others. You need to give up your small conveniences, your dates, your picnics down by the river, your toilet paper and your jobs. You will stay at home, and you will entertain yourself. The government will send you a check.

How we walk, meet and greet each other; how we socialize, and how we confine ourselves (or do not confine ourselves) to our homes: these are some of the most basic changes that we have had to make since the outbreak of the coronavirus pandemic in the United States. Part of this change is about how we connect with others, yet another is how we support them. We are in a place where we must be asking ourselves how our behavior will affect ourselves, our friends and family, and society at large. This means making many difficult decisions to slow the spread of the virus.

Some people go to greater lengths than others. Some take it far less seriously than others, and some populations are more vulnerable than others. I have been thinking a lot over the past few weeks about how the pandemic is affecting the communities in the United States that are marginalized or exist on the outskirts of society. I have also been considering the social ethics that have arisen as a result of the pandemic, and how new norms are resulting in behavioral changes partly reinforced by social shaming and guilt.

The spread of the Covid-19 virus was designated a pandemic by the World Health Organization on March 11th. Harvard had announced its imminent closure the day before. My mother, who has been teaching me survival skills since I was a small child – she stored buckets of beans and rice in the basement for Y2K – has been tracking the virus since its appearance in China in December 2019. She reminded me the other day that she had warned me, she had told me to buy masks. She knew it was going to get bad and then worse.

Mom is retired at 67 and has been stocking up again. She has cans, jars, bags and boxes of food tucked away in her room, enough to feed her for at least six months. She is not planning on leaving her room until at least July, although she is relying on experts to judge how long she will isolate. People who are not doctors, she says, get no credence. When she does go out, it is for the mail, and she goes with a mask, gloves, disinfectant spray, and she tucks the mail away on the porch for a few days before opening it. If she needs to go to the ATM, it is in the dark of night, with the gloves and the mask.

My mother is just one of many people who is higher risk during this coronavirus crisis. The elderly, the sick, those with underlying conditions; people working in “essential jobs”; lower-income families; undocumented immigrants; prisoners; the homeless, and more – these groups are more vulnerable than other segments of the United States population. These are the communities the American population is shutting down to protect.

As I have walked and biked around Cambridge and Harvard Square over the past few weeks, I have noticed how the homeless are living. Earlier in March, they were grouping together more than I have observed in the year and a half I have been here. They were still gathering outside the Porter and Harvard T stops, or in the parks, or close to Harvard’s Smith Center. Today, there were no people lingering outside of the Porter T station.

I have wondered how the lives of the homeless have changed during this crisis. Where are they getting information about the virus? Where are they sleeping? Are they isolating themselves, how could they be isolating themselves?

I met a man on March 27 while I was out on a bike ride who was able to help me understand more about how Cambridge’s homeless community is coping with the virus. The young man, who is just about my age, told me that his community includes not only the homeless, but also junkies, addicts, prostitutes, and “forest kids.” The community he is a part of, he told me, lives on the edge of society.

I was sitting on the bridge between Harvard’s Kennedy School and the sports center across the river when he first approached me. He was pushing his bike across the bridge and stopped to say something. I told him not to come too close – the virus, after all – and we started talking about the situation, and many other things besides. As we talked, he revealed how he was perceiving the virus.

He was not taking it seriously. He joked about the “sanitized community” – mainstream society – and called his own the “unsanitized.” He laughed that larger society is panicking, wearing gloves and masks and buying up all of the hand sanitizer.

The young man also told me that he does not believe that you will become sick if you have a certain perspective, or perhaps outlook, on the virus. I did not fully understand his argument, but it seemed as though he thought that a person’s immune system responds to his perspective, and if that person believes he will not catch the virus, his immune system will respond accordingly. The young man seemed afraid, though, as we more deeply discussed how serious the virus is and might become.

In general, he told me, the homeless community does not need that much money to survive. He had handled perhaps $100 over the past year. For food, the homeless either ask strangers to help them buy a meal, or they go to the local food banks. They generally do not dumpster-dive, but they especially do not want regular people to notice them and to start a “witch hunt” during the coronavirus pandemic.

However, food donations from strangers are likely no longer the most viable way for a homeless person to find a meal. The next week, while I was walking to the grocery store, a different homeless man asked me for a few dollars. I knew I did not want to get close to him for fear of the virus. “Not today.”  As I walked past him, I heard him curse under his breath. I wondered whether this man was at the end of his rope. How many people now would stop to get a meal or hand a few dollars to another person who is homeless?

On April 2nd, The Guardian reported on the problem of keeping food banks stocked for those in need. The Guardian took data from 9 American states, all of which claimed that demand is sharply increasing as Americans lose their jobs. While “the working poor, elderly and disabled and infirm accounted for the vast majority of food bank users,” about a third of those seeking aid today have never needed it before.[1]  This means that America’s homeless populations will be struggling on all counts to find meals as they usually would.

In part, these interactions and revelations have forced me to consider how poorly educated most of us were about the virus in the first few weeks of the crisis. The response of the United States has been unique in that the states are left to decide how to deal with the virus, and when to impose social distancing and other more stringent rules. At the same time, the news media is compromised by mis- and disinformation, and President Trump at first blew off the severity of the virus. We have in many ways been slow to respond to the threat, and utterly unprepared for it.

As the young man revealed, members of his community were still debating the severity of the virus at the end of March. This led me to wonder how the homeless have been getting information about the virus. His community was still gathering on the 27th of March, and he seemed upset that there was no place to meet for weekly dinners. Where had he gotten his idea about somehow being immune to the virus? Was his community not taking it seriously because, in part, they were uninformed about it? Or because of lack of trust of mainstream society and the government?

The young man told me about a conversation he had with another man on a bench near Mt. Auburn. We were discussing how the homeless, and those living without permanent addresses, might receive $1200 stimulus checks from the US Federal Government. The general attitude, he said, is that the government assistance is just propaganda. His community believes that they will only believe that a check exists when they see one.

On April 1st, The Boston Globe reported that “Social Security beneficiaries who typically do not file a tax return will automatically get the $1,200 payment.”[2] This was a reversal of a previous IRS announcement on March 30th that had set off a storm of criticism. Their website had announced that those who receive social security would need to “file a ‘simple’ tax return” in order to receive a stimulus check; such a form was not yet available. However, this stipulation also neglected many other members of society, including higher risk populations. The article cited the Center on Budget and Policy Priorities to illustrate this point: “More than 15 million Americans on Social Security do not file an annual tax return because their income is so low.”

While the Globe does not cite anything specifically about homeless populations, it noted that other Americans who will not receive stimulus money include high school and college students – parents do not receive money for children older than 16 – and immigrant families, as “each person in the household – including children – is supposed to have a valid Social Security number.” The homeless with no social security numbers are therefore not eligible.

Government responses to the critical question of what to do to protect more vulnerable communities are still developing. There were “more than 552,800 homeless people in the US” in 2018.[3] According to medical researchers, the homeless are doubly vulnerable to the virus because they are closely quartered, share utensils and often have no place to wash their hands.[4] The homeless are also often chronically sick and do not have access to reliable health care. They are sometimes also more vulnerable to lung-related illnesses: in one Seattle hospital, “32 percent of people who had a common respiratory illness were homeless, compared with 7 percent of all patients hospitalized.”[5]

The response at the national level to the issue of homelessness has been to provide general guidelines on how those working with the homeless population should safely conduct their duties. The National Low Income Housing Coalition has listed federal guidance for those working with homeless populations and in shelters, which includes instruction for emergency hygiene practice; how to communicate with clients and navigate isolation; as well as how to properly provide sleeping mats and access to clean and stocked bathrooms.[6] Shelters are also generally not spaces that have the capacity for effective social distancing. People share rooms and bunk beds in some shelters; floor mats are placed in empty rooms during colder months; spaces, including large cafeterias, “recreation rooms, bathrooms and laundry facilities are shared.”[7]

States are responding to the problem of homelessness in varying ways. In Silicon Valley, the homeless population has already been affected. Santa Clara County, California, where one homeless person has already died from the virus, has a population of 9,700 homeless individuals. Many homeless individuals are still in the streets in parts of LA, often living close together in tents – shelters in the city are now often at full capacity. Los Angeles officials responded with plans “to bring hand-washing stations, portable toilets, and weekly shower stations to these encampments,” although this solution is still not sufficient to prevent rapid spread of the virus.[8]

As the hardest-hit state in the country, New York has had to scramble to address the mounting problems that the coronavirus is causing. New York City has already given its homeless shelters instructions on screening, identifying and isolating those who already have the coronavirus.[9] As of April 6th, however, 392 members of the New York City’s homeless population were being isolated in undisclosed hotels around the city, having either tested positive for the virus or “out of an abundance of caution.” Officials stated that there were 700 places for the homeless who become afflicted by the virus. Another 213 homeless in shelters across the city had also tested positive.[10]

In San Francisco, outreach teams work to inform the homeless and provide them with hand sanitizer and have set up hand-washing stations in the streets.[11] There are nearly 10,000 homeless people in the city, but as of April 3rd, the city was only planning to acquire 4,500 rooms for isolation and self-quarantine.[12] By April 6th, three homeless individuals had tested positive for the virus.[13] They are all isolated in hotel rooms. These rooms will also become “available for homeless shelter residents who are over 60 or have underlying health conditions.”

Such a dire situation is requiring that the United States takes a hard look at how we support the most vulnerable citizens of our society. This and other ethical debates are evolving as society copes with the crisis, and conversations about ethical responsibility and social change are already echoing across America’s media, academic and other institutions. The question is how this ethical change will develop into the future.

The John Hopkins Berman Institute of Bioethics has provided ethical guidelines and recommendations for several the populations more susceptible to the coronavirus. On the one hand, they note, poor children and poor families will be most impacted by school closings, as students often get free or reduced lunch at school, and parents also rely on school for childcare. At the same time, some individuals are disproportionately impacted by social distancing guidelines – others, such as the homeless, cannot follow such guidelines.[14]

In her article “The Ethics of Coronavirus,” Heather Anderson of the Indiana School of Medicine notes that globally, there are new public obligations that must be fulfilled in order to protect our communities from the coronavirus. Recommendations include hygiene guidelines such as washing hands and getting the flu shot, but also requires that citizens remain informed without panicking, use resources – such as masks – rationally, and to stay home if sick. Other concerns include the global and local distribution of medical equipment; restrictions to individual freedoms; the closing of state or international borders; and an ethnocentric explanation for the spread of the disease that places the burden of responsibility on ethnicities or religious groups.[15]

Such considerations have prompted the development of practical rules to prevent the spread of Covid-19. A major recommendation in the United States has been “social distancing,” which requires that people stay at least six feet apart from each other in public spaces. Schools, many businesses and institutions have closed all over the country, and residents are in many areas are ordered to shelter-at-home. The federal government has also “warned against all gatherings of more than 10 people.” Experts have argued that we should be limiting our outdoor exercise, choosing “off-peak” hours to run errands and canceling play dates.[16] People have even begun questioning whether small acts, such as ordering takeout, having sex with partners, visiting sick relatives and going to see your doctor for non-urgent problems.[17]

Our social norms are shifting and requiring more of us to both think about, as well as reinforce, these varying “rules.” In some cases, people are using practices of social shaming and guilt-tripping to reinforce new norms, whether they pertain to patterns meeting and greeting, sidewalk etiquette, self-isolation or wearing masks in public.

The practice of shaming is occurring both in the streets and on social media. Some people have begun “quarantine shaming” people who are failing to social distance. Officials in the US, UK and Canada have described these individuals as “selfish, arrogant or self-destructive,” whereas social media users criticize those who attend public gatherings.[18]

Residents of some cities must be wary of their photograph being taken while they are outside – they might be shared publicly online. Others face censorious remarks if they have posted pictures of Spring Break vacationing or other outdoor adventures on social media. The wealthy are also being shamed for their complaints, largely for their ability to ride out the virus comfortably in multi-million-dollar mansions.[19] Shaming might also be directed at the people “escaping” from urban areas to “more vulnerable areas that have incredibly limited medical resources.”[20]

These new pressures, at both the national and local levels, are essential for mobilizing large segments of the population to change their behavior for the greater good. While in some cases this might take more extreme forms than warranted, and certain restrictions – particularly those resulting in unemployment – have drastically affected the population, all social contact has the potential to catalyze the infection of a much larger group of people.

The question is whether we will manage to adopt all of the changes needed to sufficiently slow the spread of the virus, and whether we will be able to look on those we have been working to protect – the more vulnerable segments of the United States population – with new eyes in the future. Will this challenge to America’s moral compass provoke evolution as we are finally able to begin recovering from the Covid-19 crisis?

 

Sources:

[1] Lakhani, Nina. “’A Perfect Storm’: US facing hunger crisis as demand for food bank soars.” April 2 2020. https://www.theguardian.com/environment/2020/apr/02/us-food-banks-coronavirus-demand-unemployment. Accessed 4.6.2020.

[2] Long, Heather. “The list of who won’t get a $1200 stimulus check is growing – and includes some surprising groups.” April 1 2020. https://www.bostonglobe.com/news/nation/2020/04/01/the-list-who-won-get-stimulus-check-growing-and-includes-some-surprising-groups/4q0fBqZcDtBydHYmw5UhiI/story.html. Accessed 4.6.2020.

[3] Kim, Catherine. “During the Covid-19 pandemic, nowhere is safe for homeless people.” Vox. March 18 2020. https://www.vox.com/2020/3/18/21183812/covid-19-coronavirus-homeless. Accessed 4.6.2020.

[4] Fuller, Thomas. “Coronavirus Outbreak Has America’s Homeless at Risk of ‘Disaster.’ The New York Times. March 10 2020. https://www.nytimes.com/2020/03/10/us/coronavirus-homeless.html?auth=login-email&login=email. Accessed 4.6.2020.

[5] Fuller, Thomas. “Coronavirus Outbreak Has America’s Homeless at Risk of ‘Disaster.’ The New York Times. March 10 2020. https://www.nytimes.com/2020/03/10/us/coronavirus-homeless.html?auth=login-email&login=email. Accessed 4.6.2020.

[6] Covid-19: Coronavirus and Housing/Homelessness. National Low Income Housing Coalition. 2020. https://nlihc.org/coronavirus-and-housing-homelessness. Accessed 4.6.2020.

[7] Lang, Marissa J., Moyer, Justin and Tiku, Nitasha. Washington Post. March 20 2020. “Cities struggle to protect vulnerable homeless populations as coronavirus spreads.” https://www.washingtonpost.com/local/cities-struggle-to-protect-vulnerable-homeless-populations-as-coronavirus-spreads/2020/03/20/1144249c-67be-11ea-b5f1-a5a804158597_story.html. Accessed 4.6.2020.

[8] Kim, Catherine. “During the Covid-19 pandemic, nowhere is safe for homeless people.” Vox. March 18 2020. https://www.vox.com/2020/3/18/21183812/covid-19-coronavirus-homeless. Accessed 4.6.2020.

[9] Fuller, Thomas. “Coronavirus Outbreak Has America’s Homeless at Risk of ‘Disaster.’ The New York Times. March 10 2020. https://www.nytimes.com/2020/03/10/us/coronavirus-homeless.html?auth=login-email&login=email. Accessed 4.6.2020.

[10] Celona, Larry; Marsh, Julia and Fitz-Gibbon, Jorge. “Hundreds of homeless with coronavirus or symptoms housed at NYC hotels.” New York Post. April 6 2020. https://nypost.com/2020/04/06/hundreds-of-homeless-with-coronavirus-or-symptoms-housed-at-nyc-hotels/. Accessed 4.6.2020.

[11] Lang, Marissa J., Moyer, Justin and Tiku, Nitasha. Washington Post. March 20 2020. “Cities struggle to protect vulnerable homeless populations as coronavirus spreads.” https://www.washingtonpost.com/local/cities-struggle-to-protect-vulnerable-homeless-populations-as-coronavirus-spreads/2020/03/20/1144249c-67be-11ea-b5f1-a5a804158597_story.html. Accessed 4.6.2020.

[12] Reuters. “Coronavirus Forces San Francisco to Put Homeless Into Hotels.” The New York Times. April 3 2020. https://www.nytimes.com/reuters/2020/04/03/us/03reuters-health-coronavirus-homelessness.html. Accessed 4.6.2020.

[13] Kendall, Marisa. “Two more coronavirus cases at a San Francisco homeless shelter.” April 6 2020.  The Mercury News. https://www.mercurynews.com/2020/04/06/two-more-coronavirus-cases-at-a-san-francisco-homeless-shelter/. Accessed 4.6.2020.

[14] “Overview: Ethical Concerns in Responding to Coronavirus.” Johns Hopkins Berman Institute of Bioethics. March 23 2020. https://bioethics.jhu.edu/news-events/news/coronavirus-ethical-concerns-in-planning-a-response/. Accessed 4.6.2020.

[15] Anderson, Heather. “The Ethics of Coronavirus.” Indiana University School of Medicine. March 6 2020. https://medicine.iu.edu/blogs/bioethics/the-ethics-of-coronavirus. Accessed 4.6.2020.

[16] Goldman, Leslie. “What are the rules of social distancing?’ Vox. March 27 2020. https://www.vox.com/2020/3/15/21179296/coronavirus-covid-19-social-distancing-bored-pandemic-quarantine-ethics. Accessed 4.6.2020.

[17] Kluger, Jeffrey. “’Is Ordering Takeout Unethical?’ A Medical Ethicist Answers Some of the Most Common Moral Questions Around Coronavirus.” Time. March 16 2020. https://time.com/5803980/coronavirus-ethics/. Accessed 4.6.2020.

[18] Cheung, Helier. “Coronavirus: How to go for a walk safely, without getting shamed.” BBC News Washington DC. March 25 2020. https://www.bbc.com/news/world-us-canada-52022743. Accessed 4.6.2020.

[19] Brown, Jennifer. “Social media shaming is spiking during the coronavirus pandemic, for better or worse.” The Colorado Sun. April 1 2020. https://coloradosun.com/2020/04/01/social-media-shaming-about-coronavirus/. Accessed 4.6.2020.

[20] Flaccus, Gillian. “‘Quarantine shaming’: US navigated radical new social norms in the wake of coronavirus.” Chicago Tribune – Associated Press. March 19 2020. https://www.chicagotribune.com/coronavirus/ct-nw-coronavirus-quarantine-shaming-20200319-ghnh7lqj25asrcvbgmjvteodge-story.html. Accessed 4.6.2020.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s