Who will be left behind when the 'new normal' begins?

“Vulnerability” takes on a new meaning in a pandemic. For some Calgarians, this is one of the few times in their lives they have felt exposed to a threat outside of their control. For others, COVID-19 is compounding the vulnerabilities they experience every day. As we emerge from isolation, the impact of compounding ­— and expanding — vulnerability is coming sharply into focus.

Dr. Katrina Milaney, PhD, and Dr. Ron Kneebone, PhD, are members of the COVID-19 data taskforce, a group of UCalgary researchers advising the City of Calgary’s pandemic response. When The City recognized the disparity of the impact of COVID-19 on citizens, Milaney and Kneebone assembled the data, and it tells a distressing story.

“This is raising awareness of just how vulnerable some Calgarians are,” says Kneebone, scientific director of social policy and health research in The School of Public Policy.

We are headed into a real crisis.

Vulnerable populations include people with disabilities, older adults, residents of long-term care facilities, people living in crowded or unsafe housing, those with severe medical conditions, and people experiencing homelessness. They also include otherwise healthy people who have low incomes and little in the way of accumulated savings.

“Poverty weakens an individual’s ability to cope with new problems piled on top of those already being dealt with,” Milaney and Kneebone state in their report to The City. “The impact of a pandemic on this population adds to already high levels of stress and in so doing compounds existing health conditions.”

'Flattening the curve' not feasible for vulnerable populations

Things citizens have been asked to do to “flatten the curve” ­are simply not feasible for vulnerable populations, they say.

“Dr. Hinshaw tells us to distance ourselves from each other, but when you’re sleeping and eating in a shelter, that’s really hard,” says Kneebone. “We’re being told to stock up on groceries to minimize the number of times that you go to the store, but if you have a very limited income, you have no opportunities to do that.”

It’s no coincidence that the people most impacted by COVID-19 are low-income workers. “They have to go to the meat-packing plant, they can only afford crowded housing, and they need to car share to get to and from work,” says Kneebone. “They’re the people who are most exposed, and who are unable to escape it and have to deal with it directly.”

Many Calgarians may go from 'managing' to 'vulnerable' 

Calgary is also home to a large population who are “managing” ­— 45 per cent of Albertans are $200 or less away from being unable to pay their bills.

“There’s concerns that we will see a whole new level of vulnerability — a group of people who were managing before but are now going into debt or using credit to buy supplies, or deferring utility or mortgage payments, and they’re going to have this debt to pay,” says Milaney, assistant professor in the Department of Community Health Sciences, and member of the O’Brien Institute for Public Health at the Cumming School of Medicine.

As stress mounts and unemployment continues, Calgarians are accessing social services in greater numbers, and with escalating severity of need.

Since Alberta’s public health measures began in March, there has been a 38 per cent increase in calls to a local crisis response team including 20 to 46 per cent increase in suicide-related calls week-over-week from 2019. The top issues are feelings of anxiety, depression, and isolation/loneliness. Calls to domestic violence and sexual assault centres have risen by 57 per cent and according to some organizations, drug overdoses have increased by 300 per cent. Alberta’s April 2020 employment decreased by an unprecedented 381,900 jobs compared to April 2019.

Milaney describes these numbers as just the beginning. “Social services are running flat out, and they’re working every day and in high-stress environments,” she says. “How do we sustain and maintain a healthy social services sector when staff are burnt out after working through COVID and dealing with the long-term realities of smaller budgets?”

She cites domestic violence shelters as an example. “If you have been isolating with an abuser and not able to reach out for support, when things reopen could we see a surge in domestic violence shelters, and will we be able to respond to that?”

What will 'the new normal' be for our most vulnerable? 

So how do we prevent our vulnerable friends, neighbours, and family members from facing a second, prolonged crisis as we begin to create “the new normal”?

One way to help will be for the government to extend access to emergency financial support programs for a period of time following a return to work, so those who have gone into debt to stay afloat during the pandemic will have a chance to begin to catch up. 

“The government is going to be faced with tough decisions, and it’s often spending on programs in support of vulnerable populations that is at the low end of priorities, and it needs to be pushed up,” says Kneebone.

“It’s our job to make sure that the government understands that when they think about trying to get back to stability, they can’t throw these populations under the bus. They can’t even go back to ‘normal’ — they’ve been pushed into crisis, and they aren’t going to able to climb out of it as quickly or as easily as others.”

Milaney, Kneebone, and the rest of the COVID-19 data task force will continue to provide recommendations to The City and the province as re-launch continues.

“The insights and inputs we have received from the University of Calgary’s COVID-19 data task force have been invaluable,” says Katie Black, acting general manager, Community Services Department at The City of Calgary.

“From our first meeting less than a week after the state of local emergency was declared, we have had regular check-ins with the mayor, the chief of the Calgary Emergency Management Agency (CEMA) and others to understand what we could learn from the data around the world and in our own city. I can’t tell you what a gift it has been to sit with such bright and committed individuals who ask ‘How can we help?’”

Ron Kneebone is a professor in the Department of Economics, Faculty of Arts and director of Economic and Social Policy Research at the School of Public Policy.  

Katrina Milaney is an assistant professor in the Department of Community Health Sciences, and member of the O’Brien Institute for Public Health at the Cumming School of Medicine.

Urban Alliance is a strategic partnership between The City of Calgary and University of Calgary to promote the seamless transfer of cutting-edge research between The City and the university, for the benefit of all our communities.