The State we’re in, it’s a Syn: that’s why we need Status Now 4 All

"The syndemic[1] nature of the threat we face demands that we not only treat each affliction, but also urgently address the underlying social inequalities that shape them— poverty, housing, education, and race, which are all powerful determinants of health.”[2]
Dr. Richard Horton, editor-in-chief of The Lancet (13th November 2020)
 
It’s Friday 13th March 2020.  I watch the woman, around 60 like me, reach for a clear plastic bag of five tomatoes.  Just moments before, my bare right hand placed it on the conveyor belt and now, her bare left hand lifts it towards the scales at her workstation. Tapping in her record of its value, she picks the bag up again, bare right hand this time, and sets it down before me. 
Suddenly, back with a vengeance, an unnameable feeling that first coursed through me last night as I listened to the Prime Minister on TV[3], now joined by the sound of a sample from a February 2020[4] radio broadcast that’s starting up inside my head: “There’s been a sudden global stock market crash”, spoken in received pronunciation[5].  It goes on repeat: “the global stock market crash… the global stock market crash”,  the soundtrack of a flickering, mind’s eye film starring the hand shadows of every person from every stage of every process that created this bag of tomatoes.  Zooming in and out, one after the other, all those hands before ours, the hands of we two women on either side of this counter.  What was it he said last night? “It is still vital, perhaps more vital than ever – that we remember to wash our hands.”[6] 
I shiver, refocus my eyes to see hers, smile, extend my hand towards the bag and mouth ‘Thank you’.  My Covid19 matrix[7] has begun.  
Walking in the front door with the shopping and, like me, my 20-something son who’s living back at home and just starting a new, very short term, contract, is thinking about last night’s TV broadcast:  “Should I meet some mates? A pint and a game of pool after this shift?” 
“Wear gloves,” is the best I can offer.
Fast forward seven months to last Friday, 13th November 2020. The Lancet published a study[8] by Global Burden of Disease[9](GBD) explaining why Covid19 is a syn- not a pan-demic:  that is, it’s an interaction between coronavirus infection and a number of non-communicable diseases[10] like heart attacks and stroke, cancers, chronic obstructive pulmonary disease, asthma and diabetes.  The critical fact though, is that more than three quarters of deaths from these diseases, 32 million deaths globally, occur where there is poverty and inequality, i.e. in low- and middle-income countries.  As the Lancet Editorial made crystal clear, communities will not be protected from future infectious outbreaks and population health will not achieve gains unless deep, structural inequalities are tackled[11].  
GBD’s scientific study confirms what the Economic Policy Unit[12] first argued on June 1st: THIS IS A SYNDEMIC.  On the 4th October 2020, when Prime Minister Johnson claimed our obesity is very important for explaining Covid rates[13] he missed out the most important bit, most simply put by the editor-in-chief of The Lancet: “The syndemic nature of the threat we face demands that we not only treat each affliction, but also urgently address the underlying social inequalities that shape them—poverty, housing, education, and race, which are all powerful determinants of health.”
On 27th March 2020, 14 days after the Prime Minister told us to wash our hands, organisations representing people without status and their allies - including the BFAWU – began the Status Now For All Network[14] calling for access to health, housing and food for ALL.  As soon as the first lockdown was announced [15], our knowledge compelled us to begin to become visible[16] so that Network members can communicate safely.  This is people like Mercy Baguma[17], with barely enough money to eat, homeless or living in very overcrowded accommodation, not accessing medical help for fear of detention or deportation[18] and working jobs under the radar, without any protection, even without wages, or basic health and safety[19].
Through Solidarity, all of us become part of the solution: moving forward so that EVERYONE can become safe and able to look after each other.   
Last Friday, Kamran Abbasi of the British Medical Journal summed it up: “the medical-political complex can be manipulated in an emergency”.[20] 


By Rhetta Moran
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[1] Syndemic: A blend of the words Synergy, from Ancient Greek συνεργία (sunergía, “cooperation”), from σύν (sún, “with, together”) + ἔργον (érgon, “work”) and demic, from the Greek word demos, or “people”..[https://www.wiley.com/en-gb/Introduction+to+Syndemics:+A+Critical+Systems+Approach+to+Public+and+Community+Health-p-9780470472033]

[2] http://www.healthdata.org/news-release/lancet-latest-global-disease-estimates-reveal-perfect-storm-rising-chronic-diseases-and

[3] https://www.gov.uk/government/speeches/pm-statement-on-coronavirus-12-march-2020

[4] https://www.forbes.com/sites/petercohan/2020/02/29/the-market-physics-behind-the-46-trillion-crash/?sh=4548c43240e2

[5] https://dictionary.cambridge.org/dictionary/english/received-pronunciation

[6] https://www.gov.uk/government/speeches/pm-statement-on-coronavirus-12-march-2020

[7] Matrix: the set of conditions that provides a system in which something grows or develops https://dictionary.cambridge.org/dictionary/english/matrix 

[8] http://www.healthdata.org/news-release/lancet-latest-global-disease-estimates-reveal-perfect-storm-rising-chronic-diseases-and

[9] http://ghdx.healthdata.org/gbd-2019COVID-19

[10] https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

[11] https://www.thelancet.com/journals/lancet/issue/vol396no10258/PIIS0140-6736(20)X0042-0

[12] https://files.epi.org/pdf/193246.pdf

[13] https://www.scmp.com/news/world/europe/article/3104133/pm-boris-johnson-says-britains-obesity-levels-are-big-coronavirus

[14] https://statusnow4all.org/about-status-now/

[15] https://fullfact.org/health/coronavirus-lockdown-hancock-claim/

[16] https://kanlungan.org.uk/wp-content/uploads/2020/07/A-chance-to-feel-safe-report.pdf

[17] https://statusnow4all.org/?s=Mercy

[18] http://www.rapar.co.uk/news/yesterday-elvis-died

[19] https://www.tuc.org.uk/blogs/leicester-and-beyond-migrant-workers-are-being-exploited

[20] https://www.bmj.com/content/371/bmj.m4425
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