Quelle Surprise! Covid Burden Falling Hardest on Low Income Workers…But Don’t Expect Any Help

An important Economic Policy Institute article (hat tip martha r) confirms what many had suspected: that Covid was hurting lower income workers the most. We’ll shortly go through its analysis, which is important and informative. We will also review its recommendations, which are more of a mixed bag. Mind you, we don’t mean to come down on EPI, which is not a public health or bioscience site. But EPI’s stance sadly reflects that a lot of analysts haven’t gotten the memo about how poor our Covid choices are, given that the officialdom has rejected containment and even Japan-level approaches of aggressive masking and attention to indoor air quality.

Mind you, this report shows yet more ways that Covid is widening inequality. We already had a big dose in how the economic support programs were carried out. In the US, the PPP loans, for businesses, nominally to preserve payrolls, were the biggest program. Supplemental unemployment was the biggest form of income support…which bypassed the elderly, many casual workers, those who’d dropped out of the workforce, and was often very very late to arrive (California and Alabama were both laggards). Even the World Economic Forum took note in 2020, because too much inequality is bad for commerce:

There are at least four ways the COVID-19 pandemic is increasing inequality:

• First, higher-paid workers are working from home while lower-paid blue-collar workers typically do not have this option.
• Second, a higher share of low-paid workers are in essential services such as nursing, policing, teaching, cleaning, refuse removal, and store attendants where they are more likely to come into contact with people who are infected.
• Third, lower paid workers are more represented in the sectors that have suspended activities such as hotels, restaurants and tourism services.
• Fourth, the pandemic is increasing poverty and inequality between richer countries that can afford to bail out their firms and provide social safety nets, and poorer countries that do not have the capacity to do so…..

The pandemic is a boon for the ultra-rich. The staggering rise in the stock-market is testament to this. In the US, over 44 million people lost their jobs and unemployment surged towards 15% between April and June 2020. Yet the fortunes of the top five billionaires rose by $102 billion, increasing their wealth by 26%. In fact, the combined wealth of US billionaires increased by over $637 billion to a total of $3.6 trillion, which is considerably more than the entire wealth of the 54 countries on the African continent.

And echoing the old economists’ joke: “It’s true in practice, but it is true in theory?” Based on the performance of past pandemics, economists anticipated that this one would also increase inequality. Apparently it takes a Black Death level labor wipeout to fundamentally restructure labor relations. From VoxEU in May 2020:

While there is much to be learnt from the experience of pandemics that occurred prior to this century – see Barro et al. (2020) on the Spanish flu of 1918-19 and Jordà et al. (2020) for even earlier events – our present analysis focuses on five major epidemics of this century – SARS (2003), H1N1 (2009), MERS (2012), Ebola (2014) and Zika (2016) – which each affected several countries….

Figure 1 shows the estimated impulse response of the net Gini to a pandemic event over the five-year period following the event. Pandemics lead to a persistent and significant increase in the net Gini measure of inequality. After five years, the Gini is above its pre-shock level by about 1.25%….

Figure 1 Impact of pandemics on inequality

We find that the impact on the net Gini is larger than that on the market Gini, which suggests that policies undertaken to address previous pandemics may have ended up having regressive effects. While further investigation of this result is needed, it is worth noting that early assessments of some government programmes enacted to combat COVID-19 suggest that the rich are the major beneficiaries

Now to the EPI paper. It presents some routes by which low-income workers are hit hard by Covid, in particularly due to directly missing more days of work than well-paid workers, due both to having been sick and to having to care for sick family members. The affluent can take sick days, make up for missed time on the weekend, or just get cut slack (who can tell how many hours you are putting in if you aren’t on Zoom or monitored all day?). And high income workers are more likely to have nannies or be able to hire help if really needed.

Key points:

Among working-aged Americans, those with 2019 household incomes less than $25,000 were 3.5 times as likely to report missing an entire week of work mainly due to their own or loved ones’ COVID-19 symptoms, relative to those earning $100,000 or more….

When low-income workers miss work due to COVID-19, they not only face the risk of severe illness—their families also report not being able to afford enough food to eat. After the expiration of the federal sick leave program, few low-income workers have access to paid sick leave to support them in self-isolating while infectious, reducing viral spread in the community, and leading a healthy recovery. Only 35% of low-wage workers have paid sick leave while 95% of high-wage workers do.

This is all very helpful, but then the report reaches conclusions that don’t clearly come from its data. For instance:

This chart does not prove that the problem of lower vaccination levels among lower income workers is a matter of access. It does clearly show that vax hesitancy/resistance is correlated with income. By not getting more information about the “would/would consider” group, it is unclear how much of the impediment is “access” versus uncertainty.1

Admittedly the plural of anecdote is not data, but none of my mother’s aides who were CNAs were vaccinated (they accepted a strict making regime, including not eating or drinking near her). And they did not have access issues. One had had Covid in the last six months and didn’t deem it necessary (yet). The others were not willing to risk a vaccine reaction forcing them to miss a day or two of work.

And I must say but this chart is not terribly informative:

Look at the time period.

The incubation period for Omicron averages three days.

White collar workers typically do not go to the office at all from Christmas to just after New Year, which this year would have been December 23 to Jan 3. Moreover, at least in big cities like New York, there was a huge scare about Omicron infections from holiday parties in the first and second week in December, so many had either already gotten sick or were being newly cautious.

Even allowing for non-vaccine income factors, this chart says absolutely nothing about the wage earners themselves because it conflates their outcomes (did they get sick or not) with caregiving for others (children in particularly; babies and under 10 years olds were very vulnerable) and the elderly. Not only do elder care burdens fall largely if not entirely on family members, since they can’t afford to hire help, lower income families are also more likely to have seniors in poor health (lifetime lower access to health care, higher probability of having diabetes and/or a poor diet; higher odds of having been in workplaces that imposed a health cost).

In other words, it is distressing to see EPI either captured by the conventional narrative or unwilling to qualify its analysis and suggest it might make sense to ask additional questions to get more definitive answers.

And as you get further into the article, you can see how it reflects the inability of the policy elites to accept the very bad hand they’ve deal themselves with respect to Covid. This article clings to the notion that getting boosted is protected when, as GM has pointed out, by ten weeks, efficacy against bad outcomes has fallen below 50%, which is too low if de novo for the vaccine to have been approved. Getting boosted 3-4 times a year is not a viable option even if the US could manage it operationally; the European Medical authority has advised against it as too likely to overtax the immune system.

So with the current vaccines, no one will be well vaccinated against Covid going forward unless they put their immune system at risk. Some may be robust enough for that to be a good tradeoff, but there’s no guidance as to what reasonable proxies might be. For instance: what should people with autoimmune diseases or a history of autoimmune diseases in their families do?

And as we keep stressing, the point of getting immunized, particularly with Omicron being so highly infectious and largely escaping the current vaccines, is to protect yourself from bad outcomes and on a societal level, to reduce strain on the medical system. And it’s not clear that that is true under Omicron:

The authorities and press have kept acting as if getting vaccinated protects others. With Omicron and these vaccines, the answer is somewhere between “barely” to “not at all”.

And even worse, the vaccine fixation has helped stymie policies that would help reduce contagion, the most important of which is to have people who have gotten Covid to isolate for ten days or at least 2 days of negative at home Covid tests.

Now that means we are back to what this site has long advocated, independent of vaccines: engaging in full bore non-pharmaceutical interventions, particularly masking and ventilation. We also said from early on that the way out would require good treatments, but with the FDA having approved Merck’s molnupiravir, which has low efficacy and good potential to breed hardier variants, we are going down the wrong track there too.

So one can read the EPI recommendations either as disconnected from the state of play, or a highly coded statement that they know the emperor has no clothes. For instance:

To inform an equitable policy response, the government needs comprehensive data on all Americans and communities most at risk. Policymakers, the Supreme Court, and researchers may use COVID-19 surveillance data on occupations with high exposure to COVID-19 to help provide further information about the virus and how to respond most effectively.

Huh? The data in the US has been terrible and is getting worse all the time. Thanks to prevalent home testing, which both has a high rate of false negatives and does not have a mechanism for reporting, the US now has no idea how many Covid cases there are. The official numbers are low, but how low is anyone’s guess.

IM Doc also reports that in his highly vaxxed county, many of his patients (and he himself, despite concerted efforts to correct his own record) are incorrectly counted as unvaxxed, so that data is corrupt too.2

Scientist GM has been sending sightings for months on how states are delaying or fudging their numbers. For instance, from a mid-January 2022 e-mail:

Reporting is already severely compromised.

It was bad already in 2020 — Florida was still reporting deaths that happened in May 2020 in October 2020.

But then last year Florida, and then Nevada, Missouri, and several others moved to reporting deaths by date (which meant that the curve always looks like it’s going down), the delays became even longer, most states stopped reporting on weekends, some moved to reporting once every few days, TN moved to reporting weekly (but with no data from the 3rd of January to the 19th this month), etc. etc.

That peak in September that is now at 2,020 deaths a day, i.e. just short of April 2020? Well, it was 1,500 or so on that date itself, the rest was added later, mostly by FL, but also MO, NV, and several others.

I would not be surprised if the actual number of people dying right now is close to 4,000 rather than the official 2,000, and I am ready to bet substantial money that it is above 3,000.

And more cheery news:

Contrast that to the thin gruel from EPI:

Vaccine mandates

Vaccine mandates are key to increasing the reach of vaccination as a tool for both reducing severe disease and limiting hospital overflows and economic and societal disruption. The Biden administration can work closely with governors and mayors to implement vaccine mandates for all workers and workplaces.

I cannot believe they wrote that. It discredits them. But there is more:

Data-driven mask policies

COVID-19 spreads through the air, and mask policies that help people mask together are one of the most effective policies for reducing the spread of COVID-19. Data-driven mask policies are linked to local transmission rates and can turn off when cases are low and can turn on when cases begin to surge. New variants are likely, and having mask policies that automatically turn on could be especially important for more lethal or vaccine-evading variants.

That horse left the barn in May 2021 when the Biden Administration confirmed the conservative “masks as oppression” position by depicting going unmasked as a reward and a sign of vaccinated virtue. It’s hard enough to get people to mask up. The flip side is that many examples, from the Creel Committee onward, have shown that full bore multi-channel propaganda campaigns (including using churches and social groups) can change public opinion massively in 6 weeks to two months. But this Administration prefers to use the deplorables as their excuse for Covid failure rather than try to reach them (which would also require listening to understand where they are coming from rather than scolding them).

The post does pump for more high quality masks, more access to tests, and paid leave for low income workers. But there is nary a mention of ventilation.

I suspect that EPI is so dependent on mainstream Democrat funding sources that it can’t stray from the party line. But reading these policies evokes the sort of images that Lambert and I discuss often, of people in charge, sitting in a car, turning wheels and hitting controls that they thing are doing something but in fact aren’t connected to anything.

And they weirdly don’t perceive that they are going nowhere.

1 Not having seen the survey instrument, you may also be seeing “shy Trump voter” behavior, that some of the “would considers” may actually be in pleasing the interviewer mode.

2 It might be pretty accurate in CA and certainly is in the VA system.

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  1. Basil Pesto

    Well, that’s all well and good, but actually the pandemic is over and the only people that think it isn’t are out of touch elitist liberals for whom the pandemic gives them meaning *nods decisively*

  2. Roger Blakely

    In California this morning there are a couple of relevant news items. First, the legislature approved a rule requiring employers with more than 25 employees to provide employees with 80 hours of COVID-19 paid sick leave. This is the third program, the 2022 program. We had the 2020 program and the 2021 program. This time, however, there is no funding. The other programs had employers getting reimbursed through a federal tax credit.The Dems in the California state legislature are forcing employers to eat this cost.

    Second, the governor promised to lift the universal indoor mask mandate next week. I have no idea how people stay healthy without wearing a respirator in all public indoor spaces.

    1. mistah charley, ph.d.

      “how people stay healthy without wearing a respirator in all public indoor spaces” – my strategy is no doubt similar to other people here

      1/ to go into public indoor spaces as infrequently as possible – for example, my physical therapy appointments for my 2 month old proximal humerus fracture are taking place by video

      2/to wear my N95 when I must mix with the public, whether or not others are doing so

      3/to keep reminding myself that my goal is to accept that we live in a world of radical contingency, and that all phenomena – the pandemic, the human race, the solar system – life, the universe, and everything – are like a beanstalk, metaphorically speaking – they sprout, grow, flourish, decline, and disintegrate

      1. allan

        The stupidity around masking is hard to fathom.
        From the University of Chicago:

        … The email also announced four changes to University policies effective upon the email’s release. One was that speakers and presenters may lower their masks “in order to be heard or understood” while speaking, reversing a policy announced December 20 by Provost Ka Yee Lee and Executive Vice President Katie Callow-Wright that required individuals to wear masks indoors at all times. …

        It is difficult to get an institution to understand something,
        when its tuition revenue depends upon its not understanding it.

    2. Jen

      Perhaps the dems are counting on the power of markets to persuade employers to continue mask mandates by making it expensive – via required paid sick leave – for employers to lift them?

      I jest of course.

  3. Basil Pesto

    Less sarcastically, related to the remarks in the post about vaccine monomaniacals, I found this twitter thread interesting.

    Stancil’s thread is a) factually accurate as far as I can tell and b) generically humanist. Yet look at the comments (and the comments on a Mehdi Hasan tweet, the latter having retweeted it in a fairly neutral but oresumably approving way). The vaccine monomaniacals are borderline unhinged. They just cannot accept the reality that these vaccines have real and serious limitations. I won’t say I’m surprised but it’s plainly obvious that it’s not just anti-vaxxers that struggle with ~ThE sCiEnCe~. It’s mental.

    The flip side is that many examples, from the Creel Committee onward, have shown that full bore multi-channel propaganda campaigns (including using churches and social groups) can change public opinion massively in 6 weeks to two months.

    This touches on something I said a couple of days ago, that, simplifying, people will pretty much do as they’re told. that in itself is perhaps a discomfiting truth – if indeed it is true (but, hey, look at how the rhetorical ground has shifted from 2020 to 2022) – but nevertheless, if American media pulled in the same direction in terms of, yknow, reality-based Covid advice à la China, I’m sure tremendous headway could be made against the pandemic (and, alas, it’s important that America takes the lead here because for better or worse – well, okay, just worse – it is the hegemon of the anglophone world). But I’m not that naïve, and I know the odds of that happening are remote.

    1. Jen

      Our great experiment with the undergrads has pierced the denial of many a vax monomaniacal in this area, but they still cling to some vestige of belief. Example: a friend who acknowledges that vaccines have done diddly to contain the spread among our undergrads but is still furious that her sister inlaw would get vaccinated to “go on vacation” but not to see over the holidays. And boy howdy – look out if you even attempt to suggest that less than 100% of the people who die from COVID are unvaccinated.

  4. BeliTsari

    Dismissal of cascading PASC symptoms*, delayed weeks after our original mild infection; mitigated by mRNA vaccines, supplements, exercise, or just undiagnosed as we’ve learned to accommodate? After five days, or (cursory) negative test, we’re all pronounced SUPER Immune© and sent out to infect others, but with shiny new co-morbiduties, to blame for lethal breakthrough infections to come?

    *A doctor on twitter noticed serious allergic reaction to hHerbs de Provence (my throat closes up from Tarragon, now?

  5. Hayek's Heelbiter

    Proven in study after study as the safest, cheapest and most effective way of stopping Covid transmission in indoor spaces with minimum air flow (most modern buildings) is air purifiers with sealed UV-C units.

    As far as I know, the only people who are actually use these are Transport of London (of all entities!) and at my dentist, where the woman who cleans my teeth has one in her treatment room (but not in the dentist’s room itself – go figure).

    So I still can’t understand all the kabuki about masks, vaccinations, etc. when there already exists a relatively low-tech method of prophylaxis.

    1. Basil Pesto

      it’s not an either/or situation. We should be doing everything we can to get the Reff as low as possible. And respirators (masks) are hardly kabuki. Until air purifiers with UV cleaning are installed absolutely everywhere (and assuming that will be enough to get the job done), respirators remain an essential tool in the fight against the virus. They are safe, cheap and effective, too.

  6. Fazal Majid

    Don’t most shocks fall more heavily on the poor and vulnerable, since by definition they have fewer resources to bounce back or even cope?

    Antivax sentiment was one area where well-off bourgeois bohemian types in Marin County, who send their kids to Waldorf schools with abysmal vaccination rates, were actually at a disadvantage over the working class.

  7. BeliTsari

    Everybody, among my “retired” friends, was infected by coworkers, 1/3rd our age, without PPE or ANY acknowledgement of aerosol contagion. It was typical to work with cytokine hijacked immune systoms without pulse oximeter or any mitigating supplements. We’ve written as several older friends passed away over the intervening two years; but few had ARDS or even ER visits to show. Nobody got PCR tests done, as we’ve no paid sick-leave, so most simply assume anosmia and apoxia as evidence? Frequently, we’d nothing on paper, until IgG, S or N protein immunoglobulin tests? I guess, schoolkids’ folks will face financial ruin, if not insured, as debilitating inflammatory CNS, CHF or circulatory damage will be ascribed to mysterious pre-existing comorbiduties (as we’re cynically 1099’d out of ACA medical plans?)

  8. Eustachedesaintpierre

    I cannot really complain as there are very many in a much worse situation than I & fortunately I had already done a huge downsize & paid off most of my debts, having to hold onto one due to 5 trips to England to help sort out things regarding my Mum including power of attorney that was stuck due to my warring sisters. Basically in 2020 I lost around 60k due to 2 postponed commissions, didn’t qualify for any grants as the years that were needed to get it I had been an official carer which don’t amount to a hill of beans in this Neoliberal world – still had to pay my tax bill but I’m OK & spent 18 months doing anatomical studies which is very useful.
    I was supposed to start a big job on New Years Day but that has now yet again been postponed till April due to planning red tape & I jumped the gun by advertising a sculpture in December for which I got 5 orders, but due to above I have had to hold the buyers back. Fortunately they are OK with that, as if I were to get that cash it might be discovered by the Universal Credit Gestapo & I didn’t mind lockdown much but a similar situation at her majesties pleasure would be a whole different thing entirely.

    I do know of a couple of people with families who are in a desperate situation in regard to getting by largely due to Covid job losses who have young kids, one of whom is very likely to lose their house – it’s all relative I suppose & I don’t want for much.

  9. Gumnut

    Things baffling me about Covid – 2 year sitrep:

    – if covid has been found in wild deer (and hamsters, minks, hippos, giraffes, snowleopards…just not bats for some reason) – what difference does human vaccination rate make to the imaginary herd immunity line? I.e. the host herd ‘n’ is so much bigger than human population ‘n’. If it is genuine zoonotic (can hop human-animal-human), then eradication is futile, no? Protecting health care from collapsing…onto that in the next point.

    – vaccine efficacy vs. omikron for both infection, serious disease & death varies somewhere between no difference to actually worse than unvaccinated, see data from Denmark, UK NHS, Germany RKI, Australia NSW health services, Iceland, Netherlands, Israel…I’m running out of breath…why are (rational minds/) we still chasing boosters, percentage population vaxxed scores, etc.? Insult to any form of rationality it feels like ever more.

    – odd excess mortality curve shapes in high-vax countries, life insurance 40% increase death numbers, funeral service business data (lots more deaths, clots in bodies to be embalmed), the DoD health database increase in all sorts of neurological, cardiovascular & cancer numbers in 2021 vs. the previous 5 years = all the things I can get by daily dose of doom on Berensen/Malone/Hirsch substacks – are they all making stuff up or are really 10s-100s of thousands of people suffering disease/premature death from the vaccines? It’s getting a bit black or white here, not gray.

    – finally, where on earth is the left critique/voice on all this? Besides NC, all the non-ministry-of-truth critiques of the covid handling/ vaccine issue/shortcomings I can get hold of are from authors who I mostly go fully along with their covid-related critiques of the powers to be, but then reveal to be center-right/fairly fantic conservatives and follow on with nuggets like what I heard on some podcast interview that “the WEF is a left-wing organisation and a marxist plot “…wtf? I know, I know, the Blairite/new labour/DNC of the ‘social democratic left’ moving to the PMC center, but still…where the hell is there a lefty critique of governments or pharma or media corp on all this? Family blogging crickets. Recent on unherd article on the left having become pro-corporatists in relation to food, but I guess pharma is all just the same: https://unherd.com/2022/02/why-the-left-eat-junk/

    1. Yves Smith Post author

      These animal versions are not transmissible to humans. But still troubling that they have it too. If you want to worry about it spreading back to humans, the population to watch (aside from bats) is rats.

      The results for three shots v. Omicron are better than two shots or no shots. Israel is “only” 50% boosted, boosted early (starting in August) so the boost effects for some (many?) have faded. I think the bigger problem with the vaccines is that the European Medicines authority is correct, you can’t boost often enough to be well protected v. Covid and not have other immune system effects.

  10. Tom Stone

    I wish I could recall Obama’ s remark that JRB is a fuckup accurately.
    This degree of consistency requires a large number of energetic and highly educated idiots.
    It is spectacular and if there is anyone left to write the histories in 50 years Biden will be remembered as a worthy successor to the Hapsburgs.

  11. lakecabs

    A lot of low income workers don’t get tested.

    Why would they when their family would starve?

    They just keep putting one foot in front of the other.

    Why do people hate these heroes?

  12. david anthony

    “We have identified a phenomenon of omicron recoverers who deteriorate and reach a severe condition after about 10 days, with problems that are not necessarily related to the airways”

    This explains what I’ve been reading on twitter and Reddit comments. People seem better then go down rapidly at the two week mark. Every variant is different, or “mild” if you want customers out there Christmas shopping.

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