Earlier this year I found myself cooking for a woman I'd never met before who lived on a local estate. She was a single mother, her teenage son had picked up Covid from school,and given it to her. She had a zero hours contract, and had run out of money to feed her family /1

They'd been surviving on tinned soup for three days, but that was used up. So she put out a call on social media and I got in touch. I have never heard anyone apologise more, she was utterly humiliated to have to beg for help from strangers. As *you* would be. It was horrible. /2

Now,this woman happened to have become very sick with Covid too.And I often wonder-if she'd been one of the many who only had mild or no symptoms,what decision would she have made?Would she have isolated to the point she had to beg from strangers?Or would she have gone to work?/3

I mean,it'd be easy for me as an epidemiologist to bemoan the fact that not enough people are isolating after testing positive or being in contact with a positive.But I have money in the bank,I work from home,I can afford to have online shopping delivered.I can stay home, easy /4

We know how Covid works by now.We know the epidemic is being driven by close contacts,+we know that those contacts are very often driven by having a lower socio-economic status.People living in crowded households.People with public-facing jobs that can't safely be done at home /5

We see this being borne out in the data.People of low socio-economic status are more likely to be infected.More likely to be hospitalised. More likely to end up in ICU.

And if that's not something you find morally wrong-know that it affects you too.

https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(20)30005-3/fulltext#%20

/6

Because it's these pressures on the health service,this lack of ICU beds,that is affecting YOUR freedoms. Because the current whack-a-mole strategy of business closures, school closures and lockdowns is a blanket response that fails to address the core factors driving Covid /7

And yet this point is almost entirely lacking from the national discussion. Difficult to know why - perhaps because control measures that address social inequalities are seen as "too political"?

https://twitter.com/ScienceShared/status/1344312833769697284

/8

Even scientists don't seem to be massively pushing this point - with some fab exceptions like @mugecevik and @jackiecassell, whose work I'd urge you to follow.

https://twitter.com/ScienceShared/status/1344312833769697284

/9

This needs to change. We need to be more creative in our thinking. We need targeted interventions that address the challenges at hand. Increased sick pay, supported isolation, a vaccine strategy that takes deprivation into account. /10

Without this, we are doomed to always be behind the curve, cursed with blunt blanket restrictions that don't work and leave us all in this mess for longer. And those had least to start with end up paying the biggest price.

It's time to start levelling up.

/End

Little PS - I meant to link to @jackiecassell 's excellent recent blog in tweet 9, but copied the wrong link over. Here it is https://twitter.com/jackiecassell/status/1343125059616071681?s=20