Corona crisis and poverty Poorer neighborhoods need to be vaccinated faster

NRW · Infection rates are higher in neighborhoods with a high proportion of migrants than elsewhere. This is due to cramped living conditions and greater poverty. Local vaccination campaigns could help.

 Cologne's satellite town Chorweiler had twice the incidence rate of the city as a whole on Friday.

Cologne's satellite town Chorweiler had twice the incidence rate of the city as a whole on Friday.

Foto: picture alliance / dpa/Rolf Vennenbernd

Peter Renzel, Essen's head of health, wanted to know exactly. He reviewed the data on all Corona-infected people reported to the city, which were received by the health department there between March 1 and April 14. "Of the 3921 people of any age, 2001 had a name that suggested a migrant background," Renzel told the newspaper Westdeutsche Allgemeine. According to this, every second person infected with the coronavirus would have a migration background. The proportion of migrants in the total population of Essen is 35 percent.

One may consider the method to be contestable, but it gives an indication that the corona pandemic is also a huge social problem because, like other widespread diseases, the epidemic primarily afflicts poorer classes. And this affects to a greater extent people with a migration background, because they have to get by with less money on average and have a higher unemployment rate than the rest of the population.

The alderman Renzel was therefore not concerned with making accusations against migrants, but with drawing attention to particular problems. Migrants made up about 72 percent of Hartz IV needy communities in Essen, many of them living on fewer square meters than people in wealthier neighborhoods. Doctors in clinics also repeatedly report that many covid patients in intensive care units have foreign roots.

In Cologne, the largest city in North Rhine-Westphalia, precise infection figures are available for the individual districts and are also published. Of the ten districts with the highest proportion of migrants, eight are above the Rhine metropolis' average of 245 in the number of new infections per 100,000 inhabitants per week (incidence) (as of Monday). Some of the neighborhoods, such as Gremberghoven (717), Neubrück (630) and the satellite town of Chorweiler (520), even significantly exceed the incidence rate of the cathedral city. Cologne's administration does not record whether patients have a migration background when it comes to infections. But the richer neighborhoods such as Lindental, Junkersdorf or Neuehrenfeld, with a significantly lower proportion of migrants, have incidences of less than 100. According to these statistics, the villa district of Hahnwald even has an incidence of 0. In view of these figures, TV satirist Jan Böhmermann wonders on Twitter in "whose interest it is to think about easing the restrictions now.

For Düsseldorf medical sociologist Nico Dragano, such numbers are not surprising. "The Corona pandemic has exacerbated social inequality - as is the case with all widespread diseases, by the way. They mainly affect the poorer classes." In neighborhoods with a high proportion of migrants, people's incomes are lower, and unemployment is higher on average. More Hartz IV recipients also live there. According to a study by Dragano using data from those insured by the AOK Rheinland/Hamburg health insurance fund, the risk for a recipient of unemployment benefit II is 87 percent higher than for an employed person.

The city of Düsseldorf, together with the Heinrich Heine University, recently conducted a research study on the detection of antibodies to determine in a representative manner how high the actual number of infected persons is. There, too, it was found that the risk of contracting the coronavirus is significantly higher in districts with lower incomes, fewer single-family homes, higher unemployment and a higher proportion of foreigners and migrants than in more affluent districts with a lower migration rate. Similar correlations are also reported from Berlin, Hamburg or Munich.

Medical ethicist Christiane Woopen therefore goes one step further and recommends vaccination mobile centers for socially difficult neighborhoods, i.e. mostly those with a high number of migrants. This would allow the vaccine to reach "families and places of work where there are problems with keeping a distance," says the Cologne professor of medicine. The city of Duisburg is already practicing this in a homeless project. There, the health authorities began vaccinating people on site at the aid facilities as early as April 8. According to the city administration, 63 of the 288 people who visit homeless assistance facilities have already been vaccinated - so far with the vaccine from the company Biontech.

Vaccines are still in short supply, so there is also a bit of a distribution battle for the syringes from Moderna, AstraZeneca and Biontech. People with pre-existing conditions, relatives of pregnant women, elementary and special education teachers, as well as doctors, educators, social workers and caregivers, are given priority for vaccination, along with the elderly. But the discussion about softening the order of vaccination has long since begun. And there are reasons to consider not only teachers or employees in areas with a lot of social contact, but also people who live in confined spaces and therefore have few opportunities to distance themselves from other people. Often in such hot spots there is domestic violence, boredom due to lack of employment, and hardly any spaces to sustain prolonged seclusion. There may also be less provision and discipline in one case or another. But this is also easier to maintain in an environment that lacks nothing.

Last but not least, reasons of better integration argue for launching targeted vaccination campaigns in socially disadvantaged neighborhoods. Most municipalities and city councils still adhere more or less strictly to the prescribed vaccination sequence. And campaigns in socially disadvantaged neighborhoods extend primarily to testing, hardly to vaccination. This could and should change. In Cologne, for example, neighborhoods with a high risk of infection will soon receive a special quota of vaccine doses. The idea is to "vaccinate people in special social structures ahead of time," said a spokesman for the city. Faster vaccinations in such neighborhoods would help everyone - the less privileged, whose risk of disease would be reduced, as well as the richer, who would have less fear of infection even if vaccinations were given later.

(Original text: Martin Kessler; Translation: Mareike Graepel)

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