Written Evidence Submitted by the London Borough of Lewisham (MRS0267)

Written evidence submitted by the London Borough of Lewisham (MRS0267) The unequal impact: Coronavirus (Covid-19) and the impact on people with protected characteristics [London Borough of Lewisham Submission] I write regarding the above-mentioned Parliamentary Inquiry and in response to the Women and Equalities Committee Call for Evidence. As this submission is being made, the social and economic impact of COVID-19 is still being felt across the country. At the same time, courageous efforts continue to be made by brave health service professionals and other key workers to reduce the spread of infection and save lives. Much as the pathology of COVID-19 is indiscriminate, what has also become clear is that certain sections of society are at greater risk of infection than others. As a borough that celebrates its demographic diversity, Lewisham is particularly concerned at the way in which the pandemic is impacting upon our communities. We now better understand that factors such as how many people live in a household and even the industry in which a person is employed, can increase their risk of infection. It is critical that we seize this opportunity to learn lessons so that we can better mitigate future risks and protect vulnerable communities. Lewisham looks forward to being part of this process of learning and in response to the Committee’s Call for Evidence, I attach the Council’s submission. Introduction Lewisham Council is a public body located in south east London. The Council serves a population of 303,5001 residents and 133,000 households. By population size, Lewisham is the 14th largest borough in London and the 6th largest in Inner London2. The role of the local authority is to promote the social, economic and environmental wellbeing of the borough and its residents. The London Borough of Lewisham is an administrative body. Our directly elected Mayor, Damien Egan, serves the whole borough and 54 elected Councillors serve the borough’s 18 wards (three for each ward). The Council is the largest employer in the borough, employing some 2,000 staff of which 51 per cent live locally3. In addition, the Council is a provider and convenor of public services. For Lewisham, the rationale for making this submission is simple; we believe that the process of learning lessons from COVID-19 starts now, not at some point in the future. We also believe that it is important to recognise that there are indeed specific communities that face greater exposure to risk than others and that the ‘next wave’ of COVID-19 could well be the long term socio-economic harm that is visited upon those whose circumstances make them most vulnerable as well as those who have now become vulnerable as a result of COVID-19. As such, thinking and planning as to how best to mitigate the above mentioned risks must be at the forefront of the Government’s thinking as it co-ordinates its short, medium and long term response to the pandemic. How people have been affected by the illness or the response to it The effects of COVID-19 on Lewisham’s population have been similar to those in boroughs elsewhere. Lives have been significantly disrupted as people infected by the virus have self- isolated, been admitted to hospital or tragically lost their lives. Businesses and schools have been closed and opportunities for people to enjoy social recreation with friends and family or fulfil religious observances have been significantly curtailed. There are also the obvious changes in behaviour that have been occasioned by the social distancing guidelines and the various restrictions that have been placed on the free movement of individuals. At the time of making this submission, there have been more than 850 confirmed COVID-19 cases in Lewisham4. The current rate at which COVID-19 cases are being confirmed in the borough is above both the London and Inner London averages. In total there have also been over 200 COVID-19 related deaths in Lewisham5. Of these the vast majority of deaths (more than 170) have occurred at Lewisham Hospital, with smaller numbers of deaths occurring in the community and in care homes. At present, Lewisham Public Health are seeking access to NHS data containing demographic information for COVID-19 cases that are hospitalised at University Hospital Lewisham, to build a local picture of any disproportional impact of COVID-19 on protected characteristic groups. It is hard to characterise any issues that have arisen as a result of COVID-19 as Lewisham specific, although there may be issues that are common to boroughs with a similar demographic profile and these are explored further in this submission. As knowledge of the virus has developed, it has become clear that its pathology is quite unpredictable. There are those who experience severe symptoms and life threatening consequences and there are those who seem to be asymptomatic. Then there are those who have underlying conditions and are able to recover from the virus and those who appear not to have underlying conditions, who sadly succumb to it. For the most part, the impact of COVID-19 locally appears to be broadly consistent with elsewhere in London and across the country. Lewisham residents are understandably anxious and uncertain. However, despite the upheaval, they are also patient and resilient. Equally, although there are no quantifiable measures of assurance, anecdotal evidence suggests that Lewisham residents have been broadly compliant with social distancing guidelines and are observant of the various restrictions placed on the movement of individuals. Clearly, we have noted exceptions to this, with the recent Easter break being a specific example. There have also been less tangible issues that have been clearly manifested such as the fear and anxiety of individuals. This was perhaps most clearly demonstrated in anticipation (and during the very early stages) of the nationwide ‘lockdown’ and was evidenced by panic buying and the artificial scarcity of goods in local supermarkets. In recent weeks however, this issue appears to have settled down somewhat as local shops have introduced their own protocols including controlling the number of people accessing their establishments at any one time and designating shopping times for specific groups such as older people. Broader impact and response The ways in which COVID-19 has impacted Lewisham residents is evident in the various concerns that have been raised by those calling the Council’s COVID-19 helplines. The help-lines which the Council has set up have taken more than 1,200 public enquires to date. A number of those calls are from residents who have raised queries about issues including the following: Whether their child will still be able to access free school meals Financial support for those who have lost their jobs or are self-employed and unable to work Support for those without close family or friends and who are living alone The length of time that schools will be closed The rights of tenants who may be facing eviction by their landlord Advice for those who want to volunteer and help On its part, the Council has acted quickly to re-purpose its entire function in response to the needs of local residents for information and to ensure that our hospitals are supported, capacity is created by ensuring discharge at the earliest opportunity and the needs of the borough’s most vulnerable residents such as older people living in care homes and vulnerable children and young people are safeguarded, as well as ensuring that staff working in social care services have access to Personal Protective Equipment. These concerns have informed the Council’s emergency planning response. For example we have called for volunteers from across the various services in the Council not directly involved in the Council’s response to COVID-19. To date more than 170 members of staff have responded and dozens have been deployed to critical service areas. Across the Council, our services have remained resilient in the face of the current pressures and demands of COVID-19. However, we are mindful of factors that sit outside of our control such as disruption to the local government supply chain, which has affected access to essential goods such as personal protective equipment, hand sanitizer and other essential items. The Council is working hard to address these challenges alongside other local authorities and with central government. If there have been specific impacts on people due to them having a protected characteristic Exposure to risk Disaggregated data for COVID-19 related deaths is limited. Nationally with the exception of age, gender and those with underlying conditions (a proxy for disability), the availability of lower layer reporting on the impact of COVID-19 on protected groups, is patchy. For those with underlying conditions, a particular concern for Lewisham is the fact that the borough performs significantly worse than London and England across the following measures: mortality rate from all cardiovascular disease6, estimated diabetes diagnosis rate7, childhood obesity (including severe obesity)8 and tuberculosis incidence rate9. By implication therefore, Lewisham residents with the above conditions could face an increased risk of COVID-19 infection, compared to residents in other boroughs who present with the same conditions and where performance against the above measures is better or in line with regional and national averages. In respect of the now widely reported impact of COVID1-9 of BAME communities, where data is available, it does seem to suggest that the pandemic has had a disproportionate impact. As a case in point, the Intensive Care National Audit and Research Centre found that 34 per cent of more than 4,800 critically-ill patients with COVID-19 identified as black, Asian or minority ethnic.

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