Residential / Public health
Areas of multi-generational houses and overcrowding at ‘greater’ virus risk
By Andrew Sansom | 14 Apr 2020 | 0
New research suggests that overcrowded neighbourhoods generate more COVID-19 infections than less-dense areas, even after taking account of where the outbreak started, local deprivation and the passage of time.
A report by the New Policy Institute (NPI), a UK research think tank, uses data on the number of older people who share a home with people of working age, with this statistic linked to the number of confirmed cases of COVID-19 across English local authority areas.
The difficulty of self-isolating faced by multi-generational families was highlighted first in a blog authored by NPI research analyst Josh Holden and director Peter Kenway. They point to the work of Neil O’Brien, MP for Harborough, Oadby and Wigston, in Leicestershire, who asked the Office for National Statistics (ONS) to provide data on the percentage of people aged 70 or over who live in a household with one or more non-pensioner (16+) adults.
The figure for Leicestershire is 16 per cent, just above the national average of 15 per cent. In the City of Leicester, however, 29 per cent of those aged 70 or over live in a household occupied by one or more working-age adults. The figures for Birmingham and nearby Sandwell are similar, 28 per cent and 30 per cent, respectively.
The London boroughs of Newham, Brent and Lambeth top the ONS list at 40 per cent, 44 per cent and 45 per cent, respectively. Both Brent and Lambeth are in the top-10 local authority areas in England for confirmed COVID-19 cases.
The NPI argues that this apparent relationship raises policy questions about the practicability of advice on social distancing for people whose housing conditions make self-isolation impossible.
The research report builds on this initial finding in two ways. Firstly, it extends the statistical research by developing a model that goes beyond correlation to measure the size of the impact of various socio-economic variables on the confirmed COVID-19 caseload. Alongside the proportion of over-70s who share a home with people of working-age, these variables include overcrowding and local area deprivation.
The second way the report builds on the initial finding is to draw out policy questions raised by the model. Some relate to the policy response to the virus over the coming months; for example, there is a serious question about the provision of suitable space for people of working-age who, if they find themselves displaying mild symptoms, may not wish to self-isolate at home because they cannot maintain the necessary distance from other household members.
Other questions focus on the more medium term and what have become norms of housing policy, especially the standards that determine what constitutes adequate accommodation. In addition, there could be implications for local authorities’ and others’ strategic plans for the provision of homes that reflect those standards.
In the blog, Holden and Kenway suggest two actions that central and local government should consider.
One is to provide alternative accommodation for key workers who would normally be living with someone elderly or vulnerable. A second potential action is to set up isolation centres where those who have the disease – even if in mild form only – can go if they would otherwise be living with someone elderly or vulnerable.
“Individuals should be left to make the decision as to whether they want to take these options, depending on the whole of their family position, but they should have that choice,” say the authors. “Self-isolation can only work as a policy if people have the space to do it.
“We stress that this is not a call to move old people out of their homes. The World Health Organization’s advice [relating to this matter] is directed not at old people but at those who have mild symptoms, cannot self-isolate at home, and so may infect other vulnerable household members.”