There are not many silver linings to the coronavirus pandemic. The scale of the health and economic suffering is hard to grasp.
COVID-19 has laid bare the ways that historic and structural racism shape patterns of infection and mortality. Inadequate social investment has created public systems that are unable to respond to the challenge.
But the crisis has resulted in rapid policy changes that have positive health and social implications. In many cases, issues that previously languished in drawn out review processes have moved rapidly with the urgency of potential infection and death.
As the conversation around the coronavirus pandemic slowly turns toward what comes next, and how to structure and phase the recovery, the policy shifts toward fairness and equality should be protected.
Our goal should not be to try to move back as quickly as possible to normal. Normal set the conditions for the devastating outbreak and inadequate response. These policy changes are illustrations of the path to a new normal — one that tries at minimum not to maintain unfair systems and at best to build stronger, more resilient communities.
Here are a few examples from California:
Medi-Cal reimbursement for tele-health: Californians who participate in Medi-Cal are disproportionately people of color and are among the state’s most vulnerable residents due to their economic insecurity. Medi-Cal’s decision to fully reimburse tele-health services will help members to receive vital medical care during the pandemic. Tele-health has also been shown to increase access to medical and behavioral health care for those who are unable to take time off work for appointments or who experience transportation barriers (because they live in rural areas or don’t own a car, for example).
Elimination of bail for individuals accused of non-violent offenses: In order to reduce California’s incarcerated population — a group that is particularly vulnerable to coronavirus due to crowded living conditions — The Judicial Council of California decided to eliminate bail for misdemeanors and non-violent low-level felonies. Many cities, including San Francisco, had already moved to eliminate cash bail in favor of a risk-assessment approach to pre-trial detention. This saves the public the cost of jail and eliminates a privilege based on wealth.
Housing stabilization measures: California has granted local governments broad latitude to halt evictions, limit foreclosures and avoid utility shutoffs. In response, counties and cities across the state have implemented a range of policies to protect renters and homeowners. At the same time, unprecedented efforts are being made to move up to 15,000 people experiencing homelessness into motels and hotels. The precise policies that have been implemented may not be applicable post-COVID-19, but many elements may make sense to maintain. The ability to act quickly to save lives and stabilize communities should be instructive for future housing policy.
Increased bike/pedestrian space: Cities across the state have closed streets to automobiles in an effort to create space for walking and biking while maintaining physical distance. The potential benefits are particularly significant in neighborhoods with limited park and bicycle infrastructure. Oakland led the way by closing 10 percent of city streets, including those that were designated to become neighborhood bicycle routes. This may accelerate movements to close streets permanently (as San Francisco’s Market Street did earlier this year) in order to increase active transportation.
Suspending SAT/ACT requirement: The University of California system suspended standardized testing requirements for admission in light of disruptions due to COVID-19. While the suspension is temporary, there is extensive research about the ways that standardized testing biases admissions against students of color and low-income students. As Audrey Dow, senior vice president at the Campaign for College Opportunity put it, the suspension “can serve as a really good pilot opportunity to figure out, does eliminating the use of the test produce a more diverse class?”
Over the coming months, there will be two parallel conversations: how to understand what happened and what to do to recover. Bringing those two discussions together is critical so that the analysis of why it happened informs decisions about what happens next. An examination and continuation of some of the policies adopted during the crisis will be an important part of that process and a reminder that we can act quickly and decisively in response to priorities.
Jeremy Cantor is the project director at John Snow, Inc. in Berkeley, and provides sustainability and policy technical assistance to the statewide Accountable Communities for Health Initiative. Alison Salomon is a consultant at John Snow, Inc., and a public health and city planning professional.