Page - 6 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE6 particularly in the United Kingdom and the United States, clear dis- tribution patterns began to emerge. For example, people living in the poorest Scottish neighbourhoods were twice as likely to die as their wealthier neighbours.23 The death rate was 86.5 per 100,000 in the poorest fifth of Scottish neighbourhoods, compared to 38.2 in the rich- est fifth. Socio-economic disadvantage is strongly correlated with vul- nerability to infection and death from COVID-19. In Canada, Quebec has the highest COVID-19 death rate per capita in the country (reportedly the seventh deadliest place in the world), propelled by very lethal outbreaks in the low-income neigh- bourhoods of Montréal.24 Some have attributed this to the province’s early spring break (i.e., Quebeckers travelled abroad and returned infected before provinces began taking strict measures).25 It is clear, however, that hot spots of the outbreak in Montréal are in poorer areas, particularly among recent immigrants living in overcrowded housing,26 some of whom work in long-term care facilities, placed there by temporary employment agencies.27 The working hypothesis is that care workers bring the illness back to neighbourhoods, where it spreads rapidly because of poverty and crowding. The extent to which Montréal differs from other major cities in Canada is not yet known. Data suggest that within Toronto, poor neighbourhoods also have vastly higher reported cases than neighbouring wealthy suburbs.28 The socio-economic dimensions of COVID-19 transmissions and deaths in HICs is raising alarm regarding how the disease will impact low-to-middle income countries (LMICs). Lockdowns, which seem to 23. Tom Gordon, “Poorest Scots Twice as Likely to Die from Coronavirus”, The Herald (13 May 2020), online: <https://www.heraldscotland.com/news/18445900. poorest-scots-twice-likely-die-coronavirus/>. 24. Tracey Lindeman, “Why Are so Many People Getting Sick and Dying in Montreal from Covid-19?”, The  Guardian (13 May 2020), online: <https://www.theguard- ian.com/world/2020/may/13/coronavirus-montreal-canada-hit-hard>. 25. Leyland Cecco, “Canada’s Bid to Beat Back Coronavirus Exposes Stark Gaps Between Provinces”, The  Guardian (15 April 2020), online: <https://www.theguard- ian.com/world/2020/apr/15/canada-coronavirus-covid-19-provinces-trudeau>. 26. Ibid. 27. For a discussion of temporary employment agencies and long-term care, see Katherine Lippel, this volume, Chapter E-3. 28. Kelly Grant & Carly Weeks, “Examining Hot Spots for Community Spread Across Ontario”, The  Globe  and  Mail (29 May 2020), online: <https://www.the- globeandmail.com/canada/article-examining-hot-spots-for-community-spread- across-ontario/?utm_medium=Referrer:+Social+Network+/+Media&utm_campa ign=Shared+Web+Article+Links>.