Many years ago, I was at a house party in San Francisco when I began to feel distinctly unwell, headachy, and woozy, and icy cold despite the sweaty heat created in a crowded room in winter.
By the time I returned home, I was barely functional, and spent a hideous, feverish night drifting in and out of hallucinatory dreams, shivering and aching, head pounding. By morning, the fever had broken and I was weak, but much better, and grateful for a long weekend of rest before returning midweek to my freelance teaching job at a Bay Area college.
A few days later, my best friend, a doctor, leaned across the kitchen table, peering at my head. “Did you know you have red bumps on your neck?” I didn’t. “Can I look closer?” I said sure.
She sat back. “Do you know if you had the measles vaccine?”
I was taken aback. Of course I had, I said. My father was a consultant; my mother, a registered nurse.
Still, my friend was adamant. All my symptoms indicated measles. And then, I remembered I'd been notified recently that one of my students was out ill with measles. A surprise measles outbreak was sweeping through California, affecting some vaccinated young adults. Maybe I did have measles. (And thus did researchers discover that a single vaccine is not enough – a booster is now routine.)
My friend told me that as long as I had the telltale measles rash, I was infectious with this highly contagious disease. And that put me in a panic.
I worked freelance, without sick leave or sick pay. I had no savings. I had expensive San Francisco rent to pay, groceries to buy. I couldn’t afford to miss work for days or weeks. They might even replace me, leaving me jobless.
Poor judgement
Thankfully, the rash subsided in days. But I agonised over what to do. In the end, I went to work, cautiously keeping my distance from everyone, and hurrying home after class. None of my students became ill. I had probably already passed the infectious stage.
Still, I’d shown appallingly poor judgement. But I was young and desperate, working in what we’d now call the gig economy, with no security, utterly dependent on each pay cheque.
Fast forward several decades. The new coronavirus is spreading. And threadbare gig economy jobs, indifferent to personal illness or misfortune, are mainstream. In Ireland and Britain, hundreds of thousands of people work in these kinds of jobs. In 2018, the ESRI estimated about 200,000 Irish people – about 10 per cent of the workforce – were in non-permanent employment.
How likely are such people to self-isolate for two weeks, losing pay, if they start to show possible symptoms? In the UK, such worries are front-page news this week. Trade unions are pressuring Boris Johnson’s government to guarantee proper sick pay.
But it’s the US that is the most concerning. There, over one-third of the workforce is gigging it – 57 million people – according to Gallup, from people doing contract work for multinationals to ride-hail drivers and delivery and service providers. People the big cloud-based, generously venture-funded tech companies insist are non-employees.
Such workers earn 58 per cent less than full-time workers, and according to a study by Prudential, more than half have no job benefits. In the US, a country without a national health service, 60 per cent of gig workers lack employer-provided medical insurance and only 5 per cent are given short-term disability pay.
Perfect storm
This is the perfect storm for a health epidemic. Already, Americans have reported that hospitals are charging more than $3,000 to test for Covid-19, a major disincentive for diagnosis. Even health insurance is no reassurance, as often people must go over a very large “deductable” amount before coverage kicks in. Using your insurance may raise your insurance premium cost. Millions of Americans have no insurance at all.
But if your Covid-19 symptoms are mild to moderate, and can be passed off as a cold or mild flu, and maybe you’re not sure anyway of what you might have and cannot afford $3,000 to find out . . . well, I know too well the pressures those gig workers face, the choices many will rationalise, the feeling of desperation, of weighing up odds, worrying about your rent or buying food for yourself or your family.
Meanwhile, the big gig companies roll over into billion-dollar evaluations, even when profitless, clinging to essential income streams from their hapless, benefit-less, exposed “independent contractors” and “franchisees” – your delivery person, your driver – who, like me those decades ago, simply cannot afford to self-isolate, to not work.
With measles, I made the wrong choice, a shameful choice, even if I try to rationalise now that this was in a limited regional outbreak of a disease nearly everyone was vaccinated against. Now, in a fast-advancing global epidemic, with a novel virus, a higher fatality rate and no vaccine, and a health and employment system that prioritises big companies and not people, the US had better hope that 57 million vulnerable people don’t behave as I once did.
