“You can pass it on before you’ve had any symptoms at all,” Matt Hancock cautioned, in an interview with the BBC.
This advice made sense for those with elderly relatives living in separate households — Covid-19 has killed a disproportionate number of those aged over 80 in England and Wales, according to the UK’s Office of National Statistics.
For all of these families, regardless of race, isolation is a luxury that is hard to come by.
Riznawaz Akbar lives in Manchester, with his wife, his 85-year-old mother and three of his daughters — Salma, Asma and Farah — who are aged 30, 28 and 17 respectively. The local politician has two more adult children: a son living in London and another daughter in Newcastle.
Akbar told CNN that communities such as his own South Asian one often lived within multi-generational households for a range of reasons — including faith, culture and affordability.
“Certainly those from the Muslim faith and in South Asian [groups], there is this belief that you’ve got a duty to look after your older parents,” he said.
“Most of the taking care of older relatives is done by family — it’s beneficial to society but sadly during the Covid-19 crisis, that has become a negative,” because of how the virus spreads among people living in multi-generational households, he said.
Akbar said his own family has been forced to implement stringent routines to cope with the pandemic. His eldest daughter, Salma, is an optometrist.
“She sees patients all day long. She comes home and has to be careful around my mum,” Akbar said, explaining that Salma tries to minimize the risk of contamination by changing her clothes immediately on returning home.
“I do know people who have had to isolate — who have booked themselves into hotels,” he said, but that is difficult too, “because it’s so expensive to rent … I’ll be honest — it’s not been easy.”
The fear of transmitting the virus to their loved ones has driven some younger people to leave their family homes.
Afua Amoah Arko, a 25-year-old Black British doctor, temporarily moved out of her parents’ home in south London earlier this year to avoid the possibility she might bring the virus home.
“I stayed in a hotel for three months and an Airbnb for one month,” she told CNN, adding that while her employer covered her accommodation expenses, the cost of food, mostly takeaways, wasn’t subsidized.
Amoah Arko described her experience as “odd and isolating,” but said she is once again planning to leave the family home due to fears of a second wave of the coronavirus.
“Three of my friends who are also doctors were in a similar position and also had to stay in hotels during the height of the spring peak,” she said. “There were a few others … who decided to stay at home, but [tried] to distance … from their parents.”
Saima Afzal, a 49-year-old British Asian woman living in Blackburn, said her son and granddaughter have lived away from the family home for three weeks because of concerns about her health.
Her son Aemon, 25, slept in leased office space in order to socially distance from his mother, who was shielding for medical reasons. Afzal said Aemon “was really terrified about bringing the virus back home … so he slept in his office for three weeks.”
Afzal said that even though she has other relatives who live nearby, she struggled with loneliness.
“Families are families, and if you take family away you will lose your mind — I know that from the three weeks I was on my own,” she said. “I had work, I was very busy and working and even with all that, I struggled.”
Afzal said that now her son has moved back in, she is partly responsible for the childcare of her 4-year-old granddaughter, Elia Rose.
“It works out, between the two of us we maintain the household income,” she said, adding that she also relied on the help of the wider family as she does not qualify for government support.
“I’m the eldest of 11 brothers and sisters and many still live locally,” she said. “So when [my siblings] realized I needed some financial help, the family really pulled together.”
Ethnic minorities in Britain have a higher coronavirus death rate than their White peers, according to the UK government. People of Bangladeshi ethnicity have around twice the risk of dying from the virus than their White British counterparts, while those of Chinese, Indian, Pakistani, Black Caribbean and other Black ethnicities have between a 10 and 50% higher risk of death.
A complex web of factors has been blamed for this disparity.
One is that BAME people are more likely to work in high-exposure frontline occupations, including healthcare, security, and public transport. High percentages of pre-existing health conditions in BAME communities are also a factor, as is the risk of transmission in multi-generational households.
According to the Runnymede Trust, a think tank which focuses on racial inequality, people of Bangladeshi heritage were most likely to live in households with more members.
UK government data shows that across every socioeconomic level in Britain, White British people live in less crowded homes than members of every other ethnic group, regardless of whether or not they own their own home.
In the past some politicians, including former Health Secretary Jeremy Hunt and former Liberal Democrat minister Simon Hughes, have praised multi-generational family structures. Both have suggested that the UK could learn from households where families care for their elderly.
The Akbar and the Afzal families both told CNN that notions of duty, supporting loved ones and a sense of pulling together in a crisis had been vital in helping them cope with the pandemic.
But amid fresh coronavirus restrictions and with a second wave of the pandemic now rolling across Europe, these living arrangements have led to fear within communities and prejudice outside them.
Fear and prejudice
Shabana Mahmood, an MP for Britain’s opposition Labour Party, represents a constituency in the city of Birmingham with a high number of multi-generational households.
She hopes the UK government will tailor more of its advice to such communities; she believes little was done at the start of the pandemic to advise people on how to isolate themselves within larger households.
“This is the situation for thousands of people in my own patch,” she told CNN. “There are large numbers of multi-generational households in my constituency that exist for primarily cultural but also economic reasons. How [government officials] assume people live their lives is very different from the reality.”
Mahmood said guidance at local levels had been much better than that offered by the national government. She said local authorities in Birmingham had provided public health advice translated into other languages, and that such targeted measures were helpful in communicating the best ways of fighting coronavirus.
CNN has contacted the UK government for comment on Mahmood’s remarks.
Mahmood said she was concerned that negative cultural stereotypes had grown due to the pandemic. Anti-racism campaigners in the UK have warned that Muslim communities are being blamed for the spread of Covid-19.
“Part of the narrative is ‘Oh, they must not be compliant [with restrictions],'” Mahmood said. “It speaks to the fact that you can’t do right for doing wrong. Minority communities are held to a standard that others are not.
“When you get back to a house of eight, you [may] infect more people than if you go back to a house of two,” she said. “It’s not a story of lack of compliance, it’s just unlucky.”
For similar reasons, some equality campaigners say the structural issues affecting BAME communities are of greater importance than cultural norms.
“We want to focus on structural inequalities,” Halima Begum, director of the Runnymede Trust, told CNN. “Because even if you wanted to live in a multi-generational household, you’d expect there to be enough space for all of you — space enough in which you can distance. The lack of space means it’s overcrowded — so [the spread of the virus] comes down to a lack of hard cash.”
A recent Runnymede Trust report found that BAME people were more than twice as likely as White people to live in households of five or more.
“Larger household sizes were found to be more common among people of Indian, Pakistani, Bangladeshi and Black African backgrounds,” the report noted.
“Nobody wants to be living in an overcrowded home,” Begum said. “But a lot of young ethnic minority people are working class. They end up living with their families until they are a lot older. Often they can only afford to move out when they’re married and have a dual income.”
Begum, like Mahmood, hopes that government solutions can help ease the burden on those in larger households.
“The government should establish a good test and trace program,” she said. “And [there should be a system where] if you can’t isolate properly in a multi-generational household, you can request government support.”
England does have a NHS Test and Trace system, designed to the curb the spread of the virus, but it has come under heavy criticism over delays and administrative issues.
Mahmood said many of her constituents had expressed concerns over housing issues during the pandemic.
“People are now hyper-aware of the risk that younger members of the family may bring the virus in,” she said. “But some people want the family structure around them. I’ve had conversations where people have said: ‘No, we’re not going to split our household apart because of the virus.'”
At the Akbars’ home, Salma spent some time isolating in the loft after having a cold.
“She didn’t come down from the loft until she knew it wasn’t coronavirus,” her father told CNN, explaining that the whole family was getting used to making adjustments because of Covid-19. “You can’t just walk into the house and chat to grandma.”
In Blackburn, Saima Afzal said being around her four-year-old granddaughter had kept her cheerful, even while coping with illness and the pandemic.
“We’re so, so careful,” she said. “I feel that I’m so lucky that I live in this household. Yes, there are risks, of course. But if I didn’t have my son and my family support network I don’t know what I’d have done.”