What has COVID-19 taught us about how we understand care?

Felicity Daly, Claire Edwards, Cliona Loughnane, Carol Kelleher & Jacqui O’Riordan

The COVID-19 pandemic has required a care response unlike any seen in modern times. The outbreak has shone a harsh light on our collective reliance on frontline healthcare workers, the informal care provided in families and communities and has brought previously obscured gaps in care to the fore. Ireland’s ‘care crisis’ became obvious as COVID-19 outbreaks in nursing homes precipitated the deaths of over 1,000 residents and almost a fifth of the population cared for someone as a result of the pandemic. Meanwhile, quarantine measures significantly reduced home care hours for older people and people with disabilities and simultaneously increased their isolation.

Care has ‘come out’ in this pandemic and is no longer an afterthought in public life, as we recognise the care needs that must be met by families, communities and the State through public services. Often regarded as ‘women’s work’, care has typically been negotiated behind closed doors and within personal relationships, rather than seen as an issue of public and political concern. Recently the Citizen’s Assembly on Gender Equality recommended that the State revise the outdated language in the Constitution about women’s caring within the home and issued a series of recommendations to improve care policy and practice. Yet despite the growing public recognition of the importance of care, there remains a real need to rethink how we understand it as a concept and a value in Irish society.

As part of the three-year CareVisions research project hosted within the Institute for Social Science in the 21st Century (ISS21) at University College Cork, we are exploring how we might imagine a future ‘care-centred society’ by reflecting on the challenges and inequalities that COVID-19 has revealed in Ireland. Drawing on ideas from the feminist ethics of care our research begins from the starting point that we need to re-assert the importance of care in our lives and our politics, and challenge some of the taken for granted understandings of care that currently exist in society.

One of these understandings relates to how we think about care itself as an activity. Care is often understood as something that is done to one person (the care receiver), by another (the care giver). Requiring care or support in this context is often interpreted negatively and associated with the idea of deficit or dependence; the work of providing care is also frequently devalued. However, another way to look at this is that we are all interdependent – that is, as humans we have a universal need for care and will all experience intersecting roles of carer and cared for throughout our lives.

Another of these understandings concerns who is recognized as requiring care in society, particularly from the perspective of governments and policymakers. For example, while older people living in nursing homes have quite rightly received significant attention during the pandemic in Ireland, far less focus has been placed on some other groups who have also been disproportionately affected. The significantly higher COVID-19 death rates for people with disabilities (41 per 100,000 compared to 23 per 100,000 people without a disability), for example, are of acute concern, with the Irish Human Rights and Equality Commission criticising the lack of measures to address the impacts of the disease on people with disabilities.

Asylum seekers and refugees have also been left gravely exposed to COVID-19. A survey of people living in Direct Provision and emergency accommodation found that 55% of residents felt unsafe during the pandemic and 50% were unable to socially distance themselves from other residents.  Yet these experiences, and asylum seekers as a group, have been largely hidden from view in public conversations about care during the pandemic.

In reframing care then, we need to widen our view of who care givers and receivers are and recognize the challenges that different groups face in accessing care. More importantly, we need to consider what ‘good care’ might look like in a post-pandemic world. This inevitably means focusing attention on care as a political concern, recognising how care is part of the structures of our society and addressing inequalities in current care systems. Disparities in provision of health and social care services, lack of supports for unpaid carers, and the low paid, feminised nature of the care work sector are all part of the complex picture of care inequalities.

As we recover from the pandemic there is an opportunity to re-think care responses by interrogating how care is provided and valued in Irish society, and globally. Thinking beyond the idea of care in terms of interpersonal relationships, we can also see how it is vital to so many of the converging global crises that we find ourselves in, from the environment, to the economy. Researchers from a variety of fields see this as a crucial moment to consider the future direction of societies, as the shared response to the pandemic has revealed that human well-being, rather than economic growth, ought to be the key priority for the future. They suggest that our recovery from COVID-19 will require more people employed in care and greener investment, amongst other things, if we are to create more caring and sustainable societies.

There are then profound questions to be asked about care in post-pandemic Ireland:  how we define care and care needs, how COVID-19 has impacted on the provision of care services, and, importantly, whether and how care can remain a central concern in politics? By drawing on the experiences of care givers and care receivers during the pandemic, and initiating public conversations through citizens’ panels, CareVisions aims to address these questions by asking what a care-centred society might look like in Ireland and beyond.