High levels of deprivation and job insecurity, vast income inequality, housing discrimination and medical disparities have long had a severe impact on the tangle of communities and ethnic minority populations that live in these boroughs. But when combined with the necessity to go to work, to take public transport and to share space in densely packed housing, they also provided the perfect breeding ground for a deadly virus. The domino effect would prove catastrophic.

For people of low socio-economic status (SES), a number of factors increase their exposure to COVID-19. Possible causal mechanisms include an increased exposure to the virus, the stress and comorbidities associated with poverty and reduced access to health care. UK policymakers rapidly identified people with multiple comorbidities as particularly vulnerable. However, they must expand their definition of vulnerability to include social factors as risks for COVID-19.