Policies to addressthe impact of Covid-19 on low income energy consumers have rightly focussed onenergy bills, particularly in the context of home confinement and increasedenergy consumption. In the longer term, however, we need policies to improvehome energy standards. The evidence shows that higher standards reduce the riskof getting a respiratory illness, improve the health of those already with arespiratory illness, improve the ability of our immune systems to fight offillness and reduce the use of health services.
Blog by FPRN’s William Baker, Aimee Ambrose, Jenny Brierley, Danielle Butler, Robert Marchard and Graeme Sherriff. Published 13th May 2020
Home confinement and energy bills
While total energy consumption has declined due to shuttingdown large sections of the economy, domestic consumption has increased. Uswitchestimates that home confinement will cost the average energy consumer an extra £16 per month [1]. This is due to putting theheating on when it wouldn’t usually be, using extra gas and electricity forcooking, making cups of tea and increased use of televisions and computers.These costs are likely to be higher for people living in homes with poor energystandards. Even in normal circumstances, it costs £2,000 per year more to heat ahome rated EPC G to adequate standards than a home rated EPC C or above [2].
The Government, Ofgem and energy industry recently reached an agreement to support low income consumers [3]. Withrespect to the 4 million prepayment meter consumers, many of whom may be struggling to keep their meters in credit, supplier support can include adding discretionary credit or sending a pre-loaded top up card. For other consumers in financial distress, suppliersupport may include debt repayments or reassessment of bill payments, reducedor paused where necessary. Disconnection of credit meters is completelysuspended.
Welcome as these measures are, suppliers still expect consumers to repay the amounts owed. Many low income consumers will be anxious about how they can afford the extra energy costs entailed by home confinement. Many will try to cope by rationing their fuel use. The recent advent of warmer weather and therefore lower heating requirements may help reduce these concerns (although other energy requirements will remain high). However, they will inevitably rise again this winter with the number of households in fuel poverty also likely to swell, given the rapid growth in job losses.
The implications for people suffering from Covid-19, particularly those with existing respiratory conditions, are even more serious. A brief review of the evidence on the association between cold homes and respiratory illness suggests there are important lessons for long term policy.
Cold homes and respiratory illness
Cold homes greatly increase thelikelihood of damp or mould growth. NEA’s ‘Underone roof’ gives a useful overview of their association with respiratoryillness [4]. Damp and mould are associatedwith a 30-50% increase in respiratory problems. Children in cold homes are more than twice as likely to sufferfrom asthma or bronchitis than children in warm homes. Studies also show a strong dose-response relationship between theseverity of damp and the severity of respiratory obstruction. Cold homes and unaffordable fuel billsalso have a significant deleterious impact on mental health [5], which home confinement will inevitablyexacerbate.
But there is also evidence that improving warmth in the homes can have a positive impact on people with respiratory conditions (and on other health conditions, particularly mental health). A health impact assessment of the Nest energy efficiency scheme in Wales, for example, found that for those receiving help the number of GP visits by people with respiratory conditions decreased by 4%, compared to a 10% increase for those not receiving help [6]. The difference was even greater for those with asthma.
A Cochrane systematic review ofthe impact of housing improvements on health found that ‘housing investmentwhich improves thermal comfort in the home can lead to health improvements,especially where targeted at those with chronic respiratory disease’ [7]. Milner & Wilkinson’s review of theimpact of energy efficiency and heating improvements found an association withimprovements in respiratory and other chronic illness, reduced contact withhealth services and that for some target groups, e.g. children with asthma, theinterventions were justified in their own right for managing clinical conditions [8].
Warm homes and Covid-19
One of the striking features of Covid-19 is the extreme variation in its impact on people. Some may carry the disease without suffering any symptoms, others get relatively mild symptoms, while for some the impact is substantial, including death in the worst cases. People with existing respiratory problems are more likely to fall in the last group [9]. An important factor appears to be the ability of individuals’ immune systems to fight off the illness. While there is no specific evidence to date on whether warm homes can contribute to tackling Covid-19, the evidence suggests warm homes can play an important role in tackling respiratory illness in general:
- Warm homes enable immune systems to better fight off viruses
- Warm homes may improve the likelihood of people with viruses only suffering ‘mild’ symptoms (a wide range of other factors will also influence this); and
- Warm homes are likely to help improve the recovery process for those returning from hospital after receiving treatment for the virus (as is the case for many other illnesses).
This reinforces the importance of putting every effort into making sure people can afford their energy bills. It implies immediate help with fuel bills for those on low incomes and those with existing health conditions, particularly respiratory illness. Help that will need to be ramped up this winter, given the likely growth in fuel poverty. Schemes that only defer payment may not reassure people struggling to pay their fuel bills that they should keep the heating on.
In the longer term, we should improve home energy standards such that low income households, particularly those with respiratory and other illnesses, can enjoy warm, healthy homes and affordable fuel bills. Initiatives such as the Irish Government’s Warm and Wellbeing scheme, which is targeted at people with respiratory conditions, seem remarkably prescient in this respect [10].
A major home energy standards improvement programme will take some time to get off the ground, particularly given that ‘normal service’ is not likely to resume for quite some time. It is therefore only likely to play a limited role in the armoury of anti-Covid-19 measures. Nevertheless, there is evidence that Covid-19 will result in many people suffering long term damage to their respiratory systems [11]. It is also possible that mutations of the virus, albeit less aggressive than Covid-19, will emerge in the future [12].
Government policies to improve home energy standards
The Conservative 2019 general election manifesto promised a £2.5bn ‘Home Upgrade Grant’ scheme and a £3.8bn social housing decarbonisation scheme [13]. The new Government’s 2020 Queens Speech reaffirmed this commitment. Many therefore expected a significant announcement in the March 2020 budget. Not surprisingly, there was widespread disappointment when this didn’t materialise. Yes, money had to be found for tackling Covid-19 but £30bn was still earmarked for a massive road-building programme. It is hard to understand why roads should take priority over keeping millions of people warm and healthy in their homes.
Covid-19 has focussed minds onthe appalling impacts of virus epidemics on people’s health. But it should alsoremind us of the hardship and lives lost every year through cold homes, which Covid-19 is likely to exacerbate. The Government has had to commit vast sums ofmoney to tackling a huge public health crisis. But when the dust settles, theGovernment will need to reassess its priorities for action in the post Covid-19 world. Surely, a programme to make sure our homes are warm, healthy andaffordable to heat and power should be right up there?
This article has been published in People, Place and Policy and by the Social Policy Association.
[1] Uswitch press release (24/3/20), Stay-at-home Britons could spend an extra £52 million a week on energy bills, www.uswitch.com/media-centre/2020/03/stay-home-britons-spend-extra-52-million-week-energy-bills/
[2] BEIS (2019), Annual fuel poverty statistics report (2017 data), www.gov.uk/government/statistics/annual-fuel-poverty-statistics-report-2019
[3] BEIS (2019), Government agrees measures with energy industry to support vulnerable people through COVID-19, www.gov.uk/government/news/government-agrees-measures-with-energy-industry-to-support-vulnerable-people-through-covid-19
[4] NEA (2019), Under one roof, NEA
[5] Liddell, C & Guiney, C (2015) ‘Living in a cold and damp home: frameworks for understanding impacts on mental well-being’, Public Health 129 (2015),191 to 199
[6] Welsh Government (2019), The impact on health of the Welsh Government’s Warm Homes Schemes, Welsh Government
[7] Thomson, H et al (2013), Housing improvements for health and associated socio-economic outcomes, Cochrane database of systematic reviews
[8] Milner, J & Wilkinson, P (2016), Effects of home energy efficiency and heating interventions on cold-related health, Epidemiology, 28(1):1
[9] NHS (2020), Advice for people at higher risk of Coronavirus (Covid-19), www.nhs.uk/conditions/coronavirus-covid-19/advice-for-people-at-high-risk/
[10] SEAI (2020), Warmth and wellbeing pilot scheme, https://www.seai.ie/grants/home-energy-grants/free-upgrades-for-eligible-homes/warmth-and-wellbeing/
[11] WHO (2019), Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
[12] Broyd, N (2020), COVID-19: UK Scientists Track Genetic Code and Mutations, www.medscape.com/viewarticle/927313
[13] Conservative Party (2019), Conservative 2019 manifesto, Conservative Party