Remember that old joke they used to tell — and maybe still do — in luxury retail circles? The customer, precious product in hand, walks over to a haughty sales clerk at a high-end emporium and timidly asks: “How much does this cost.”

“If you have to ask,” the sales clerk smiles back, “you can’t afford it.”

How much more unequal have we become in 2020? This question demands that we turn that old joke inside-out: We have to ask because we can’t afford not to know. And we can’t afford not to know because inequality is killing us. We have to know exactly what we’re facing.

And what we’re facing, the economists Anne Case and Angus Deaton have just reminded us, doesn’t look good. Yes, they acknowledge, we most certainly will be getting the pandemic much more under control over the course of the year ahead. But that will just leave us with an intolerable status quo ante, with “deaths of despair” — suicides, drug overdoses, and liver disease — taking lives by the tens of thousands.

In 2019, the last full pre-pandemic year, “deaths of despair” felled 164,000 Americans, almost triple the annual total a generation earlier. These deaths may well increase significantly in 2021, Case and Deaton fear, “as the structure of the economy shifts.” Many more people will be working remotely post-pandemic than before Covid-19 first hit. Downtowns will be losing service jobs on a permanent basis. The resulting disruptions will likely seriously expand the ranks of the despairing.

But we will have more than deaths of despair to fear. Covid-19 will indeed eventually ebb, but inequality is slowing that ebbing. One reflection of inequality’s sobering impact: We’re now privileging the already privileged in the emerging chaotic rush to administer precious life-saving vials of vaccine.

“Rural areas and towns with smaller populations are being trampled in the stampede,” notes science writer Leigh Phillips. “The regions and hospitals able to bid the highest are not necessarily the ones most in need.”

Our corporate vaccine makers, meanwhile, are fighting all efforts to move vaccine patents into some sort of emergency public domain status, a step that would enable wider and faster vaccine manufacture and distribution, especially within poorer societies worldwide.

The prime argument Big Pharma is making against patent reform? Pharmaceutical firms, the argument goes, will have no incentive to develop vaccines if they can’t count on their patent-guaranteed market power, an incredibly cynical defense, observes science analyst Phillips, given that “almost every penny of the cost of research, development, and manufacture” of the Covid-19 vaccines has come from government grants and contracts.

Still another key reason inequality is slowing progress against the pandemic: The less equal societies become, the less they seem to trust science.

So suggests the University of Melbourne’s Tony Ward, based on his analysis of data published this past October in the Swiss journal Frontiers in Public Health. The journal surveyed over 25,000 scientists worldwide about their Covid-19 experiences, and one of the survey questions asked scientists whether lawmakers in their nations had used scientific advice to inform their pandemic strategy.

The results varied substantially. In some nations, large majorities of scientists felt that their governments were listening to what they had to say. In the ferociously unequal United States, only 18 percent of the scientists surveyed felt that government officials were taking what they were saying into account.

On average, notes the University of Melbourne’s Ward, trust in what scientists have to say appears to decrease as the level of inequality within a society increases, with an increase of one percentage point in inequality “associated with a decrease of 1.5 percentage points in listening to scientists.” Inequality, Ward concludes, makes for “a corrosive solvent.”

Maybe corrosive for science, but not for grand fortune. Those who sit at the top of the world’s most unequal societies have seen their fortunes explode, not corrode, over the past pandemic year. U.S. billionaire net worth has soared by over $1 trillion, Institute for Policy Studies research shows, since the pandemic first hit at full blast. The nation’s top 10 billionaires alone now hold a combined fortune worth over $1 trillion.

Researchers at Forbes, meanwhile, have found 50 new billionaires in the global health care sector. Vaccines have generated some of these fortunes, but, Forbes adds, “companies developing antibody treatments and drugs to help doctors fight the virus have also benefited from the market frenzy.”

The bottom line: We may have just experienced the greatest ever single-year redistribution of wealth to the already wealthy. In some corners of the world, even mainstream voices are taking notice. In a year-end editorial, for instance, the Korea Times — the English-language version of one of South Korea’s top daily papers — is decrying how the pandemic is making “the poor poorer, the rich richer.”

Covid has wrought “devastating havoc,” the editorial continues, and “deepened the growth imbalance between rich and poor countries.” Societies everywhere need to “take the coronavirus-triggered divide seriously” — and with more than the “empty slogan of inclusive growth.” That will require, the Korea Times concludes, real moves “to expand the social safety net and promote income redistribution.”

“Influencers” worldwide need to be sounding that same alarm. Our task for 2021 could hardly be clearer. We have to prevent our societies from returning to — our deeply unequal — business as usual.

This post was originally published on Radio Free.