Intended for healthcare professionals

Feature Essay

Love in the time of coronavirus

BMJ 2020; 369 doi: (Published 06 May 2020) Cite this as: BMJ 2020;369:m1801

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  1. Iona Heath, retired general practitioner
  1. London, UK
  1. iona.heath22{at}

In the defining crisis of our times, one thing underpins actions, decisions, politics, and healthcare: love, writes Iona Heath

John Berger’s 1995 novel To the Wedding1 was written in response to the horrors of the AIDS epidemic, which had a much higher fatality rate than covid-19 and an age profile affecting children and younger adults disproportionately. Responding to that first decade of the AIDS epidemic, Berger wrote:

We’re living on the brink, and it’s hard because we’ve lost the habit. Once everybody, old and young, rich and poor, took it for granted. Life was painful and precarious. Chance was cruel.

The fortunate inhabitants of the richer countries of the world had lost their painful familiarity with the arbitrariness of death.

For two centuries we’ve believed in history as a highway which was taking us to a future such as nobody had ever known before. We thought we were exempt . . . Now people live to be much older. There are anaesthetics. We’ve landed on the moon . . . We apply reason to everything. We forgave the past its errors because they occurred in the Dark Ages. Now, suddenly we find ourselves far from any highway, perched like puffins on a cliff edge in the dark.

Back in the 80s and 90s, stigmatised minorities were perched on the cliff edge. Now, we all are, although the current virus seems particularly skilled at exploiting almost every dimension of pre-existing disadvantage, systematically picking on people who are poor, old, or imprisoned, who live in overcrowded conditions or are from black and minority ethnic communities.

Before AIDS, SARS, Ebola, and now covid-19, it was tuberculosis, the plague, cholera, typhoid, and influenza that cut swathes through the populations of the world. Perching like puffins on the cliff edge is the historically normal …

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