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Views And Reviews Wounded Healer

Clare Gerada: Tackling intersectionality must be our post-covid legacy

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n766 (Published 23 March 2021) Cite this as: BMJ 2021;372:n766

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  1. Clare Gerada, GP partner
  1. Hurley Group, London
  1. clare.gerada{at}nhs.net

A year ago I became infected with covid-19—a gift from New York, where I was attending a large medical conference. There were only a few cases, all apparently contained among tourists on a cruise ship docked in the harbour. President Trump was reassuring American people that “it” (the virus) was all under control and would soon disappear. On the day I left, the governor declared a state of emergency—not because I was leaving, but because of a large new outbreak away from the ship.

I was staying in Times Square in a large international hotel, packed with tourists from around the world, including a large contingent of students from Italy. Everyone felt some slight anxiety, but the virus wasn’t the topic of conversation, and no one was really concerned about anything other than whether their travel plans would be affected.

I’m not sure whether many of us really understood what a “pandemic” meant—certainly not with respect to the global disruption it’s brought to our lives since March 2020. Few could accurately predict its full impact. The latest pandemic before covid-19 was HIV/AIDS nearly 40 years ago—which, even while it was ravaging certain societies, communities, and countries, largely passed most of the world’s population by.

We now have a vaccine and, with it, a glimmer of hope that life can soon return to normal. As we emerge from the crisis we’ll reflect on what the pandemic has meant to us on a personal level, as well as its impact on our families, friends, colleagues, and communities.

This reflection will also form part of the NHS’s recovery. The NHS, an organisation that’s been part of my life for more than 40 years, has been at the centre of the UK’s response to covid-19. We have seen our professional lives changed overnight, and many will never return to pre-covid ways, as systems, policies, practice, and teams have transformed to accommodate new ways of working.

However, hope is in the air. Many of us are already coming together remotely, to mourn our losses, celebrate our successes, and think about the future, and we’ll continue to do so once we can meet in person. The hope is that introspection among our global leaders has also begun and will accelerate as countries, government institutions, and international organisations conduct inquiries into their handling of the pandemic. Although we’ve yet to see any evidence of this.

An important lesson I’ve learnt is that covid-19 (like HIV, decades ago) has exposed the impact of intersectionality1—how characteristics such as class, sex, ethnicity, and disability combine to create interdependent and overlapping systems of discrimination, entrenching disadvantage. Future inquiries must tackle their origins and find solutions: this must be our post-covid legacy.

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