The “Second Pandemic”: Taking a look at structural inequality in the context of the COVID-19 pandemic in Europe


Early in 2020, media coverage emphasized the “unprecedented” nature of the pandemic. Memes depicted humanity, caught in a single boat out at sea, amid various calls for solidarity: in Italy people sang from balconies, in the UK neighbors joined in the evening to clap for the NHS, in Germany kids stuck rainbows in their windows with hopeful messages.

Yet, while there are many novel aspects to the COVID-19 pandemic, there are also many ways in which the pandemic has exacerbated familiar fault lines of inequality and pre-existing socio-economic disparities. While the story of this pathogen continues to evolve, it is apparent that the effects of the pandemic have been felt most profoundly by the most vulnerable: those who are homeless, incarcerated, or migrant; those living in poverty, refugee camps, crisis zones, or unsafe domestic settings; those living with pre-existing medical conditions.

During the pandemic, far-reaching societal prevention measures, such as ‘lock-downs,’ have been imposed, health resources reallocated, and non-COVID-19 care postponed or cancelled. In the media, public debates on pandemic response have often pitted public health against public wealth, as though pandemic responses required choosing one over the other.

Drawing on longitudinal data from qualitative interviews conducted as part of the ‘Solidarity in times of a pandemic’ Consortium (SolPan), we looked at the reported effects of the pandemic on health and wealth across 6 European countries. Drawing from an analysis of 482 interviews across Germany, Italy, Ireland, Austria, German-speaking Switzerland and the UK, we found that the supposed dichotomy between life and economy quickly broke down in the tensions and connections that were woven within participants’ own accounts of how inequality is reproduced.

Health- and wealth-related inequalities intersect to create the “second pandemic,” a term that we borrow from one of our participants to explain the various forms of devastation that accompanied the pandemic. Our study thus complicates dichotomies of health and wealth through a qualitative understanding of the pandemic as a lived experience.

Key themes that emerged from our analysis include:

1)    Participants were concerned that the pandemic had compromised the delivery of healthcare, and that individuals who were socioeconomically disadvantaged would be less able to compensate for this.

2)    Participants expressed a need for more governmental support, while also pointing out that many of the existing initiatives failed to reach those who most needed them.

3)    Participants were worried about some people being more at risk of infection due to their jobs, or because they lived in precarious conditions that affected their ability to comply with safety measures.

4)    Participants expressed fear, anger, and sorrow for their own or others’ economic struggles.

5)    Participants observed that social groups that were already vulnerable, such as ethnic minorities and migrants, were exposed to further segregation and discrimination through the pandemic.

6)    Participants were concerned about the widening of the socioeconomic gap, and criticized privatization and austerity as upstream causes of the crisis.

We argue that rather than creating new social and economic inequalities out of whole cloth, to a large extent the pandemic has reinforced structural ones, made them more visible and exacerbated them, by worsening the conditions of the worst off. The pandemic emerges as a critical juncture which, in exacerbating these existing structural inequalities, also poses an opportunity to work to better resolve them. Understanding the pandemic as a lived experience, refracted through the particularities of individual biographies and local circumstances, will be vital for crafting global health responses that indeed aspire to ‘leave no one behind.’


This article is a summary of a scientific article. The full text can be found here:

Amelia Fiske, Ilaria Galasso, Johanna Eichinger, Stuart McLennan, Isabella Radhuber, Bettina Zimmermann, and Barbara Prainsack. 2021. “The second pandemic: Examining structural inequality through reverberations of COVID-19 in Europe,” Social Science and Medicine. doi:

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