COVID-19 has infected hundreds of thousands of people globally, bringing a range of primary and secondary effects on several individuals and communities. Domestic violence organisations report there has been an increase in household tension and domestic violence as a result of forced coexistence and economic stress along with fears about the virus (Roesch et al, 2020). The COVID-19 pandemic has also restricted access to support services for survivors, particularly in the health, police and justice sectors.
It is women who are affected more than men by the social and economic effects of infectious-disease outbreaks, bearing the brunt of care responsibilities as schools close and family members fall ill. Although more men than women worldwide may have contracted COVID-19, women struggle from a number of perspectives: physically (domestic violence), financially (their livelihoods) and emotionally (including their sexual and reproductive health) (Wenham et al, 2020). Every government has a responsibility to keep all of its citizens safe, supporting all of those at the margins—this is just as true during a pandemic.
COVID-19 has emphasised, as have previous outbreaks, such as Zika and Ebola, how societies are dependent on women on the front line and also at home. It has also revealed structural inequalities across every domain from health to the economy, security to social protection (UN Women, 2020). Women and girls face disproportionate impact in times of crisis, when resources are stretched.
Besides domestic violence, another aspect is a reduction in the autonomy and self-determination of women and girls, harming their health and wellbeing. Humanitarian emergencies have the potential to cause disruption and to limit the provision of sexual and reproductive health services. Access to safe abortion services and contraception can be interrupted, with some seeing the provision of these services as non-essential. Disruption of termination of pregnancy services can lead to the performance of unsafe abortions. Legislation was changed in England in March 2020 to allow medical abortion at home through the use of mifepristone and misoprostol to terminate pregnancy after a telemedicine consultation with a health professional.
Women have a higher representation in those sectors that are laying people off as a result of the financial impact of COVID-19, including hospitality, retail, domestic work, home-based work and travel. Many women have had to stop work during lockdown to attend to care responsibilities in the home. The economic costs of COVID-19 are likely to be worse for women, as women work in more precarious employment than men (European Institute for Gender Equality, 2021) and many governments appear to have overlooked this.
Any data derived during the COVID-19 pandemic need to be disaggregated, by doing this more effective interventions can be put in place, supporting policies and strategies used to address the underlying health inequities to ensure no one is left behind. Lessons from past humanitarian crises must be taken on board to identify what is best practice and share initiatives so as to inform nursing's future response to pandemics and outbreaks. Making any response to the COVID-19 pandemic is not just about correcting any long-standing inequalities, it must also be about building a world that is robust and in the interest of everyone, with women at the core of recovery.