Published: 28th July 2020 Professor Iyiola Solanke – PLP’s newest patron – has written a guest blog drawing on her keynote speech from our July conference, The Equality Act 10 years on: Where are we now? There are currently two viruses causing death and destroying lives around the world: one is coronavirus, the other is discrimination. There are similarities between viruses and discrimination: neither can be seen with the naked eye yet victims recognise how they sound and feel – they experience the results of the infection; both are highly infectious and can pass from one person to another rapidly, often without recipients being aware that they have been infected; and both can maim and kill, having the potential to affect the life of a victim every day for a lifetime. A public health strategy has been successfully adopted in Glasgow to tackle violence – can the same be adopted to tackle racism? A key public health goal is to ‘break the chain of infection.’ There are 6 key elements in the chain of infection, beginning with identification of the ‘infectious agent’ – the thing which causes infection and potential death. In the case of COVID-19, this is a virus. The second element is the reservoir, or the place where the infectious agent grows and develops – for COVID-19, people are the reservoir. Thirdly it is important to identify the ‘portal of exit’, or the way in which the infectious agent leaves the reservoir – for COVID-19, this has been identified as bodily secretions including mucus and sputum. Fourthly, the mode of transmission, or how the agent spreads, must be known – for COVID-19, this is through airborne droplets. The fifth element is the ‘portal of entry’, or the way in which the infectious agent enters a host – as we know, COVID-19 enters through the respiratory tract. Finally, the chain of infection identifies the ‘susceptible host’, the traits that individuals have which make them susceptible to infection and illness – in the case of COVID-19, this includes age, gender and possibly race and ethnicity – South Asian men have been identified as having the highest rates of infection and death. The cruel irony of the analogy is that, as the PHE Report clearly shows, those who suffer the most from COVID 19 are also key targets of discrimination – the medical virus maps onto and magnifies the virus of racism. It attacks the weakest parts of society, just as it attacks weak parts of the body. The chain of infection could be adopted to effectively tackle racism. The infectious agent could be both words and images, both those that are included as well as those that are omitted. The reservoir – the place where the virus grows – could include locations such as educational curricula or television scheduling that contains little or no contribution from Black and minority ethnic experts or scholars. How does the infectious agent leave the reservoir? The portal of exit might be practices and policies, for example those that create racially homogeneous institutions or degree awarding gaps. The modes of transmission, or the way in which racism spreads, are likely to be direct and indirect: from person to person as well as via social and traditional media. The portal of entry is likely to be multiple – verbal, visual and aural – for example images that present black men as criminals rather than judges, entrepreneurs or astronauts. Finally, in thinking about a susceptible host in relation to racism, we could consider whether the lack of organisational leadership and anti-racist policies increases the likelihood of susceptibility to racist ideas. Ultimately, in public health, success depends upon a very high level of co-ordination and co-operation with national authorities, between the public and private sectors, teaching hospitals, universities and volunteers. As is clear, tackling COVID-19 is everybody’s business – those who suffer are not left to overcome the virus by themselves – and the same applies to discrimination. Infection control (eg. litigation) is just one form of action: a broader set of interventions are equally vital to halt the spread of the disease. Interventions to reduce or remove risks in institutions and the environment are the norm rather than the exception – the public or social aspects of the epidemic must be addressed in order to break the chain of infection. The faster, more co-ordinated and more committed the reaction to a virus, the more effective it is – interventions are joined up for maximum impact. Imagine if we use this approach to tackle discrimination: if discrimination is viewed as a virus, a public health style intervention focusing on breaking the chain of infection could help us to more effectively tackle and perhaps even eradicate it. As Patron, I am excited to be working with PLP to achieve this goal.