When Mariana Agiu reflected on her time as a hospital critical care nurse at the height of the pandemic’s first wave she had a startling realisation: almost everyone in the room was a woman.
"I understand the reasons why….most of us in this profession are women, from the cleaners, the healthcare systems, nurses, even [half] the doctors are female," explains Ms Agiu to The National. "It was always there, it's just that we never thought about it."
She described her experience on a Covid ward as “very draining”.
“Every day I would work hard thinking, I need to be there, I need to help. We are not enough. There are too many sick people,” she says.
Two of her female colleagues ended up in ICU themselves, highlighting the risks they faced particularly at that early stage when little was known about the illness.
As International Women’s Day is marked today, it’s worth reflecting that for the past year, female medics, scientists, health workers and politicians have played a crucial role in the battle against Covid, arguably the first global crisis that has not been a male-dominated affair.
A woman heavy front-line
Indeed, data produced in the early days of pandemic by economics think-tank, Autonomy, revealed that 2.5m out of 3.2m – or 77 percent – workers in ‘high risk’ jobs in the UK were held by women.
The analysts at Autonomy created a risk factor index by scoring how exposed to infections, and physically close to others, the jobs were. Unsurprisingly, health care workers were the most at risk of all the occupation groups. Within the top ten jobs, the nursing profession had the highest number of women, just over half a million, and 74,100 men.
Nurses have been a crucial asset, particularly during the peaks that overran some hospitals and staff. It was a female British-Filipino nurse, May Parsons, who administered the world's first Pfizer/BioNTech coronavirus vaccine outside clinical trials to Margaret Keenan, 90. It was also a woman, scientist Elisa Granato, who received the first Oxford-AstraZeneca vaccine during trials.
After the situation calmed down at the end of the first wave Ms Agiu decided to take a long break from clinical work. She now researches treatments for Multiple Sclerosis.
“There's a point where you just feel so drained that you're saying I can't cope with this anymore, I'm going to explode, I'm going to have a breakdown and I'm not going to recover. So when everything finished, I felt intoxicated, I felt like I needed to have space to go away to forget and to breathe.”
Others were shunted to the frontline at the very start of their careers.
For Molly Dineen it was out of the classroom and onto her first ever job as a junior doctor in the middle of a pandemic. Her graduation was fast-tracked a few months so she could join the ranks.
“I think a whirlwind is probably the way to describe it,” she says. “Not only have I been adapting to life as a doctor but I've been adapting to life in the pandemic and having to adapt a lot of the skills that I'd learned in medical school to work in this new way.”
Ms Dineen works in acute medicine and admits to feeling like a “deer in the headlights”.
“I think it's the intensity of entering work for the first time and I don't have support from friends and family in the same way that I would have done. And I don't have the usual escapes of hobbies and travel and all the things that I usually have as a break. So it's just been very intense. And I think that's probably mentally what's been the biggest challenge. My life has gone from being a university student to suddenly the world of work and nothing else.”
Social media support in dark times
Without the comfort of friends to turn to, Ms Dineen used her rare free moments to develop with colleagues an Instagram page called Humans of Covid. Inspired by the intimate stories captured in the internationally popular Humans of New York account, Ms Dineen says they wanted to 'use emotion' to encourage the public to follow government guidelines.
She spends her evenings interviewing other front-line workers and putting their stories and pictures on the social media page. She says it helps her and her colleagues process what they’ve been through.
“People really want to share their stories, I think it's really therapeutic for those of us on the frontline to just have a space to share what we're experiencing, and have an outlet to say this was really tough, and this is what I experienced,” says Ms Dineen.
Like that of Dorcas Baxter, an intensive care nurse who wrote that she went back to work after a three year career break because “once you’re an ITU nurse you’re always an ITU nurse.” When she finally joined her colleagues during the second wave she found “a lot of unspoken trauma” and “a lot less glory”.
Sarah Blanchard was on the medical frontline for years before the pandemic started. As one of 1,300 female paramedics – 200 fewer than male ones – she is often patients’ first contact. “We’ve had such a high increase in respiratory call intake, whether that be anxiety or chest infections, sepsis or Covid. It’s often almost impossible to tell the difference,” she wrote on the Humans of Covid page.
Her post described visiting an 80-year-old who overdosed on medication while grieving the death of his wife from suspected Covid-19. “We’ve seen a lot of pain, anxiety and suffering from the illness itself, but it’s the elderly being so lonely that hurts the most. Whenever I get called to someone elderly, I spend more time with them, because I know they might not see anyone else for a long time,” she says.
And it was also women who overwhelmingly took care of the country’s most vulnerable in the care homes which employ a whopping 650,000 women.
Ms Dineen says the demographics of engagement with the page seem to correlate with the statistics. “There's been an overwhelming response from women. And I think women really want to be proud and share the stories of their experience of the frontline,” she says. “I think we know how inspirational that can be for not just young women but everyone.
“I think this pandemic has been challenging for women in a particular way. They're trying to home school children often….and then going out on the front line. And it's just accentuating many of the challenges that we maybe already had.”
More responsibility, less pay
Not only are women more exposed to the direct effects of the virus in the workplace but the indirect effects have been acutely felt by mothers in their home space as well. By and large, it has been women saddled with the bulk of childcare responsibilities. According to an ONS survey last year, women carried out on average two-thirds more childcare duties than men during the first lockdown. For the majority of female frontline healthcare workers there were many anxious months, particularly at the start of the pandemic, when they were separated from their children.
Women have also been crucial behind the scenes. As the pandemic spills into its second year, vaccine programmes have become key to easing lockdowns and reducing hospitalisations.
Melanie Leis, Director of the Big Data and Analytical Unit at the Institute of Global Health Innovations at Imperial College, has been leading a team trying to track different attitudes related to people’s fears around Covid.
They carry out international studies to spot problem areas.
The data they gather is published weekly and helps inform decisions made by organisations such as the World Health Organisation.
She said: “There was a big gap in understanding why people would or would not adhere to guidance. Our research filled that gap. We worked with the WHO who wanted to know why people did or didn’t wear masks.
“Essentially it’s a tool to understanding people’s attitudes and behaviour to the pandemic over the year.
“We are coming up to a year’s worth of data now so we get to see a lot of trends.”
One trend stands out.
“We’ve been asking people how they feel about the Covid-19 vaccine and back in November people were very worried and concerned and saying they wouldn’t take it….and now in the vast majority of countries people are more comfortable and feel less worried about side effects and are actually saying they would regret it if they didn’t take it.
“The government should use that information to target their campaigns around what people are still worried about.”
Data analytics is a typically make environment, but that is also changing.
“I’m lucky to work in a field that is predominantly filled with men but I am lucky enough to be leading this project with another woman - Dr Sarah Jones - and we have tried to make sure that the work we do and people we hear from are wide and diverse.
She said that from the data it’s obvious that women have been disproportionately affected. They suffer higher anxiety and depression levels, for example. “This is something that was the case pre-pandemic but we think that the trend has been kept open in the pandemic,” she said.
Women have also been at the forefront of the science wielded to fight the virus. Professor Sarah Gilbert, who led the team that developed the Oxford vaccine was last week awarded a medal by Royal Society of Arts for her efforts. Katalin Kariko pioneered the research behind the mRNA technology used in the first UK approved vaccines. Dr Ozlem Tuerci is one-half of the husband and wife team who founded BioNTech, the company Pfizer partnered with to develop a vaccine.
The government’s recent budget announcement included a 1 per cent hike for NHS workers which is expected to translate into a real-term cut in pay. The Royal College of Nurses branded the proposal “pitiful and bitterly disappointing”.
Women are highly represented in many of the worst-affected industries, including healthcare, hospitality and entertainment, and the UN has already warned that women have been hit harder by worsening economics than men.
Nevertheless, according to a study done by Ipsos MORI and the Global Institute for Women's Leadership at King's College London less than one third of the British public think closing the gender pay gap should be a top priority.
Regardless of the progress needed on gender equality, it's clear to the women who spoke to The National they're aware of their value.
“When a family or a patient needs someone to talk to support…woman can cope with that more,” muses Ms Agiu, “This is what I've been observing over the years in the hospital. And I'm not saying men are not good enough because they are in their own way. But when it's about caring being there at the bedside all the time, and being patient and I think women are doing an excellent job.”