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Dear Editor: The current coronavirus pandemic has been frequently called a “great leveller”—it is not. It is an “inequality virus”(McGreal 2020) which has disproportionately affected marginalized groups, through both its unequal health burden and its disparity of economic losses. From the Spanish flu to the most recent H1N1 pandemic in 2009, historical evidence highlights the role of social inequalities as fuelling the spread of infections and the extent of their health impacts, by amplifying predisposing conditions related to living and working environments—which in turn provide susceptible hosts and “hot spots” for pandemics to thrive (Farmer 2001; Zhao et al. 2015). We discuss the key contributors to this inequality and make practical recommendations for public health decision-makers.