Hundreds of new cases of COVID-19, or coronavirus, are being reported daily as the virus continues to spread to new countries. The virus is currently spreading through the US and the first deaths have been reported in Washington State. COVID-19 has now truly reached global proportions and the World Health Organization (WHO) is encouraging governments and the public to be prepared.
How the world is reacting to this global emergency is raising some serious ethical questions about the responsibilities of the public as well as governments. Fortunately we are living during a time where we have tested and created effective medical and ethical frameworks to guide response to this epidemic.
Some public obligations regarding virus containment are:
Wash your hands and get a flu shot — Read this quick New York Times blog, by IU Center for Bioethics faculty Aaron Carroll, laying out the easiest ways that the public can and should act in order to prevent the spread of this and other virus.
Be informed, but do not overreact — The WHO posts daily situation reports, compare the numbers for yourself and keep things in perspective. Get answers to your questions from reliable sources. WHO Q&A on COVID-19 is a good place to start and for state information visit your local state health department’s website. Here in Indiana the Indiana State Department of Health has created a COVID-19 page that is updated daily with relevant information. If you listen to podcasts, IU Center for Bioethics faculty Ross Silverman was on The Week in Health Law talking about the legal and public health perspective of this outbreak.
Rational use of resources — Should you wear a mask? The ethical answer is, only when necessary and educate yourself on the proper use of masks. People with no respiratory symptoms should not be wearing medical masks. This overuse of medical equipment leads to shortages for those who really need them, medical professionals and those caring for the sick. The best way to prevent the spread of this virus is to wash your hands frequently and properly.
If you are sick, stay home — social isolation is the best way to stop the spread of this and any virus.
Ethical issues that arise from this type of medical state of emergency are many and governments have an obligation to respond morally. Having an ethical framework ready for such a situation is crucial in order to promote, protect, and provide for the health of all residents in the community.
Some government obligations regarding virus containment and treatment are:
Allocation of medical equipment — during times of emergency, governments have to make difficult decisions about scarce resource allocation. Having an ethical framework in place helps to ensure that it is done responsibly. This technical advisory document, created by the IU Center for Bioethics and the Fairbanks Center for Medical Ethics, provided an ethical framework for Indiana State Department of Health to build a preparation plan for the event of an epidemic.
Restriction of individual freedom — in China and elsewhere, during this outbreak, we have seen quarantine restrictions that are not evidence-based in effectiveness and infringe on individual liberty. Cordon sanitaire, the erecting of either virtual or material community-wide barriers restricting travel in and out of a geographical area, should not be used in an attempt to control the spread of disease. They disproportionately affect the most vulnerable members of society and carry heavy social costs such as erosion of public trust.
Closing state or international borders — similar to Cordon sanitaire, this is neither an effective nor ethical reaction from governments to quell the spread of disease. Russia has restricted travel between its borders with China since the end of January. These types of restriction increase risks to the most vulnerable and lead to xenophobic discriminatory acts by government and the public at large.
Ethnocentric blame of disease spreading — governments must avoid singling out certain ethnicities or religious groups. This practice has strong ties to countless historical instances of mistreatment and should be avoided at all times. The virus does not care where someone was born, the color of their skin, nor the god(s) they worship.
COVID-19 is presenting the world with a unique opportunity to prove just how far we have come from the mediaeval practices that have been used in the past. Implementation of rational, ethical, and effective measures is the only way forward. So don’t panic or blame, be prepared but don’t overreact, and if all this is just too much I implore you to remember this one thing—wash your hands.
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Graduate Assistant, IUSM Center for Bioethics
Heather is currently pursuing a graduate degree of bioethics at IUPUI. She is also a GA in the IUSM Center for Bioethics and the Brand Fellowship for Bioethics recipients for 2019-20.