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The Ongoing Pandemic: An Urgent Call to Global Solidarity
By Andrea Vicini, SJ
Health is a very fragile good. As human beings, we try to protect it, both in our own lives and in those we care for. At the beginning of each class, in the current course “The Ethics of the Global Public Health and the Common Good,” with my students we update one another on the progress of the global pandemic caused by the Coronavirus named COVID-19. We share newspapers’ stories and scientific findings. We comment on the sheer numbers of those affected and of those who died, wondering how those numbers might still be imprecise and somehow inaccurate. Behind those numbers, however, there are the faces and stories of those many thousands who are infected, sick, isolated, and hoping to recover.
Moreover, in mainland China millions live in locked or partially locked cities. According to some estimates, five hundred million people live in these cities. Reuters reports:
As of February 14, at least 48 cities and four provinces in China have issued official notices for lockdown policies, with measures ranging from ‘closed-off management,’ where residents of communities in a city or province have to be registered before they are allowed in or out, to restrictions that shut down highways, railways and public transport systems.
In human history, we never faced situations in which we tried to contain and mitigate the spreading of a viral infection by implementing social measures in these proportions. How are these millions of people coping with what is disrupting their lives so forcefully? When this crisis will end? Both an optimistic and a worst scenario have been proposed, but we cannot yet anticipate which one will be accurate. When the whole world will be able to look back and assess the human, social, and economic cost of this pandemic?
Dramatically, the sheer vastness of this pandemic shows our collective, global vulnerability, which is added to the other pandemics–HIV/AIDS, tuberculosis, malaria, and the seasonal flu–with their continuous burdens on people and countries.
Our hope is that while we realize and experience anew the extent of our fragile health and vulnerability–individually and globally–we might long and strive for a renewed, concrete solidarity among people across races and cultures, with the desire and the commitment to help each one, as we would want anyone to help us in our times of need.
Who Do We Believe?
By Nadia Abuelezam
Assistant Professor Connell School of Nursing
If you’ve taken a public health class on campus, you know that public health is a data centered discipline. We like numbers, figures, and graphs. But public health practitioners need to be more than just consumers and collectors of good data (“data people”), they need to also be “people people.” Public health practitioners need to understand the needs, the desires, and the ailments of the populations they serve. This means public health practitioners must have good qualitative skills to systematically understand the needs of populations and the social determinants of health.
I can’t help but feel like the past few weeks of health headlines point to the fact that society is not doing a good job of listening to people and their needs. Here are some headlines that suggest a need for better understanding:
- Stephanie Snook, an indigenous woman aiming to shine light on maternal mortality statistics among Native Americans, died from cardiac arrest during her third trimester. She had been engaging with NBC News reporters to better understand maternal mortality rates in her community. She complained of pain and told her doctors that she felt she had dropped early, but her concerns were ignored. When will we start listening to women of color about their health concerns?
- A Chinese doctor who aimed to alert his colleagues about the potential danger of the new coronavirus died from the disease itself. While there is an investigation underway about what happened, it is clear that this doctor was trying to prevent new infections of this fast spreading disease. When will we start paying attention to warning signs of fast moving epidemics and the people who observe them?
Whether people are whistleblowing and telling us that something might be wrong in their communities or whether its people telling us they need more support, something we can learn from the past few weeks is we need to do better at listening and understanding the needs of underserved populations. That means that as a future public health professional, it’s important to keep your ear to the ground and be receptive to patterns, trends, and observations that may feel foreign or new. It’s only by keeping an open mind (and heart) that we can begin to understand the needs of others and go on to improve their health.
A Public Health Nightmare: Coronavirus
By Dr. Erika Sabbath
Assistant Professor, School of Social Work
It’s a public health nightmare scenario. Days before the Lunar New Year celebration during which many people in China travel, a mysterious and unknown respiratory infection with a high case fatality rate emerges in Wuhan, a Chinese city of 4 million people in Hubei Province. (For context, Wuhan is the size of the Boston metropolitan area; Hubei Province is home to 59 million people, 1.5 times the population of California). With 2,700 cases of the novel coronavirus (nCoV2019) reported in China as of Monday, 80 dead, and cases reported in 10 countries (including the U.S.), the Chinese government opted to take extreme measures to contain the virus after initial critique that they were downplaying risk and that inaction was accelerating the spread. They implemented a “cordon sanitaire,” or a total shutdown of all routes in and out of Wuhan in order to keep the disease from spreading. A cordon sanitaire is more restrictive than quarantine, in which exposed people are isolated to their homes for a defined period of time. After a surge in cases over the weekend, 12 other cities in Hubei Province issued travel restrictions, and Beijing announced the suspension of inter-province bus travel into the city. Coronavirus has a long incubation period (up to 14 days), during which an infected person can spread the disease before they know that they’re sick.
While a cordon sanitaire sounds like a good way to contain the virus, public health experts feel that it may be too late for this measure to actually stop the spread out of Wuhan, given that the disease had already begun spreading when the shutdown was implemented. There is fear that such blunt measures are human rights abuses because they trap healthy people in infected cities and expose them to the virus, rather than letting them protect themselves by leaving. But from a population perspective, and thinking about primary prevention, maybe this drastic measure is necessary. Locking down major cities like Beijing before the virus arrives—and preventing travel from affected areas like Hubei Province—may indeed be the best way to protect the unexposed in the world’s most populous country, and the rest of the planet. So whose rights matter more? How can we protect the most people from this disease, and what restrictions to individual rights can we tolerate in the name of protection?
Making public health decisions in the midst of an outbreak of a novel virus is one of the most difficult parts of public health practice because the facts change every day, but changing course to align with new developments can erode public confidence. Yet we are charged with protecting the public’s health with the best information available at the time.
P.S. Here’s some information from the CDC about nCoV2019
Note: the statistics and other facts in this article were accurate at the time this was written (morning of 1/27/2020) but as noted above, it’s an evolving situation.