3 moral virtues necessary for an ethical pandemic response and reopening


3 moral virtues necessary for an ethical pandemic response and ...

The health and economic impacts of the coronavirus pandemic are not equally felt. From the United States to Brazil and the United Kingdomlow-wage workers are suffering more than others and communities of color are most vulnerable to the virus.

Despite the disparities, countries are reopening without a plan to redress these unequal harms and protect the broader community going forward. Our ethics research examines the potential for using virtues as a guide for a more moral coronavirus response.

Virtues are applied morals – actions that promote individual and collective well-being. Examples include generosity, compassion, honesty, solidarity, fortitude, justice and patience. While often embedded in religion, virtues are ultimately a secular concept. Because of their broad, longstanding relevance to human societies, these values tend to be held across cultures.

We propose three core virtues to guide policymakers in easing out of coronavirus crisis mode in ways that achieve a better new normalcompassion, solidarity and justice.

1. Compassion

Compassion is a core virtue of all the world’s major religions and a bedrock moral principle in professions like health care and social work. The distinguishing characteristic of compassion is “shared suffering:” Compassionate people and policies recognize suffering and take actions to alleviate it.

As the French philosopher André Comte-Sponville said, compassion “means that one refuses to regard any suffering as a matter of indifference or any living being as a thing.”

Individual acts of compassion abound in the coronavirus crisis, like frontline health care professionals and neighbors who deliver food, among other examples.

Compassion and solidarity on display at New York’s Elmhurst Hospital, during the April peak of the city’s coronavirus outbreak. Noam Galai/Getty Images

Some pandemic-era policies also reflect compassion, such as regulations preventing evictions and expanding unemployment benefits and giving food aid to poor familes.

A compassion-guided reopening aimed at preventing or reducing human suffering would require governments to continually monitor and alleviate the pain of their people. That includes addressing new forms of suffering that arise as circumstances change.

2. Solidarity

In a global pandemic, the actions people do or don’t take affect the health of others worldwide. Such shared emergencies require solidarity, which recognizes both the inherent dignity of each individual person and the interdependence of all people. As United Nations officials have emphasized, “we are all in this together.”

Public health measures like stay-at-home orders, social distancing and wearing masks reflect solidarity. While compliance in the United States has not been universal, data indicate broad approval for these measures. A new study found that 80% of Americans nationwide support staying home and social distancing and 74% support using face coverings in public.

To achieve these acts of solidarity, the leaders most praised in their countries and abroad – from U.S. National Institutes of Health director Dr. Anthony Fauci to New Zealand prime minister Jacinda Ardern – have relied primarily on moral persuasion, not threats of punishment.

By delivering clear information, giving simple and repeated behavioral guidance, and setting a good example, they’ve helped convince millions to take personal responsibility for protecting their community.

Face masks signal that wearers care about protecting others around them. Islam Dogru/Anadolu Agency via Getty Images

3. Justice

Justice focuses on the fair distribution of resources and the social structures that enable what the Dutch philosopher Patrick Loobuyck has called a “condition of equality.”

Justice-oriented policies are necessary for a moral reopening because of the pandemic’s disproportionate health and economic impacts. The evidence clearly shows that communities of colorlow-income populationspeople in nursing homes and those on the margins of society, such as homeless people and undocumented immigrants, are hardest hit.

Justice-oriented policies would aim for equitable balancing of necessary pandemic resources. That means directing testing and health equipment toward vulnerable communities – as identified by COVID-19 tracking data and risk factors like housing density and poverty – and ensuring free, widespread vaccine distribution when it becomes available.

In the U.S., economic justice will also require aggressively investing in minority-run businesses and poorer areas to guard against further harm to owners, employees and neighborhoods.

Similarly, all American school children have lost critical classroom hours, but lower-income children have been disproportionately damaged by remote learning in part due to the digital divide and loss of free lunch programs. Justice would demand channeling additional resources to the students and schools that need them most.

A moral reopening

Using virtues to guide social policies is an old idea. It dates back at least to the Greek thinker Aristotle.

Social distance stickers to prepare Nepal’s empty Tribhuwan International Airport for reopening. Narayan Maharjan/NurPhoto via Getty Images

New Zealand is a good example of virtuous pandemic policymaking, even considering its advantages in having wealth, low density and no land borders. Its coronavirus response included not only aggressive public health measures but also a well articulated message of being united in the COVID-19 fight and recurring government payments so workers did not have to risk their health for their job.

Note that it isn’t enough to apply just one virtue in a crisis of this magnitude. Policies built on compassion, solidarity and justice should be deployed in combination.

A compassionate post-pandemic response that does not address underlying inequalities, for example, ignores certain communities’ specific needs. Meanwhile, tackling specific injustices without engaging everyone in efforts like mask-wearing endangers the public health.

Bolstered by scientific evidence, virtue ethics can help nations reopen not just economically but morally, too.





Providers show support amid unrest: #WhiteCoatsForBlackLives


Dive Brief:

  • The American Hospital Association on Monday condemned what they called the “senseless killing of an unarmed black man in Minneapolis,” referring to George Floyd, who died more than a week ago after a police officer held his knee on Floyd’s neck for more than eight minutes. AHA said the group’s vision is a “society of healthy communities, where ALL individuals reach their highest potential for health.”
  • Medical societies, providers and other healthcare organizations weighed in to support peaceful protests, especially as the COVID-19 pandemic shines a light on racial inequities in access to healthcare and job security in America.
  • Health officials also expressed worry that the protest gatherings could further spread of the novel coronavirus. Minnesota Gov. Tim Walz said hospitals in the state could be overwhelmed. And some COVID-19 testing sites have been shut down for safety reasons, further exacerbating concerns.

Dive Insight:

Since protests and occasionally violent police confrontations in recent days were sparked by Floyd’s death, providers have taken to social media with notes of support and pictures of themselves taking a knee in their scrubs under the hashtag #WhiteCoatsForBlackLives.

The American Medical Association responded to ongoing unrest Friday, saying the harm of police violence is “elevated amidst the remarkable stress people are facing amidst the COVID-19 pandemic.”

Board Chair Jesse Ehrenfeld and Patrice Harris, AMA’s first African American woman to be president, continued: “This violence not only contributes to the distrust of law enforcement by marginalized communities but distrust in the larger structure of government including for our critically important public health infrastructure. The disparate racial impact of police violence against Black and Brown people and their communities is insidiously viral-like in its frequency, and also deeply demoralizing, irrespective of race/ethnicity, age, LGBTQ or gender.”

Other organizations weighed in, including CommonSpirit Health, the American Psychiatric Association, the American College of Physicians and several medical colleges.

The nascent research and data from the pandemic in the U.S. have shown people of color are more likely to die from COVID-19 than white people. The reasons behind that are myriad and complex, but many can be traced back to systemic inequality in social services and the healthcare system.

Payers, providers and other healthcare organizations have attempted to address these issues through programs targeting social determinants of health like stable housing, food security and access to transportation.

But despite these efforts over several years to recognize and document the disparities, they have persisted and in some cases widened, Samantha Artiga, director of the Disparities Policy Project at the Kaiser Family Foundation, noted in a blog post Monday.

Health disparities, including disparities related to COVID-19, are symptoms of broader underlying social and economic inequities that reflect structural and systemic barriers and biases across sectors,” she wrote.

Providers have waded into political issues affecting them before, including gun violence. Several organizations also objected to the Trump administration’s decision to cut ties with the World Health Organization in the midst of the pandemic.

The American Public Health Association in late 2018 called law enforcement violence a public health issue.





In front of White House, nurses read names of colleagues killed by coronavirus


Coronavirus deaths: Nurses read names at White House of colleagues ...

Registered nurses gathered Tuesday in front of the White House to read the names of health-care workers who have died fighting the coronavirus pandemic.

Wearing masks and standing six feet apart, the nurses held up photographs of the deceased as Melody Jones, a member of the National Nurses United union, addressed the news media in an otherwise empty Lafayette Square.

The names came from all over the country — New York and Alabama, Puerto Rico and Nevada, California and Michigan, Florida and Maryland, New Jersey and the District.

A man in blue scrubs stood behind Jones as she read, holding a metallic gold sign painted with the message: “20 seconds won’t scrub ‘hero’ blood off your hands.”

“Let us remember and honor the ultimate sacrifice these nurses paid,” Jones said. “We commit ourselves to fight like hell for the living.”

The protest stood in stark contrast to demonstrations in recent days in some parts of the country in which protesters have demanded the reopening of nonessential businesses. Nurses have been spotted at those gatherings, too, standing arms crossed, in opposition to demonstrators, many of whom are unmasked and milling in crowds.

More than 9,000 health-care workers in the United States have tested positive for the novel coronavirus, according to figures from the Centers for Disease Control and Prevention. Those numbers are believed to be an undercount of infections due to a lack of tests in many areas.

The nurses said Tuesday that they wanted to bring their demands for more personal protective equipment directly to President Trump’s doorstep.

Health-care providers in hospitals, clinics, nursing homes, assisted-living facilities and rehabilitation centers have for weeks asked lawmakers and government agencies for more protective equipment to shield themselves and their vulnerable patients from the spread of covid-19.

National Nurses United last month petitioned the Occupational Safety and Health Administration to institute an emergency safety standard that would provide nurses with more protective gear, including N95 respirator masks, face shields, gowns, gloves and shoe coverings.

Health-care workers, governors and other officials have for weeks demanded that Trump enforce the Defense Production Act to order mass production of those materials. Many have also petitioned Congress to mandate Trump use his authority to help boost the production of such gear.

Last week, a protest in the shadow of the Capitol displayed the faces of health-care workers demanding better protection on 1,000 signs. The sign represented protesters that organizers said would not have been safe if gathered together on the Capitol lawn.





Standing Up to a Tidal Wave of Ignorance, Fear and Abuse

Image may contain: one or more people, people standing, sky, tree and outdoor

Today I stood with some of my fellow nurses and faced a tidal wave of ignorance, fear, and abuse.

I was mocked. I was called more names than I can remember. I was told I was ignorant, unintelligent, and compassionless. I was accused of being a fake nurse, a paid protester, a fraud. I was told I was nothing. I had cigarette smoke blown in my face. I was sexually harassed. A few times, I was surrounded on all sides by multiple people yelling at me.

Desperation and fear bring out the worst in people. I will admit, I cried a bit. How could I not in the face of so much hate?

But I when I did, I was crying for my fellow healthcare workers on the front lines, who are working their asses off fighting this illness, who are being put at worse risk because of the lack of essential protective equipment in this country. I cried for those who have left their families behind to go help where the situation is most dire. I cried for those who have died and will continue to die, after working their hardest to help those who needed them.

I cried for every protester who doesn’t know how they are going to make ends meet, that are afraid for their businesses, their jobs, their homes, and their lives. I cried for every American who has received less than adequate help from the government, who felt like this is the only way for them to get the resources they need, and who have been failed by our president who has not implemented the measures required to help and protect our most vulnerable people.

I cried for every person at this protest that will inevitably get sick, and increase the spread in our state when we had been doing a pretty good job of flattening the curve and delaying the spread of covid-19 in Arizona. I cried for every person who will be infected by those that contracted the disease today.

But more important than the few tears I shed today, was that I stood strong for what is right.

I stood for using science, not feelings, to make important decisions in a pandemic. I stood for the healthcare workers who are going to keep working our hardest to help heal the sick, whether they appreciate it or not. I stood for those who couldn’t. I stood for the lives we have lost, many unnecessarily, to this virus. I stood strong and looked every protester fighting to open Arizona in the eye, so they would have to stare into the face of some of the individuals they are hurting with their ignorance. My hands cramped up from standing in this position so long, but I kept standing until everything died down.

And I will keep standing.


Health Care Workers Stand Up To People Protesting Stay-At-Home Orders


View image on Twitter

Remarkable scene at 12th and Grant, where two healthcare workers from a Denver-area hospital — they declined to say which or give their names — are standing in the crosswalk during red lights as a “reminder,” they say, of why shutdown measures are in place.

Two health care workers blocked a parade of protesters in Denver, Colorado on Sunday, who were storming the capitol to protest the state’s stay-at-home order.

Powerful images and videos of the standoff were widely shared on social media of the two unidentified people wearing scrubs and N95 masks, standing in a crosswalk blocking protesters’ vehicles. The two were identified as health care workers by photographers on the scene. 

One video shared by Twitter user Marc Zenn, captured cars lined up and beeping their horns at the two medical workers, with a woman hanging out of her vehicle’s window shouting “Go to China if you want communism. Go to China,” and “You get to go to work, why can’t we?”

View image on Twitter

They say they’ve been treating COVID patients for weeks. Today most of the people driving by have been “very aggressive,” they say. I’ve been standing here for a few minutes and already seen two people get in their faces.

Hundreds of people showed up on foot and in their vehicles for two separate protests in Colorado’s capitol on Sunday. The protests were reportedly planned by ReOpen Colorado and “various Libertarian parties,” according to a local Denver news outlet. People attending the march were shown carrying American flags, “Don’t Tread on Me” flags, and signs about reopening businesses and schools.

“Coloradans have a first amendment right to protest and to free speech, and the Governor hopes that they are using social distancing and staying safe,” Colorado Gov. Jared Polis’ office said in a statement. “No one wants to reopen Colorado businesses and lift these restrictions more than the Governor, but in order to do that, Coloradans have to stay home as much as possible during this critical period, wear masks and wash their hands regularly to slow the spread of this deadly virus.”

As of Monday morning, Colorado has more than 9,700 cases of COVID-19, leading to at least 420 deaths, according to the Johns Hopkins coronavirus tracker. The state of Colorado is set to continue its stay-at-home order until at least April 26, to slow the transmission of the virus.  

Colorado isn’t the only state where protesters are demonstrating against their government’s stay-at-home orders—Several other states held protests over the weekend including Utah, Idaho, and Washington state. Last week, parts of Michigan, New York, Ohio, Virginia, North Carolina, and others also saw a wave of demonstrators

President Trump encouraged the protesters last week during his Friday press briefing and in tweets which said to “liberate” multiple states holding protests.

In a Politico poll, 81% of Americans agreed we “should continue to social distance for as long as is needed to curb the spread of coronavirus, even if it means continued damage to the economy.” An NBC News poll found that 60% of responders agreed with keeping at-home restrictions.



Current State of the Union


These Pictures Show Crowds Protesting Against Coronavirus Lockdowns At State Capitols

Conservative demonstrators gathered at the capitol buildings of Michigan, Kentucky, and North Carolina to protest against stay-at-home orders during a pandemic that has already left more than 26,000 Americans dead.


Governors Reject Pence’s Claim on Virus Testing

Coronavirus and Reopening: Governors Say They Lack Tests as Trump ...

Democratic and Republican governors bristled at claims from the Trump administration that the supply of tests was adequate to move firmly toward reopening the country.

Governors facing growing pressure to revive economies decimated by the coronavirus said on Sunday that a shortage of tests was among the most significant hurdles in the way of lifting restrictions in their states.

“We are fighting a biological war,” Gov. Ralph Northam of Virginia said on “State of the Union” on CNN. “We have been asked as governors to fight that war without the supplies we need.”

In interviews on Sunday morning talk shows, Mr. Northam was among the governors who said they needed the swabs and reagents required for the test, and urged federal officials to help them get those supplies.

The governors bristled at claims from the Trump administration that the supply of tests was adequate. On NBC’s “Meet the Press,” Vice President Mike Pence said “there is a sufficient capacity of testing across the country today for any state in America” to go to the first of three phases that the administration says are needed for the country to emerge from the coronavirus shutdown.

Mr. Northam, a Democrat, called Mr. Pence’s claim “delusional.” In Michigan, Gov. Gretchen ​Whitmer, also a Democrat, said the state could perform “double or triple” the number of tests it is doing now “if we had the swabs or reagents.” ​Gov. Larry Hogan​ of Maryland, a Republican, said that it was “absolutely false” to claim that governors were not acting aggressively enough to pursue as much testing as possible.

“It’s not accurate to say there’s plenty of testing out there, and the governors should just get it done,” Mr. Hogan ​said​ on “State of the Union​.​”​ “That’s just not being straightforward.”

The conflicting messages come as the debate over how and when to reopen the economy has intensified. President Trump on Saturday expressed his confidence in the nation’s testing capability and said some governors have “gotten carried away,” while state officials said they feared moving too early could cause the virus to flare again.

“As tough as this moment is,” Ms. Whitmer said in an interview with CNN, “it would be devastating to have a second wave.”

In a news conference on Sunday evening, Mr. Trump expressed his confidence in the federal response, including his administration’s relationship with governors and the capacity for testing.

Mr. Trump said the administration was preparing to use the Defense Production Act to compel one U.S. facility to increase production of test swabs by over 20 million per month. The announcement came after he defended his response to the accusations that there was an insufficient amount of testing to justify reopening the economy any time soon.

“You’ll have so many swabs you won’t know what to do with them,” Mr. Trump said.

Officials at every level have faced increasingly competing pressures, balancing maintaining stay-at-home orders against the exasperation and economic toll they are producing. On Saturday and Sunday, modest protests took place in several cities across the country, where demonstrators flouted social distancing rules as they demanded that restrictions be relaxed.

Yet there was also a widespread sense that much of the public understood the governors’ concerns and shared them. Nearly 60 percent of American voters said they were worried that measures would be relaxed too soon, causing deaths to rise, according to a new poll from NBC News and The Wall Street Journal.

Officials in various states said they had started staging plans for reopening their economies and were working in concert with neighboring states in determining when to lift restrictions.

In South Carolina, Gov. Henry McMaster said that he had spoken with the governors of other southeastern states, including Florida and Tennessee. “Told them South Carolina was ready,” Mr. McMaster, a Republican, said on Twitter on Saturday.

On Sunday, governors from across the Northeast, including New York, New Jersey, Connecticut and Pennsylvania, said they were creating a regional council focused on restoring the economy and addressing unemployment.

Still, many governors, including Andrew M. Cuomo of New York and Philip D. Murphy of New Jersey, said that testing still needed to be ramped up considerably before moving forward, and that they needed federal help to do so.

There are currently about 150,000 diagnostic tests conducted each day, according to the Covid Tracking Project. Researchers at Harvard estimated last week that in order to ease restrictions, the nation needed to at least triple that pace of testing.

Dr. Deborah Birx, the coronavirus response coordinator for the White House, also pushed back against criticism that not enough people were being tested, saying that not every community required high levels of testing and that tens of thousands of test results were probably not being reported.

“We need to predict community by community the testing that is needed,” Dr. Birx said Sunday on CBS’s “Face the Nation​.” “Each will have a different testing need, and that’s what we’re calculating now.”

On the ABC program “This Week,” Dr. Birx said she thought statistics on testing were incomplete: “When you look at the number of cases that have been diagnosed, you realize that there’s probably 30,000 to 50,000 additional tests being done that aren’t being reported right now.”

Shortages of supplies have restricted the pace of testing, according to commercial laboratories. Dr. Birx said that a team at Walter Reed National Military Medical Center was calling hundreds of labs around the country to determine exactly what supplies they need “to turn on full capacity, which we believe will double the number of tests that are available for Americans.”

In the news conference on Saturday, Mr. Trump said the criticism of the administration was driven by Democrats. “Unfortunately, some partisan voices are trying to politicize the issue of testing,” he said.

Yet, Gov. Jay Inslee of Washington noted that governors from both parties had been among those voicing frustration over a lack of federal support with testing. He also criticized what he saw as a discordant message from Mr. Trump, which, he argued, undermined governors’ stay-at-home orders and inspired “people to ignore things that actually can save their lives.”

“These orders actually are the law of these states,” Mr. Inslee, a Democrat, said in an interview with “This Week.” He added: “And, again, these are not just Democrats. These are Republican-led states as well. To have an American president to encourage people to violate the law, I can’t remember any time during my time in America where we have seen such a thing.”

Now, with states transitioning away from addressing the peak of the pandemic, governors stand to face a difficult landscape to navigate.

Governors across the political spectrum have stepped into the spotlight during the coronavirus crisis, holding daily news briefings and going back and forth with the president. But if they drew praise for taking quick action to protect public health, taking responsibility for when and how to reopen could prove far more politically perilous, said Ray Scheppach, a public policy professor at the University of Virginia and a former longtime executive director of the National Governors Association.

“That is one of the reasons you’re seeing groups of governors and states get together,” he said, noting the alliances made by clusters of governors around the country.

“Doing something with the surrounding states does give you a certain amount of political cover,” both with constituents and the White House, Professor Scheppach said. “They don’t want to get pushed around by this president and they are stronger in a group.”

Having claimed responsibility for reopening the country, governors are now offering hesitant timelines. Offering no date for reopening may leave people feeling despondent at a time when “people need more certainty as opposed to less,” Professor Scheppach said. But being too firm comes with the risk of having to push out deadlines and test the public’s patience.

“You can do it once,” he said, as Mr. Cuomo and others have done. “But you begin to lose if you do that two or three times.”

Governors said they had become acutely aware of the dilemmas they face.

In his appearance on CNN, Mr. Hogan was shown footage of a long line winding around a supermarket in a Maryland suburb of Washington where free food was being handed out. The video was an unsettling avatar of the economic damage wrought by the virus. He said he shared in the frustration over the economy, but he also noted that his state had not yet reached its peak in cases.

“My goal is to try to get us open as quickly as we possibly can,” he said, “but in a safe way.”