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.





Battling the ‘pandemic of misinformation’

Social media used to spread, create COVID-19 falsehoods

During COVID-19 Pandemic It Isn't Just Fake News But Seriously Bad ...

Ubiquity of social media has made it easier to spread or even create COVID-19 falsehoods, making the work of public health officials harder.

This is part of our Coronavirus Update series in which Harvard specialists in epidemiology, infectious disease, economics, politics, and other disciplines offer insights into what the latest developments in the COVID-19 outbreak may bring.

When a disease outbreak grabs the public’s attention, formal recommendations from medical experts are often muffled by a barrage of half-baked advice, sketchy remedies, and misguided theories that circulate as anxious people rush to understand a new health risk.

The current crisis is no exception. The sudden onset of a new, highly contagious coronavirus has unleashed what U.N. Secretary-General António Guterres last week called a “pandemic of misinformation,” a phenomenon that has not gone unnoticed as nearly two-thirds of Americans said they have seen news and information about the disease that seemed completely made up, according to a recent Pew Research Center study.

What distinguishes the proliferation of bad information surrounding the current crisis, though, is social media. Kasisomayajula “Vish” Viswanath, Lee Kum Kee Professor of Health Communication at the Harvard T.H. Chan School of Public Health, said the popularity and ubiquity of the various platforms means the public is no longer merely passively consuming inaccuracies and falsehoods. It’s disseminating and even creating them, which is a “very different” dynamic than what took place during prior pandemics MERS and H1N1.

The sheer volume of COVID-19 misinformation and disinformation online is “crowding out” the accurate public health guidance, “making our work a bit more difficult,” he said.

Misinformation could be an honest mistake or the intentions are not to blatantly mislead people,” like advising others to eat garlic or gargle with salt water as protection against COVID-19, he said. Disinformation campaigns, usually propagated for political gain by state actors, party operatives, or activists, deliberately spread falsehoods or create fake content, like a video purporting to show the Chinese government executing residents in Wuhan with COVID-19 or “Plandemic,” a film claiming the pandemic is a ruse to coerce mass vaccinations, which most major social media platforms recently banned.

In order to be effective, especially during a crisis, public health communicators have to be seen as credible, transparent, and trustworthy. And there, officials are falling short, said Viswanath.

“People are hungry for information, hungry for certitude, and when there is a lack of consensus-oriented information and when everything is being contested in public, that creates confusion among people,” he said.

“When the president says disinfectants … or anti-malaria drugs are one way to treat COVID-19, and other people say, ‘No, that’s not the case,’ the public is hard-pressed to start wondering, ‘If the authorities cannot agree, cannot make up their minds, why should I trust anybody?’”

Mainstream media coverage has added to the problem, analysts say. At many major news outlets, reporters and editors with no medical or public health training were reassigned to cover the unfolding pandemic and are scrambling to get up to speed with complex scientific terminology, methodologies, and research, and then identify, as well as vet, a roster of credible sources. Because many are not yet knowledgeable enough to report critically and authoritatively on the science, they can sometimes lean too heavily on traditional journalism values like balance, novelty, and conflict. In doing so, they lift up outlier and inaccurate counterarguments and hypotheses, unnecessarily muddying the water.

“That’s a huge challenge,” said Ashish Jha, K.T. Li Professor of Global Health and Director of the Harvard Global Health Institute, during an April 24 talk about COVID-19 misinformation hosted by the Technology and Social Change Research Project at the Shorenstein Center for Media, Politics and Public Policy.

“People are hungry for information, hungry for certitude, and when there is a lack of consensus-oriented information and when everything is being contested in public, that creates confusion among people.”
— Kasisomayajula Viswanath

“What I have found is a remarkable degree of consensus among people who understand the science of this disease around what the fundamental issues are and then disagreements about trade-offs and policies,” said Jha, who is a frequent commentator on news programs. “The idea of covering the science in a two-sided way on areas where there really isn’t any disagreement has struck me as very, very odd, and it keeps coming up over and over again.”

Then there is the problem of political bias. This has been especially true at right-leaning media outlets, which have largely repeated news angles and viewpoints promoted by the White House and the president on the progress of the pandemic and the efficacy of the administration’s response, boosting unproven COVID-19 treatments and exaggerating the availability of testing and safety equipment and prospects for speedy vaccine development.

Tara Setmayer, a spring 2020 Resident Fellow at the Institute of Politics and former Republican Party communications director, said what’s coming from Fox News and other pro-Trump media goes well beyond misinformation. Whether downplaying the views of government experts on COVID-19’s lethality, blaming China or philanthropist Bill Gates for its spread, or cheering shutdown protests funded by Republican political groups, it’s all part of “an active disinformation campaign,” she said, aimed at deflecting the president’s responsibility as he wages a reelection campaign.

But turning around those who buy into false information is not as simple as piercing epistemic bubbles with facts, said Christopher Robichaud, senior lecturer in ethics and public policy at Harvard Kennedy School (HKS) who teaches the Gen Ed course “Ignorance, Lies, Hogwash and Humbug: The Value of Truth and Knowledge in Democracies.”

Over time, bubble dwellers can become cocooned in a media echo chamber that not only feeds faulty information to audiences, but anticipates criticisms in order to “prebut” potential counterarguments that audience members may encounter from outsiders, much the way cult leaders do.

“It’s not enough to introduce new pieces of evidence. You have to break through their strategies to diminish that counterevidence, and that’s a much harder thing to do than merely exposing people to different perspectives,” he said.

While Facebook, Twitter, and YouTube have all recently ramped up efforts to take down COVID-19 misinformation following public outcry, social media platforms “fall short” when it comes to curbing the flow, said Joan Donovan, who leads the Technology and Social Change Project at HKS.

Since the national shift to remote work, many social media firms are relying more heavily on artificial intelligence to patrol misinformation on their platforms, instead of human moderators, who tend to be more effective, said Donovan. So many users suddenly searching and posting about one specific topic can “signal jam search algorithms, which cannot tell the difference usually between truth and lies.”

These firms are reluctant to spark a regulatory backlash by policing their platforms too tightly and angering one or both political parties.

“So they are careful to take action on content that is deemed immediately harmful (like posts that say to drink chemicals), but are reticent to enforce moderation on calls for people to break the stay-at-home orders,” said Donovan.

Viswanath said public health officials cannot, and should not, chase down and debunk every bit of misinformation or conspiracy theory, lest the attention lends them some credence. The public needs to more closely scrutinize and be “much more skeptical” about what they’re reading and hearing, particularly online, and not try to keep up with the very latest COVID-19 research. “You don’t need to know everything,” he said.

Putting the onus entirely on the public, however, is “unfair and it won’t work,” said Viswanath. Institutions, like social media platforms, have to take more responsibility for what’s out there.

Public health organizations should be running effective communication surveillance of social media to monitor which rumors, ideas, and issues most worry the public, what is understood and misunderstood about various diseases and treatments, and what myths are circulating or being actively promoted in the community. And they need to have a strategy in place to counter what they’re picking up. “You cannot control this, but you can at least manage some of this,” Viswanath said.

Though some COVID-19 misinformation and conspiracy theories are outlandish or even dangerously inaccurate, Robichaud said it’s a mistake to dismiss those who believe them as people who don’t care about the truth.

Many cognitive biases get in the way of even the best truth-seeking strategies, so perhaps we could all benefit from a little more intellectual humility in this time of such great uncertainty, he said.

“Most of us are, at best, experts in a tiny, tiny area. But we don’t navigate the world as if that were true. We navigate the world as if we’re experts about a whole bunch of things that we’re not,” he said. “A little intellectual humility can go a long way. And I say that as a professor: It’s true of us, and it’s also true of the public at large.”




Cartoon – Coronavirus Recovery Plan

Then a Miracle Occurs | HENRY KOTULA

Whistleblower alleges Trump administration ignored coronavirus warnings


Whistleblower alleges Trump administration ignored coronavirus ...

Rick Bright, the former director of the U.S. Biomedical Advanced Research and Development Authority (BARDA), filed a whistleblower complaint Tuesday alleging that the Department of Health and Human Services failed to take early action to mitigate the threat of the novel coronavirus.

Flashback: Bright said last month he believes he was ousted after clashing with HHS leadership over his attempts to limit the use of hydroxychloroquine to treat the coronavirus.

What’s new: In his complaint, Bright claims he was excluded from an HHS meeting on the coronavirus in late January after he “pressed for urgent access to funding, personnel, and clinical specimens, including viruses” to develop treatments for the coronavirus should it spread outside of Asia.

  • Bright alleges it “became increasingly clear” in late January that “HHS leadership was doing nothing to prepare for the imminent mask shortage.”
  • Bright claims he “resisted efforts to fall into line with the Administration’s directive to promote the broad use of chloroquine and hydroxychloroquine and to award lucrative contracts for these and other drugs even though they lacked scientific merit and had not received prior scientific vetting.”
  • He adds that “even as HHS leadership began to acknowledge the imminent shortages in critical medical supplies, they failed to recognize the magnitude of the problem, and they failed to take the necessary urgent action.”

The White House declined to comment. HHS did not immediately respond to a request for comment.





White House plans to scale back coronavirus task force


Anthony Fauci - Axios

The White House is in the early stages of winding down its coronavirus task force, Vice President Pence’s office confirmed Tuesday.

The surprise decision comes as most states are preparing to loosen restrictions meant to slow the spread of the virus, while a number of areas continue to see increases in new COVID-19 cases and deaths.

Pence’s office confirmed to The Hill that the vice president told reporters at a limited briefing that his plan is to scale back the task force’s role by Memorial Day. Pence has been leading the task force since late February.

Members are likely to return to their respective departments and manage the coronavirus response from there.

Dr. Deborah Birx, who was brought in from the State Department to coordinate the White House virus response, will “continue to review and analyze data and work with the departments in agencies to help that data inform their decision making processes,” a spokesman for Pence’s office said.

The New York Times first reported on the expected demise of the task force.

The task force, which includes nearly two dozen officials from various government agencies, held near-daily press briefings for more than a month but has been less visible in recent weeks as President Trump and others transition their focus to the economic consequences of the pandemic.

There have been no coronavirus task force briefings in more than a week, and the daily meetings have become less frequent. The group was scheduled to meet Tuesday afternoon.

But the decision to formally disband the task force is sure to raise concern among public health experts who have warned the coronavirus will likely be part of life in the U.S. until there is a widely available vaccine, which could take a year or longer to develop.



The High Stakes of Low Scientific Standards


The Lucky Seven States Already Pursuing Gambling Legislation In 2018

In the midst of this pandemic, science is suffering from low standards for some research, a new study argues.

The big picture: Science — which is slow, methodical and redundant — isn’t necessarily made for the immediacy and acute public interest brought on by a health crisis.

  • Scientists rely on peer review and back and forth exchange that leads to a more polished final study. But a health crisis like the current pandemic, or the Ebola outbreak, creates a sense of urgency that can be antithetical to the scientific process.

What’s happening: A new study out today in the journal Science warns many of the clinical trials and studies first published about treatments and other issues involving the current pandemic were designed poorly or had other issues that affected their outcomes.

  • Studies that have yet to go through peer-review — like a recent, flawed study of the use of hydroxychloroquine to treat coronavirus — have found their way into news stories thanks to pre-print services, leading to problematic reporting and real-time peer review through Twitter.
  • More than 18 clinical trials testing hydroxychloroquine to treat the novel coronavirus have enrolled more than 75,000 patients in North America.
  • “This massive commitment concentrates resources on nearly identical clinical hypotheses, creates competition for recruitment, and neglects opportunities to test other clinical hypotheses,” the study says.
  • Early, flawed work has potentially increased the risk that later results may have gotten false positives and more media attention than they deserved, the new study says.

Yes, but: While the pandemic is exacerbating these problems with misinformation and lax research standards, it isn’t the cause of them.

  • “Some of the problems that we’re seeing right now are actually not that exceptional compared to the problems that we have under normal conditions as well, just that maybe they’re a little bit more amplified and have a little more visibility,” Jonathan Kimmelman, director of the Biomedical Ethics Unit at McGill University and one of the authors of the new paper, told Axios.
  • These kinds of issues cropped up during previous health crises, and while the authors of the new study argue that some of those problems around information sharing and standards of research have improved, there’s still a long way to go.

What’s next: Many of these issues around varying standards of research and communication could be remedied through better communication among researchers and the agencies funding their work.

  • Instead of having a number of fragmented studies competing for resources and looking for effective treatments, the researchers say it would make more sense to bring them under one umbrella, allowing them to coordinate.
  • “You could reduce variation, and you might get answers more quickly,” Alex John London, the director of the Center for Ethics and Policy at Carnegie Mellon and one of the authors of the new study, told Axios.
  • The authors are also calling on clinicians to resist performing their own small studies, instead opting to join up with larger trials.
  • They also say agencies need to help build those larger studies and avoid making statements to the public about unvalidated treatments that may or may not work, instead opting to elevate larger studies in their various stages to the public.