Many of us have become accustomed to a new daily ritual: every day, millions of Canadians tune into news conferences in which political leaders and public health officials speak about the spread of COVID-19 and measures to slow it.
B.C. Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix have won plaudits for their transparency. “This is a time where we really need to stand together to support each other,” urged Henry after presenting an update on COVID-19. Dix added, “what we see is people around British Columbia who are taking part, who are participating, who are all in, who are helping to bend the curve.”
Prime Minister Justin Trudeau, Canada’s Chief Public Health Officer Dr. Theresa Tam and Ontario Premier Doug Ford have been projecting the same message: we are in this together and everyone must be committed.
News conferences are an essential ingredient of a successful COVID-19 response: they provide authoritative information based on science and evidence. As leaders of our health-care systems, health officials can tell us how they are mobilizing their staff, including doctors, nurses and other first responders, re-allocating resources and securing supplies needed to handle the tsunami of illness.
They can communicate modelling data with us and provide the tools to understand them. And they can tell us what we need to do to play our part.
But politicians are also playing a crucial role in this fight. The co-operation of the public is essential, so it falls to our elected representatives to mobilize a collective effort on a scale that few of us have seen in our lifetimes. To win, political leaders must tap into a vital resource: our willingness to sacrifice for the greater good.
Humans, at our best, are highly co-operative creatures. Our capacity to co-operate is motivated by empathy, care and bonds of attachment. Research in economics and psychology tells us that fairness fosters co-operation. Primatologist Frans de Waal has found that chimpanzees reward co-operative behaviour in other chimps. According to psychologist J. Kiley Hamlin, pre-verbal human babies are also amenable to co-operation.
Fairness and front-line workers
Fairness requires that front-line workers, who bear the responsibility to provide care, are prioritized to receive personal protective equipment since they are most exposed. Fairness also plays a role in the tough choices medical professionals make when they consider how to allocate scarce resources: who gets a bed, a ventilator, a vaccine.
These decisions are guided by the values of life and equality, and the priority of those in our society who are most vulnerable. Indeed, in a pandemic, health care necessarily shifts from patient-centred to public-centred care.
Fairness must be a cornerstone of the economic policy response to COVID-19. The willingness to make sacrifices for the public good is being tested as physical distancing takes a toll on the economy, jobs and the ability of people to meet basic needs. That is why Ford was right to declare zero tolerance on price gougers and for Trudeau to warn businesses not to game the Canada Emergency Wage Subsidy.
But here is the kicker: there is nothing fair about COVID-19.
It will take a far greater toll on the poor. COVID-19 disproportionately affects the elderly and those with underlying health issues. It is ravaging communities that cannot afford physical distancing and lack access to medicines and potable water; it is attacking those with underlying conditions associated with poverty, like diabetes and obesity; it is disproportionately affecting racialized minorities and Indigenous communities.
It will be devastating in low-income countries where welfare protections are limited and many people work in the informal sector.
A new egalitarianism
And it is not just that COVID-19 is unfair in its effects or that the disease exposes existing inequalities and injustices. It is precisely these inequalities and injustices that have amplified the pandemic’s deadly impact. Yesterday’s problems — the fraying of welfare systems, the chronic under-funding of health care and the over-reliance on low-income labour in care centres — have become today’s calamities.
In countries where dysfunctional politics leads to incoherent policy responses, and mixed messages to the public, COVID-19 will take an even deadlier toll.
And yet the very unfairness of the pandemic may encourage a new egalitarianism. Public officials and citizens have praised not only doctors and nurses, but also truck drivers, janitors and grocery store employees.
Beyond the obvious imperative of physical distancing, practising good hygiene and staying home to flatten the epidemic curve, our ethical challenge is to harness fairness in the fight against COVID-19. By appealing to our sense of fairness, politicians may be laying the foundation for a new kind of social equality — in our health-care systems, our economic policies and in our democracies.
Judy Illes, Professor of Neurology and Director of Neuroethics Canada, University of British Columbia and Max Cameron, Acting Director, School of Public Policy and Global Affairs, University of British Columbia.
Voices of the RSC” is a series of written interventions from Members of the Royal Society of Canada. The articles provide timely looks at matters of importance to Canadians, expressed by the emerging generation of Canada’s academic leadership. Opinions presented are those of the author(s), and do not necessarily reflect the views of the Royal Society of Canada.