Page - 10 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE10 job losses, economic recession, increased mental health issues, and ris- ing domestic violence. In the longer run, we will have to account for both sides of the ledger, namely the people who were saved because of precautionary measures and the people who were lost or harmed. Fourth, we do not yet know which of the various approaches taken by governments to combat COVID-19 are most effective. This will be important to know when responding to further waves of infection. Some claim that Japan has been relatively successful because people commonly and willingly wear masks. Others suggest that the strict separation of suspected COVID-19 patients into separate hospitals or treatment facilities is key. Many analyses refer to the importance of testing and tracing, or the importance of acting early and closing borders. Others promote a strong focus on high-risk populations in long-term care settings, prisons, factories, and other sites. We need detailed scientific research into the range of approaches taken and the factors that determine their efficacy in order to understand the impact of different approaches on different vulnerable groups. Vulnerability as an Organizing Theme We employ a lens of vulnerability throughout our analysis. COVID-19 has exposed and created vulnerabilities that follow the fault lines of pre- existing structural inequities. COVID-19 has flourished in settings where people were already vulnerable because of government policies and cor- porate bottom lines. Many of the virus’s hot spots in high-income coun- tries (HICs)—long-term care homes, prisons, immigration detention centres, and slaughterhouses, among others—are spaces of acute vul- nerability because they are sites of long-standing structural inequalities. Governments have long tolerated substandard quality of care in long-term care homes, caused by, among other things, understaffing and low wages.34 Oversight of public and private long-term care facili- ties varies between jurisdictions, but is often inadequate. In Ontario, for example, annual inspections have essentially evaporated in the global-development/2020/may/13/unicef-6000-children-could-die-every-day- due-to-impact-of-coronavirus>. 34. Martine Lagacé, Linda Garcia & Louise Bélanger-Hardy, this volume, Chapter D-2; Matthew Kupfer, “‘Something Is Bound to Break’: More Long-Term Care Staff Needed, Families Say”, CBC News (23 April 2020), online: <https:// www.cbc.ca/news/canada/ottawa/madonna-care-community-orleans-staff- recruit-1.5541610>.