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315How
Should We Allocate Health and Social Resources During a Pandemic?
consequent illnesses and deathsâhow a society allocates resources
also reflects and impacts the parallel social concern of equity.
The following discussion argues that the particular use and
applications of two scientific ideas profoundly affected national
pandemic responses, including the allocation of resources, with sig-
nificant harmful implications for social and health equity. First, the
familiar âcontain and controlâ approach to infectious diseases was
applied maximally by countries (through national lockdowns) and
was without precedent. Second, the epidemic forecasting models and
modelling that were so influential early on were mono-dimensional;
they modelled scenarios of how human bodies will likely spread infec-
tions and of the biological impacts infected, recovered, or dead) over
time. They used assumptions about equal susceptibility and probabil-
ity of death, which then motivated the society-wide lockdowns. The
assumptions obfuscated inequalities in the vulnerabilities of social
groups to exposures, infections, and death. Plus, used in isolation,
with a focus on only one dimension, these models could not identify
the impacts of policies to reduce virus transmissions on other health
and well-being issues or on other important social domains (for exam-
ple, the economy). In light of this argument, a partial answer to the
question âhow should we allocate resources during a pandemicâ is
that we should allocate resources with greater attention paid to social
equity, particularly through more close scrutiny of the proposed use
and application of infectious disease science and control methods.
For many readers, the social concern around equity during this
pandemic might initially and most easily be recognizable regarding
the distribution of limited health care in the face of overwhelming
need. Equity as a concept is often used in relation to the distribution
of valuable things. Indeed, the ethical or fair allocation of limited
ICU beds, ventilators, and protective equipment rose to prominence
in the media and scientific journals early on in the pandemic as the
infections spread to high-income countries, particularly in the United
States.1 Concerns are also being expressed around equity related to
the future distribution of treatments or vaccines, both domestically
and globally, which are currently being researched and developed.2
1. Ezekiel J Emanuel et al, âFair Allocation of Scarce Medical Resources in the Time
of Covid-19â (2020) 382:21 N Engl J Med 2049.
2. David Pilling & Andrew Jack, ââPeopleâs Vaccineâ for Coronavirus Must be Free,
Leaders Urgeâ, Financial Times (13 May 2020), online: <www.ft.com/content/
af929941-7c02-415a-a692-bf8443ede58a>.
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Title
- VULNERABLE
- Subtitle
- The Law, Policy and Ethics of COVID-19
- Authors
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Publisher
- Ottawa Press
- Date
- 2020
- Language
- English
- License
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Size
- 15.2 x 22.8 cm
- Pages
- 648
- Categories
- Coronavirus
- International