Seite - 321 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

321How Should We Allocate Health and Social Resources During a Pandemic? mental health impairments. The devastating impact reflected in these chapters is only a partial story. And the argument here is not meant to lead to the conclusion that governments should not vigorously act to control pandemics or deploy scientific resources. Rather, much of the incredible deprivations can be traced back to the lack of sufficient concern for equity by national leaders, and to the use and expansive influence of a particular set of scientific ideas and tools. The science could have been better. The remaining discussion in this chapter focuses on the large- scale application of the contain-and-control approach to infectious diseases, followed by an examination of the use of epidemiological models and the impact on equity. The fourth section concludes the chapter. Contain-and-Control Approach to the Max The first and foremost national capacity identified by any PPP is epi- demiology, which is the study of the causes, frequency, and distri- bution of disease and disability. Epidemiology is the informational engine that drives all biomedical sciences and health care as well as public and global health. From infectious disease epidemiology, we get the standard “contain-and-control” approach to outbreaks. This approach involves identifying the pathogen, source, or vector of infections and all carriers; isolating carriers so they do not trans- mit the infections further; and treating them, if possible. Because the contain-and-control approach is seen to be so effective, it is the stan- dard approach. Pathogens, vectors, and routes of transmissions have an impact on the biological parts and processes, and the treatments that address infection and biological parts and processes are accepted as sufficient information. Other biological facts such as age and sex are also recorded, as they can be important facts when it comes to documenting transmission, discovering which biological parts and processes are affected, and determining the natural progression of disease, behaviours, and so forth. The contain-and-control approach was applied to the outbreak in Wuhan, China, but it did not contain the spread of infection. Likely, the approach was implemented too late, after too many infections had spread. The decision to quarantine an entire city of over 11 million peo- ple was decided based on the likelihood that the spread of infection was beyond a few people, families, or a neighbourhood. And there is