Seite - 522 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE522 In most slums and villages, many people often live together in one or two rooms, sharing common utensils, towels, and much else, perhaps including a toilet nearby. Safe physical distancing is virtually impossible in these circumstances. Even basic hygiene and other pre- scribed sanitary measures, such as washing hands with lather for at least a certain amount of time, is not easy when clean running water is scarce. Transmission patterns are determined by social factors that are both local and intimate, which international and even national public health decision makers are often oblivious to, but which com- munity members know all too well. Therefore, joint learning, involv- ing both experts and affected communities, can be vital for effective responses. Lessons learned from previous epidemics may be useful. Governments need to consider the specific nature of the COVID-19 pandemic and its unique, but nonetheless varied, implications in vari- ous contexts. After all, an effective vaccine is believed by many to be at least 18 months away. A standardized set of interventions, even ostensible best practices, is unlikely to be universally applicable, as the COVID-19 pandemic has different ramifications in various cir- cumstances over time. As an economy cannot be locked down for too long, authorities have to choose between lives and livelihoods rather than between life and the economy, as is often said. The bulk of the population in many developing countries is in the informal sector, earning meagre, typi- cally daily incomes and having paltry savings. All too many develop- ing countries do not have enough fiscal space to provide sufficient relief for vulnerable populations and small businesses for long. Hence, extending strict lockdown measures is likely to lose broad public sup- port, even if such support is high at the beginning. Countries can have less disruptive and less costly, yet very effec- tive, containment strategies, especially if they act early and quickly, as timing is critical. The ability to trace and test as many suspected cases as possible, for example, those who have come into close recent contact with an infected person, is also crucial. Effective containment depends heavily on voluntary compliance, and hence, community acceptance and trust, helped by transparency and shared understand- ing of what needs to be done. All these require state capabilities work- ing together (“all of government”), as well as credible and inclusive leadership to mobilize and co-ordinate the “whole of society” for