What the authors suggest is for public health experts , economists , social scientists , and bioethicists to work together to assist governments in developing interventions that protect the overall societal well-being .
• saving lives and saving livelihoods as all these concepts are intimately intertwined . The ongoing pandemic is both a public health and economic crisis with dreadful consequences on morbidity and mortality . Globally , economic contraction and growth closely mirror increases and decreases in COVID-19 cases . Appropriate public health strategies that reduce SARS-CoV-2 transmission also safeguard the economy since the toll of widespread illness in workers can lead to disability and death . Aggregate data have shown that many countries that suffered severe economic hardship performed worse in protecting their population ’ s health from COVID-19 over the past months . However , the physical and mental health effects and the profound socioeconomic impact of COVID-19 and the related countermeasures must not be overlooked . Health disparities driven by existing socioeconomic and racial / ethnic inequities are prevailing challenges during
this pandemic . Disadvantaged , rural , low-paid , and non-salaried individuals , blue-collar workers , informal workers , daily-wage earners , migrants , and people with mental health and addiction problems are more likely to be harmed by both the pandemic and the response . Healthcare and socioeconomic disparities differentially impact the capacity of vulnerable populations to engage in physical distancing responses .”
What the authors suggest is for public health experts , economists , social scientists , and bioethicists to work together to assist governments in developing interventions that protect the overall societal well-being . As Escandón , et al . ( 2021 ) emphasize , “ The COVID-19 pandemic has painfully revealed the importance of caring for vulnerable populations , ensuring food and medicine supply chains , keeping non-COVID-19-related healthcare services , generating employment , adapting businesses , and addressing children deprived of learning and subjected to psychological distress caused by the pandemic .” Lockdowns without appropriate support measures in place are untenable , the authors say .
Indefinite Lockdown Versus Unlimited Reopening
The second dichotomy as identified by Escandón , et al . ( 2021 ) is indefinite lockdown versus unlimited reopening , with the core tenets being stringent public health measures pitted against natural herd immunity in the population .
As we know , it is critical to separate infectious , exposed and susceptible individuals early in an infectious disease epidemic while there are still so many unknowns . But as the authors point out ,
“… inconsistencies in pandemic preparedness plans and delays in implementing robust testing and contact tracing prohibited reliance on the isolation of infectious individuals and quarantine of exposed individuals to bring SARS-CoV-2 under control . Given the progression to community transmission ( where numerous cases are not linkable to transmission chains or clusters ), many governments enacted lockdowns , stay-at-home orders , travel bans , curfews , and closing of workplaces , schools , and other community gathering spaces such as gyms and entertainment venues . Such blunt measures were deployed by governments during times of unabated community transmission and high surges in cases . Many public health experts viewed them as stopgap tools needed in unprepared regions with widespread virus transmission to restrict SARS-CoV-2 transmission chains during the first moments of the pandemic , while the test-trace-isolate infrastructure , personal protective equipment ( PPE ) supplies , and hospital capacity were scaled up and strengthened . However , because of inconsistent messaging about the purpose of lockdowns and the uncertain duration of the pandemic and response , many people believed COVID-19 was no longer a threat when lockdowns were lifted .”
One alternative approach that alarmed many public health experts was the desire to achieve natural herd immunity , which , as the Great Barrington Declaration ( GBD ) signatories proposed , was a way to ensure protection of “ high-risk ” individuals while allowing uncontrolled viral transmission among “ lowrisk ” individuals . The authors say this approach “ reflected a misunderstanding of virology and immunology principles and management of public health emergencies ,” and add that the GBD strategy was “ an illusory way to rush back to normality , which understandably gained community and government supporters because of public discontent over lockdowns and diminishing trust in public health agencies . Their rhetoric stoked , if not created , a false choice between total lockdown and a wholesale return to pre-pandemic life .”
Politicians seized upon this lockdown vs . return-to-normal riff , and the mainstream media / social provided a platform from which the misinformation flowed .
Escandón says that the follow-the-science directive was hijacked in the name of politics .
“ This pandemic has brought a health and economic crisis ( unprecedented to all of us ), which has been accompanied by constant polarization , misinformation , and politicization ,” he emphasizes . “ Reasons for this are several : the increased global connectivity ( virtually and geographically ) which allows sharing of information in real time ( leading to watching the pandemic like an endless movie ), the nationwide political crises everywhere , and the unprecedented nature itself of a global event like a pandemic in our lifetimes . Not a single other pandemic has been experienced by the living humans in similar ways , i . e ., in the context of modern technology and with the current engagement of community members and social struggles . Therefore , preparedness efforts were largely undermined since the very beginning , even if humanity had been exposed to other pandemics , just because our context is a particular one , just because social determinants of health are key influencing factors that remain largely unresolved . And in fact , there are numerous contexts across the entire globe . So , while previous epidemics , especially pandemics , have indeed triggered important public reactions and afflictions , the reach of SARS-CoV-2 is far different . This virus is a highly transmissible