Public Health and the Pandemic Whiplash

With the shift from collective care to a fend-for-yourself approach, regions that experienced success are now mired in failure and regret.

Small differences can have a big impact in the ways countries and regions responded to the COVID-19 pandemic.

While some of those small differences are down to specific public health measures, the differences are also about the social, cultural, and historical context. The pandemic has all along had a social dimension, in the sense it is about how people live and act as much as it is about epidemiology.

Canada’s Atlantic Provinces, for example, were extremely successful in containing the virus and keeping the impacts to a minimum. Similar success stories around the globe included Japan, Vietnam, Singapore, New Zealand, and Australia.

Social cohesion, community bonds, and what I call the ethics of collective care play a role in these success stories.

However, recently some of these regions and countries that were so successful have removed most all public health measures. The result is they have begun to experience the daily levels of deaths and infections that people have long-since become desensitized to in other places.

The quick shift from relative success to what is called “learning to live with it” creates a feeling of pandemic whiplash.

I have heard it described by people in Newfoundland and Labrador, my home province, as having the rug pulled out from under them. It is a feeling of being abandoned by the public health officials who were for so long their stalwart leaders. And unfortunately, it is also the sinking feeling that it was pointless to have bothered trying for so long.

People are made to feel their efforts at keeping everyone safe were naïve and that, paradoxically, ethical behaviour was a mistake.

A recent article in the CBC, for example, suggests that places with higher levels of infection are better at weathering new variants as they arise: “the difference between provinces like Prince Edward Island and Ontario throughout the pandemic is that the Maritime provinces that took a COVID zero approach had little pre-existing immunity over the last two years.”

This would naturally lead one to conclude that allowing mass infection was somehow a strategic success for a place like Ontario rather than a shocking failure.

Just beneath the surface of this amoral logic lurks the odious ideas of eugenics, in the sense that mass infection and the suffering and death it causes is something to be encouraged, sacrificing or excluding the weak so that healthy and productive members of society can “move on.” 

Particularly troubling is that those who are so often the victims of mass infection are the same vulnerable people that an ethical pandemic response set out to protect—that is, older adults, people with disabilities, and other marginalized people.

Rather than prioritizing the needs of some of the most vulnerable, the current mass infection approach hinges on a tacit acceptance of their disposability. And this is to be encouraged or even something to be cheerful about, such as when CDC director Rochelle Walensky remarked that it was “encouraging” that mostly people with multiple “comorbidities” were dying during the Omicron wave.

Pandemic whiplash is being caused by the biological and epidemiological fact of the virus, but it is also caused by the social pressure to embrace mass infection and the human toll it brings. It undermines social cohesion and invalidates the ethics of collective care. For places like Newfoundland and Labrador that had some level of success at keeping the pandemic at bay, it is the feeling of abjection brought on by the unmasked immorality of the new situation.

But thoughtful people in these places need to remember that it was never a mistake to control the spread of the virus and protect vulnerable people, just as it was never a mistake to have a pandemic response with a solid moral ground.

And now, even with so much having been lost, it is never a mistake to go back to doing the right thing.

Doing the right thing might look different from one place to the next, whether reverting to a COVID zero approach or simply putting in place appropriate public health measures based on quantifiable thresholds.

No matter what that approach might be, the important first step is reaffirming the ethics of collective care that played a part in the initial success. That also means rejecting the logic of disposability and stating clearly that it is not acceptable to sacrifice anyone to the virus for the sake of convenience.

That is not to say the pandemic will not continue to claim lives. But if it does it will be despite the best efforts, not because it was enabled by lack of action from those responsible for public health and by callous disregard.

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