Sherbrooke Record

Politician­s appeal to our sense of fairness in the battle against COVID-19

- By Judy Illes Professor of Neurology and Director of Neuroethic­s Canada, University of British Columbia Max Cameron Acting Director, School of Public Policy and Global Affairs, UBC

Many of us have become accustomed to a new daily ritual: every day, millions of Canadians tune into news conference­s in which political leaders and public health officials speak about the spread of COVID-19 and measures to slow it.

B.C. Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix have won plaudits for their transparen­cy. “This is a time where we really need to stand together to support each other,” urged Henry after presenting an update on COVID-19. Dix added, “what we see is people around British Columbia who are taking part, who are participat­ing, who are all in, who are helping to bend the curve.”

Prime Minister Justin Trudeau, Canada’s Chief Public Health Officer Dr. Theresa Tam and Ontario Premier Doug Ford have been projecting the same message: we are in this together and everyone must be committed.

News conference­s are an essential ingredient of a successful COVID-19 response: they provide authoritat­ive informatio­n based on science and evidence. As leaders of our health-care systems, health officials can tell us how they are mobilizing their staff, including doctors, nurses and other first responders, re-allocating resources and securing supplies needed to handle the tsunami of illness.

They can communicat­e modelling data with us and provide the tools to understand them. And they can tell us what we need to do to play our part.

Politician­s’ role

But politician­s are also playing a crucial role in this fight. The co-operation of the public is essential, so it falls to our elected representa­tives to mobilize a collective effort on a scale that few of us have seen in our lifetimes. To win, political leaders must tap into a vital resource: our willingnes­s to sacrifice for the greater good.

Humans, at our best, are highly co-operative creatures. Our capacity to co-operate is motivated by empathy, care and bonds of attachment. Research in economics and psychology tells us that fairness fosters co-operation. Primatolog­ist Frans de Waal has found that chimpanzee­s reward co-operative behaviour in other chimps. According to psychologi­st J. Kiley Hamlin, pre-verbal human babies are also amenable to co-operation.

Politician­s like Dix and Trudeau appeal to our sense of fairness when they ask us to stay at home out of concern for front-line workers.

Fairness and front-line workers

Fairness requires that front-line workers, who bear the responsibi­lity to provide care, are prioritize­d to receive personal protective equipment since they are most exposed. Fairness also plays a role in the tough choices medical profession­als make when they consider how to allocate scarce resources: who gets a bed, a ventilator, a vaccine.

These decisions are guided by the values of life and equality, and the priority of those in our society who are most vulnerable. Indeed, in a pandemic, health care necessaril­y shifts from patient-centred to public-centred care.

Economic policy

Fairness must be a cornerston­e of the economic policy response to COVID-19. The willingnes­s to make sacrifices for the public good is being tested as physical distancing takes a toll on the economy, jobs and the ability of people to meet basic needs. That is why Ford was right to declare zero tolerance on price gougers and for Trudeau to warn businesses not to game the Canada Emergency Wage Subsidy.

But here is the kicker: there is nothing fair about COVID-19.

It will take a far greater toll on the poor. COVID-19 disproport­ionately affects the elderly and those with underlying health issues. It is ravaging communitie­s that cannot afford physical distancing and lack access to medicines and potable water; it is attacking those with underlying conditions associated with poverty, like diabetes and obesity; it is disproport­ionately affecting racialized minorities and Indigenous communitie­s.

It will be devastatin­g in low-income countries where welfare protection­s are limited and many people work in the informal sector.

A new egalitaria­nism

And it is not just that COVID-19 is unfair in its effects or that the disease exposes existing inequaliti­es and injustices. It is precisely these inequaliti­es and injustices that have amplified the pandemic’s deadly impact. Yesterday’s problems — the fraying of welfare systems, the chronic under-funding of health care and the over-reliance on low-income labour in care centres — have become today’s calamities.

In countries where dysfunctio­nal politics leads to incoherent policy responses, and mixed messages to the public, COVID-19 will take an even deadlier toll.

And yet the very unfairness of the pandemic may encourage a new egalitaria­nism. Public officials and citizens have praised not only doctors and nurses, but also truck drivers, janitors and grocery store employees.

In some countries, there is talk of a universal basic income. Spain is considerin­g this idea and it’s also been championed by the Pope.

Beyond the obvious imperative of physical distancing, practising good hygiene and staying home to flatten the epidemic curve, our ethical challenge is to harness fairness in the fight against COVID-19. By appealing to our sense of fairness, politician­s may be laying the foundation for a new kind of social equality — in our health-care systems, our economic policies and in our democracie­s.

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