Another essay! This time answering the question: How might scholarship addressing the social and ethical context of health and illness help us respond to the challenges of COVID-19?
To understand how best to meet the challenges of the COVID-19 pandemic a diverse body of
multidisciplinary scholarship must be generated and consulted to address the unique challenges it brings in relation to the social and ethical context of disease. By identifying and learning from the different stages of the pandemic, and different countries responses, health care professionals and governing bodies can develop an evidenced based approach which seeks to minimise transmission of the virus and mortality in an ethical manner. Addressing underlying healthcare inequalities to prevent them from becoming worse forms a key component of this. As the pandemic continues to exact its toll the importance of social support in facing the aftermaths of national lockdowns becomes evident.
A key focus at the current stage of the pandemic is that of vaccine efficacy and roll outs. Ethical challenges in developing a vaccine are important to consider, such as in relation to the commencement of human challenge trials. A utilitarian approach would mandate that this is ethical, as we are exposing individuals to the virus to determine the efficacy of the vaccine quicker than usual to allow the largest number of people to benefit from it and prevent COVID deaths. A paternalistic duty based approach would suggest this is unethical as we are placing patients at what may emerge in the future at harmful risk. The importance of regulatory bodies to weigh and judge ethical scholarship is imperative.
Furthermore, behavioural research into the vaccine uptake is key. Analysing the best ways to convey information and counter misinformation is imperative. Utilising biobehavioural models such as nudging, can also encourage people to take steps to take the vaccine- such as posters in public places encouraging people to accept the offer for the vaccine when they get it. With news outlets broadcasting the risks of blood clots with the Astro-Zeneca virus, the role of health care professionals to communicate effectively with all patient populations, especially ethnic minority populations, becomes more important than ever.
Prior to the pandemic racial inequalities were present in the NHS. One of the groups worse affected were the Gypsy and Traveller communities as outlined in a recent parliamentary report. It was reported that due to barriers to accessing primary healthcare such as requiring a proof of a address to register at a GP practice, patients would often present in acute situations with worse prognosis. Reaching out to these communities to disseminate information regarding vaccine registration and social distancing guidelines is a challenge that we must look to the literature towards, and where literature doesn’t exist begin to generate it.
If these inequalities are allowed to grow, then it can have further impacts on future generations. Jacob et al (2008) posit that the importance of robust evidence based maternal, neonatal and child health services policy to combat the effect of increased socioeconomic poverty as the country deals with a burgeoning depression. In such cases the role of inducing political will is important to make changes in health policy which can positively impact ethnic minorities facing larger health outcome gaps.
Finally, the long-term effect of the pandemic must be addressed as we look to the future. Due to repeated national lockdowns, the issue of loneliness and isolation is rising. The importance of social support integration is underestimated by the public in comparison to behavioural aspects ( Haslam et al 2008) therefore it is important that social support networks, such as long covid support groups are put in place. Our home visit case, the patient was a single mother who was also taking care of an elderly relative whilst all the while recovering from an abusive relationships. Talking to us we realised that she was very lonely and just wanted someone to offload her feelings to. In the current situation where life can become claustrophobic, scholarship surrounding the importance of social support should be disseminated to the
public, and policy should be introduced to provide the increased levels of mental health support – particularly for young people because of harm to their developmental processes by schools and play areas being shut- when the current infection wave of the pandemic subsides.
The challenges posed by COVID-19 are diverse and multifaceted. We must learn from scholarship generated from previous stages of the pandemic to inform our future approach- including planning for both the short and long term. A multidisciplinary approach will allow a robust response, and health care professionals will take a key role in generating and disseminating knowledge to the public due to their trusted role in society. However, ultimately we must use scholarship and professional guidance to sway political will in favour of a robust response for health outcomes.