Ethical reflections on the COVID‐19 pandemic: The epidemiology of panic

• DOI: 10.1111/jpc.14882
• Publication Date: 2020-05-14T09:09:26Z
• Authors: David Isaacs; Philip N Britton; Anne Preisz
• Keywords: Pandemic; Isolation

In many of the more relaxed civilizations on Outer Eastern Rim Galaxy, Hitch-Hiker's Guide has already supplanted great Encyclopaedia Galactica as standard repository all knowledge and wisdom, for though it omissions contains much that is apocryphal, or at least wildly inaccurate, scores over older, pedestrian work in two important respects. First, slightly cheaper; secondly words DON'T PANIC inscribed large friendly letters its cover. (Douglas Adams, The Hitchhiker's to Galaxy) world been preparing a pandemic, most likely be caused by novel strain influenza newly emerged respiratory virus, decades.1 However, unpredictable nature pandemic means that, when does occur, tends induce panic. Tellingly, spelling 'panic' form beginning end word pandemic. A also raises multiple ethical considerations. COVID-19 illustrates features such uncertainty, shifting circumstances rapidly changing recommendations. responsible planning allocation resources becomes major consideration if health service unable sufficiently cope with number sick patients give them optimum care. Public measures designed limit spread virus – this case, coronavirus called SARS-CoV-2 because closest relative SARS epidemic often impinge valued civil liberties. Home isolation, which may recommended exposure spread, shown have significant effects mental health, causing post-traumatic stress prolonged years.3 There are fears home isolation will increase risk domestic violence. Furthermore, restrictions activities economic implications individuals, families society. rationale imposing restrictions, those travel movement, common good: individuals benefit from not being infected, but very function society depends able amount disease, turn rate infection. It suggested core components an decision-making process fairness, inclusiveness (engaging relevant stakeholders), transparency, reasonableness, accountability responsiveness (timeliness).4, 5 benefits engaging public's opinion arguably outweighed need follow expert advice how manage complex, evolving infectious disease way best balances issues conflict, population individual Experts context epidemiologists, specialists, public specialists modellers. wise government forms committee drawing experts these disciplines, who highly trained, keep up latest research literature better than rest us close touch leading international experts. Australia, Chief Medical Officer (CMO), Dr Brendan Murphy, chairs Australian Health Protection Principal Committee (AHPPC). bound legislation CMO during leans heavily AHPPC. accountable decisions recommendations he makes government. With regard transparency decision-making, AHPPC posted regularly Department website,6 explanations continuous oversight frequent changes make widespread consultation impractical even problematic. names provided experience tells passions running high they now, would face abuse death threats social media, conducive providing advice. conflicts our obligation protect welfare One aspect values preserves liberties members can voice their dissatisfaction decision-makers fearlessly. But should we trust available us? Yet every day, quasi-experts arguing remiss acting sooner, example, closing schools immediately. Closing effective pandemics children spreaders influenza. reason did recommend earlier school closure there no good evidence transmitters SARS-CoV-2, contrast influenza, big financial schools. some private decided ignore close, puzzling confusing message, raise anxiety levels rather lower them.7 unwise compare course Australia differing taken different countries, given enormous differences epidemiology, speed introducing preventive measures, level testing emphasis each country puts media commentators professionals apparently think know quick suggest doing more. 'doing more' infringements raising societal anxiety. uneducated use emotive 'exponential' describe current situation threatens worry exponentially. wonder confused engages panic buying when, instead trusting expertise key positions, so people express own reinforcing promoting messages others. Solidarity collective responsibility premium Angela Merkel spoken statesmanlike, poignant terms her about democracy responds crisis.8 milieu certainty what happen next. Baseless reassurance futile, paramount preventing We thank Professor Ian Kerridge, Associate Henry Kilham Mr Tim Knapp constructive criticism.