Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity

George A. Gellert MD, MPH, MPA


Decades into the era of emerging infectious diseases, the 2019-2020 coronavirus pandemic has caught the world, and the United States in particular, poorly prepared to engage effective public health disease prevention and control measures. In part, this reflects poor public health planning, response, logistical preparation and pandemic readiness, and complacency by governments and disease control agencies. In terms of future responses to emerging infection pandemics, these deficiencies can be readily addressed by engaging well established and proven methods of public health disaster and epidemic preparedness planning and mobilization. In part, however, the disastrous 2020 coronavirus disease control response, in the United States but elsewhere, reflects longstanding indifference to essential ethical imperatives, gaps and deficiencies in public policy that extend well beyond public health disease control activities and strategies per se. These imperatives are reviewed and discussed. A key underlying feature, operationally and from an ethical viewpoint, is a chronic failure to understand and actively manage the fundamental global health interdependence that exists among individuals in every jurisdiction or community, including municipal, state, national and international/global. Local, national and global public health interdependence, though existing and ignored for decades, must become the central strategic, operational and ethical recognition for effective coronavirus disease control, and should inform current pandemic response and planning for inevitable future emerging infection outbreaks.

Key Words: Coronavirus pandemic, SARS-Cov-2, COVID-19, coronavirus disease control, ethical issues, global health interdependence, social inequity, racial inequity, economic inequity



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