The USA's COVID-19 pandemic experience is an example of privileged thinking that what generally works for those in power ought to be the standard for what makes medical interventions, research, treatments, and policy ethical. As a result of not focusing on doing whatever was required for vulnerable or susceptible populations or their members to achieve their health and flourishing, there are a disproportionate numbers of COVID-19 infections and deaths in Black, Hispanic, and indigenous communities. Future studies will likely show even more harm and larger health failure than known of now. Instead of using the language of privilege and power in their thinking, public health organizations should focus far more on the language of diversity and meaningful inclusion. If we truly are interested in the vulnerable and susceptible communities flourishing as individuals and populations within our society, as well as the society's flourishing, then those terms have to be defined in the language of the vulnerable and susceptible. It is only by using this approach that we can make pragmatic plans that work to the advantage of those who are vulnerable or susceptible.
This personal narrative recounts the experience of a nursing student, Sonia Sweat, and her family as they battled COVID-19 in 2020. After Sonia fell ill, her husband Jason followed suit, and his condition quickly deteriorated. Despite her efforts to care for him at home, Jason was eventually hospitalized and placed in the ICU, battling severe complications. Sonia details the emotional turmoil, the challenges of navigating a health system during a pandemic, and the anxiety of being separated from her husband due to strict quarantine protocols. Her story highlights the personal impact of COVID-19 and the strength of families facing such life-threatening challenges.
In 2022, Dr. Ebony Michelle Collins-a scholar, author, and vision-health advocate-suffered sudden bilateral retinal detachment and blindness following a COVID-19 infection, despite no prior history of ocular disease. Her story reveals a largely overlooked consequence of the pandemic: the potential for serious neurological and ocular complications. This paper uses narrative ethics, supported by virtue ethics, to explore the personal and ethical dimensions of COVID-19-induced neurological impairment. Narrative ethics centers patient stories to humanize clinical data, while virtue ethics emphasizes empathy and compassion in care. Dr. Collins' experience underscores the urgent need for greater awareness and research into the neurological and ocular effects of COVID-19, particularly retinal conditions such as hemorrhaging, vascular occlusion, and detachment. Her case calls for an ethically grounded, patient-centered approach in both research and clinical practice to better address the long-term consequences of the pandemic.
Efforts to reduce the unequal impacts and generations of systemic disadvantage and inequality in healthcare for black and brown communities became amplified and were made more urgent during the COVID-19 pandemic. Moreover, public health surveillance systems have been challenged to address the vulnerabilities that residents within these environments and experiences. This paper describes the methodology used to develop a public health ethics and bioethics surveillance system grounded in empathy and care ethics. This surveillance system was designed to assess the prevalence of ethical and social justice violations relative to the COVID-19 vaccines administration. The authors describe the methods used to establish content validity of the questionnaire, evaluate the data, and compare three ethical theories (i.e., deontology, utilitarianism, and care ethics) that would best undergird public health ethics to increase health equity.
The 2019 novel coronavirus disease (COVID-19) has brought to the forefront racial disparities in health outcomes across the US, but there is limited formal analysis into factors associated with these disparities. In-depth examination of COVID-19 disparities has been challenging due to inconsistent case definition, isolation procedures, and incomplete racial and medical information. As of June 2020, over 14,000 (25%) confirmed COVID-19 cases in Georgia did not have racial information. However, nearly all COVID-19 deaths had racial and ethnic information for analysis. Using county-level information from the Georgia Department of Public Health and the national County Health Rankings & Roadmaps, we found that Black Americans represented 31.5% of all Georgia residents but 46% of COVID-19 deaths. In the metropolitan Atlanta area, this over-representation was most pronounced in Fulton County which houses the City of Atlanta. The opposite pattern - worse disparity in counties surrounding the central city-bearing county - was instead observed in Albany, Columbus, and Macon, with no significant disparity difference in counties surrounding Savannah. Principal component analysis of health-related outcomes and social determinants of health from these 46 counties identified 17 themes, with greater racial disparities in COVID-19 deaths associated with worse air pollution, more rural communities, and paradoxically greater adherence to guidelines for screening mammography. We conclude that factors associated with the virus responsible for COVID-19 and healthcare disproportionately impact Black Americans.
