COVID-19

Just at the point where vaccine trials are showing promise, levels of infection circulating in the general population in the UK are relatively low. This is obviously good news from many perspectives – but makes the next stage of testing more difficult. Is one possible answer human challenge trials?

Guest post: This blog is an extended version of a presentation given by Professor Bobbie Farsides at last week’s Nuffield Council on Bioethics’ webinar “Ethical implications of antibody testing and 'immunity certification'."

In order to exit lockdown safely, the UK will need to be able to identify virus hotspots and have a robust track and trace process in place to ensure that people who might be infected know that they need to self-isolate.

In most emergencies, affected communities play a key role in initiating and leading response activities – in stark contrast to the stereotype of people overwhelmed by the emergency waiting helplessly for help from outsiders.

A mantra of recent government policy reporting in recent weeks is that they are only following the science. The science recommended the lockdown, and the science will let us know when it can be relaxed, apparently. It tells us what tests need to be done for whom and what protective equipment is needed for whom. How exactly can it do this?

In their recent statement on digital contact tracing, NHSX, the NHS Unit leading digital transformation of the NHS, acknowledge that the public will need to trust this new technology for it to be effective in tackling COVID-19, and that NHSX will seek to earn that trust by working with ‘transparent standards of privacy, security and ethics’.

Debate about how to exit from lockdown is increasing. What evidence is there that the ethical dimension of that process has been considered? So far there is little or no such evidence.

It’s amazing how much (and how many people) we trust in and how reliant we are on trust. Imagine a world in which you never trusted your doctor to try to do her best for you. In an emergency such as the present one when things are so uncertain trust matters even more. But you cannot just command trust (‘Trust me I am an expert/Minister/whatever’) and when trust has been built up over time it is very easy for it to be destroyed in an instant.

At some point in this terrible pandemic doctors will have to make some unbelievably difficult life and death decisions. It is the point at which the demand for the intensive life saving resources outstrips their supply. At that point doctors will have to decide who receives care and who does not. No one should have to make such decisions, and yet they will have to be made.

Legal and policy responses to COVID-19 rest on and express the balance of different basic values and principles. Earlier and current regulatory approaches bring into sharp relief how liberty must be understood and weighed against other values. This is for the sake of liberty itself, but crucially too for other compelling aspects of social justice.

A brief analysis of what the Government is doing now to contain COVID-19, the possible restrictive measures that they might take to prevent and control the spread, why these might be justified, and why it is important that the Government sets out publicly – and early - the case for implementing such restrictive approaches.

So what relevance has our report to the enormous challenges being posed to health systems and governments the world over by COVID-19? Unsurprisingly, quite a lot.