OMNIA Q&A: COVID-19 Outcomes

As the far-reaching effects of the COVID-19 pandemic continue to impact communities around the world, OMNIA spoke with Kok-Chor Tan, Professor of Philosophy, to learn more about how external factors—such as socioeconomic status, health care, and social biases—can exacerbate or mitigate suffering.

How will a disparity in GDP impact the outcomes of citizens in different countries?

The consequences of extreme global economic inequality are aggravated during a global crisis like the one we are presently facing. Countries with Low Human Development (scored using indicators including life expectancy, per capita income, and education) are less able to respond to COVID-19 due to the lack of essential health resources such as hospitals, medical equipment and medication, and doctors and nurses. Weak infrastructure in transportation and communications, for example, will hamper efforts to provide care and information. Poor countries also suffer disproportionately from preexisting health deficits. Populations with widespread underlying health problems such as tuberculosis and HIV are especially vulnerable to COVID-19.

So far, the shifting epicenter of the coronavirus—first in China, then to Europe, and now North America—has been in wealthier countries or regions of the world. But if, or rather when, it takes hold in sub-Saharan Africa, the devastation there to both public health and the economy will be more catastrophic than seen elsewhere. The international community has to be prepared to respond and step in. We should not think that what happens in other countries is not our concern. Our basic duties of humanity and justice aside, this is a pandemic that by definition knows no borders. If it cannot be contained anywhere in the world, it remains a serious threat to all of us. Under normal conditions, the ideals of global justice and equality might seem like abstract concepts, and the implications of global poverty easy to ignore. But in extremis, the truth of the saying that “inequality is a ticking time bomb” is laid bare.

On a more local level, how does socioeconomic status alter a given household's well-being during a pandemic?

Socioeconomic inequality within a country raises additional issues of justice. While this is a pandemic that touches all of us, its effects on people’s lives are uneven even within a wealthy country. Some people are able to ride it out better than their neighbors. The lack of universal health care here in the U.S., and our broken health system more generally, is compromising our ability as a society to respond effectively. But it will be the poor and the uninsured who will bear the brunt of this collective failure.

Socioeconomic disparity also means that there will be inequality in people’s access to information and their ability to access health facilities and care. This is especially problematic when there is stiff competition for extremely scarce resources like hospital beds, ventilators, and healthcare providers. Socioeconomic inequality has consequences beyond matters directly related to health. Poor families will suffer more under an economic lockdown because low-paying jobs tend to be the most vulnerable. Educational inequality is also accentuated. Schools are closed in much of the country, but not all families are able to exploit remote or virtual learning. And parents who depend on free school meals for their children now face additional burdens. Everyone is affected by the pandemic, but some will be more severely affected. COVID-19 has made very visible, and is in danger of widening, the deep cracks in our system.

A crisis of this dimension is a moment for us, as a society, to reflect on the implications of social inequality and how we have failed each other. A more just society is also in our self-interest even if we are among the advantaged. A society divided—not just politically but economically—will lack the solidarity and mutual trust that are especially necessary in times of crisis. It will be a silver lining if this dark moment can prompt us to really take stock of our society when we finally emerge from it.

How do governmental safety nets tend to fare at times like these?

Governmental safety nets, like unemployment benefits, are important. But we must make sure that the assistance goes to the right place and the right people. We are often told that some corporations are too big to fail. But we must not forget the ordinary individuals, the small business owners (like your neighborhood grocer and corner pharmacist) who are providing essential services at this moment. We should also not forget undocumented workers who mostly occupy low-paying jobs with no security. How hard will it be for them to receive government assistance? The $2.2 trillion relief package passed by Congress is a step in the right direction. But we must not forget the baseline here. In many other wealthy countries, there is mandated protection for workers by default. So, workers aren’t laid off when their sector shuts down. In many cases, even in the current situation, they keep their jobs and their governments cover a percentage of their wages even though they are unable to go to work.

If the unemployment insurance and other safety nets put in place as an emergency response here in the U.S. seem generous, it is because of our lower starting point. The relief package in fact exposes deeper, underlying deficiencies in our institutions. We can say the same about financial relief for health care related to COVID-19. This would be less necessary if there was already universal health care in our country. If there is a recurring theme in our discussion here, it is that a crisis exposes and magnifies existing institutional failures, both domestically and globally.

How do high-stress environments such as this alter social dynamics, including stigmas or shared values, between groups? 

The pandemic has seen a rise in anti-Asian prejudice in this country, and elsewhere. Donald Trump’s “America First” policy, his recurring “us-versus-them” rhetoric, and his modus operandi of insulting foreigners and disparaging international cooperation, have already created a general atmosphere of xenophobia. The onset of COVID-19 and Trump’s morally irresponsible insistence on calling it the “Chinese virus” (at least early on), have brought on a perfect storm for racism and prejudice. Heightened anxiety and uncertainty can create irrational fears and prejudices and the need to find easy targets to scapegoat. But instead of dousing the flames of prejudice, we see our leaders fanning them. In the wake of 9/11, G.W. Bush publicly condemned retaliatory attacks against ordinary Muslim Americans and reminded Americans that "the face of terror is not the true faith of Islam." We are not getting enough of this kind of messaging from Trump—unfortunately, quite to the contrary.

Having said all this, we also see and read about selfless acts of kindness and generosity, not to mention self-sacrificing actions by many—such as frontline medical workers, social workers, and others providing essential services to keep our society functioning. A common crisis can bring out the best in us and remind us of our common vulnerabilities and shared values. Our leaders should be focused on bringing people together and not be fomenting divisions, not especially in a time like this.

What role does the media (and social media) play when it comes to ethics?

This is a very complicated equation. The media has enormous influence in shaping people’s outlook, including their ethical views and attitudes. Mainstream media has the responsibility to provide truthful, unbiased and fact-based reporting, and not, say, advertise fake cures or perpetuate stereotypes in its coverage of the pandemic. On this last point, I recall how early news reports on the coronavirus as a looming danger for America (and now of course actual) were commonly accompanied by photos of Asian-Americans, set in American Chinatowns for full effect. We are not just talking about Fox News here—we saw these in places like The Guardian and The New York Times. These images create a strong association in the mind of the public between the virus and people of Asian-descent.

On a different and more basic point, journalists and reporters have this important and challenging balancing act to perform: convey the seriousness of the situation without inducing panic and irrational fears. Social media is yet a different thing, more amorphous and harder to categorize and to say one thing about. People in positions of power and authority should exercise their outsized presence on social media with extra-vigilance. A careless tweet by a person in authority, floating a conspiracy theory or touting a miracle cure, is bad enough in the best of times. In moments of uncertainty and anxiety, it is dangerous.