The Bioethics of Covid-19: Should Governments Let the Virus Run its Course?

We are facing a global public-health crisis in which almost every country in the world is involved. Most countries are experiencing a shortage of medical equipment and need more rapid and generalized testing for Covid-19.

Forced isolation goes hand in hand with preventing health systems across the world from collapsing. It restricts the movements of the entire population of a country without taking into account the varying risks that individuals face.

Studies claim that most patients infected with Covid-19 recover in a matter of days, and only a small number needs to be hospitalized. Only a tiny percentage — the most vulnerable patients — dies. Considering these findings, the idea of protecting and isolating the most vulnerable from death or long-term damage from Covid-19 and treating the rest of society only when they experience other health threats does not sound so far-fetched.

Would it be possible, as some argue, to minimize the threat to the most vulnerable people and maximize the chances for the greatest number of people to safely return to work as soon as possible?

Argentinean President Alberto Fernández and his Brazilian counterpart Jair Bolsonaro have opposing ideas regarding this issue. Argentina has imposed a strict quarantine on the entire population, while in Brazil, Bolsonaro, who compared the pandemic to a cold, has tried to reassure his citizens that nothing would happen if they went out onto the street.

Everyone fears for their loved ones and most would find strict quarantine measures to prevent the spread of the virus somewhat reassuring. Ironically, vulnerable populations could be exposed to greater risk of getting infected during quarantine if they live with suspected patients. It is important that people at risk are isolated from their families, even in their own homes.

No one knows how mass quarantine would affect mental health and family relationships. The growth of gender violence and depression are two risks that could increase in this context.

Should governments allow people to catch the coronavirus, recover and return to work, while doing as much as possible to reduce health threats to vulnerable populations – or should they apply forced isolation for months to save everyone from the virus, regardless of their risk profile, at the expense of other priorities such as the economy?

It is easier and more efficient to reduce transmission by mass quarantine and social distancing, but studies have shown that social isolation alone cannot stop the spread of the virus and that more comprehensive measures are required.

Now that practically everyone is isolated, we can adopt a more focused approach based on risk variables such as age and health condition. Isolating people who fall under these categories and protecting them in a targeted way would minimize the number of infections among vulnerable populations, and as a consequence, prevent the collapse of health systems. We need an aggressive public health response to find ways to protect and treat those who are especially vulnerable to severe Covid-19 infection.

To take this path, we need to assemble interdisciplinary teams of doctors, biologists, economists, engineers, mental health professionals and bioethicists, among others. Until we find a vaccine for Covid-19 infections and efficient antiviral drugs, it is essential to commit to maintaining good personal hygiene and distance from others and to increasing testing and isolation of suspected patients. Our current priority has to be to save as many lives as possible while buying time for medical advances to provide a lasting solution.