Reflections on the pandemic 6 weeks before lock-down in the US

This is a discussion board post from my Health Policy Class in the Spring term of 2020. It is dated January 30, 2020. I remember seeing news reports at this time with a deep sense of dread about the potential of it wrecking the world. Surely, this will not happen, I hope. Yet we all know now the inevitable of what we then thought was the impossible.

January 30, 2020

Describe and discuss an ethical (bioethical) issue related to health care and health policy. You have a range of issues provided in the Module, but feel free to bring up others.  Be thoughtful and provide informed discussions about these policy issues and topics. You can include your opinion, but it should not be the only thing supporting your position. Each of you should use the ethical principles and materials from your required readings to frame your discussion and reach a conclusion. Think through what principles apply (or don't) to healthcare.

Take the time to respond to classmate postings. You certainly can challenge each other's opinions, but do so respectfully.

As of January 29, 2020, there have been 6065 confirmed cases of coronavirus, of which 5997 in China and 5 in the United States. Although the virus is essentially contained to one region at this time, it is important to note that an epidemic in one area of the world is a concern for all as international travel is easily accessible. Current protocols to mitigate risk of transmission of this disease include screenings and travel restrictions. Screenings consist of a short questionnaire and temperature checks at point of entry. However, cases may be undetected due to concealment of fever or the traveler may be in the incubation period (WHO, 2020).

Ethically, one issue is that those who are in an area of travel restriction, such as the Hubei Province, may feel “trapped” as they are unable to leave and seek refuge from the disease. There is conflicting information on mechanism of disease spread and virulence of the virus. Additionally, there is conflicting information on travel restrictions.

At this time the “WHO advises against the application of any restrictions of international traffic based on the information currently available on this event” (WHO, 2020). The CDC is following these recommendations for travelers entering the US from China. However, in regard to travelers entering China, the CDC has issued a warning level 3, recommending that “travelers avoid all nonessential travel to China”.  There is a warning level 4 for the Hubei Province, meaning do not travel. At this time, authorities in China have imposed travel restrictions for an indefinite period. Specifically, Chinese officials “have closed transport within and out of Wuhan and other cities in Hubei province, including buses, subways, trains, and the international airport. Other locations may be affected” (CDC, 2020). This has affected over 30 million people in 11 cities in the Hubei Province (CNN, 2020).

Access to healthcare is scarce in certain regions, related to the spread of the virus and restrictions. Patients are currently being turned away from the hospital due to lack of bed space and availability of health care. However, Chinese authorities are currently building a 1000 bed hospital dedicated to treating cases of pneumonia (CNN, 2020).

It is important for nurses to be directly involved in developing health policy to promote health and protect patients and the community. Provision 8 of the American Nurses Association Code of Ethics for Nurses states “The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities” (American Nurses Association, 2015). Nurses have a responsibility to share knowledge and expertise with the public. The interpretation from practice and the front lines is a critical component to developing policy that is feasible, relevant and appropriate to the pathogen and disease process. This in turn will reduce health disparities through improvements in health and access to care.  

American Nurses Association. (2015). Code of ethics with interpretative statements. Silver Spring, MD: Author. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.htm 

Centers for Disease Control (2020). Travelers from China Arriving in the United States. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/travelers/from-china.html

CNN (2020). Coronavirus death toll in China hits 41 as medical staff struggle to cope. Retrieved from https://www.cnn.com/2020/01/24/china/wuhan-coronavirus-update-intl-hnk/index.html

WHO (2019). Updated WHO advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV. Retrieved from https://www.who.int/ith/2020-27-01-outbreak-of-Pneumonia-caused-by-new-coronavirus/en/

World Health Organization (2020). Novel Coronavirus(2019-nCoV) Situation Report – 9. Retrieved from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200129-sitrep-9-ncov-v2.pdf?sfvrsn=e2c8915_2