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Since the start of the Covid-19 pandemic, societies have faced agonizing decisions about whether to close schools, shutter businesses, delay nonemergency health care, restrict travel, and authorize the use of emergency Covid-19 countermeasures under limited scientific understanding. Measures to control the spread of COVID-19 have disrupted our health, educational, and economic systems, tarnished our mental health, and took away our cherished time with family and friends. Conflicting advice from health agencies on the utility of public health measures left us wondering, was it all worth it? We still do not have all the answers to guide us through difficult risk-risk tradeoff decisions during a health emergency.

When both action and inaction can result in significant harm and irreversible damage, decisions surrounding infection control measures become complicated, and there is no single correct answer. Yet ethics can help us think about hard trade-offs that weigh competing values and have deep consequences for society and particularly the most disadvantaged.

This essay discusses the challenges of making policy trade-offs amid scientific uncertainty. While there may be no perfect formula for deciding what to do and when, we propose four key considerations for assessing risk-risk trade-offs, involving effectiveness, less-restrictive means, harm identification and amelioration, and equitable distribution. We then and apply those four considerations to the areas of education, economies, health care, travel and migration, social engagement, and medical countermeasures, examining governments’ response to the COVID-19 pandemic, and assessing how responses to the next major outbreak can be improved.

Publication Citation

The Hastings Center Report, Vol. 52, Issue 1, 15-20, January/February 2022.