World-leading researchers from the UK Pandemic Ethics Accelerator Collaborative consider how we should evaluate decisions made during the covid-19 pandemic and the future response to pandemic threats.

Professor Ilina Singh, the Ethics Accelerator’s Principal Investigator, Oxford Health BRC theme lead, and Co-Director of the Wellcome Centre for Ethics & Humanities at the University of Oxford, said:

We are going to have to learn how to live with covid-19. The work of the Ethics Accelerator facilitates grappling with the hard decisions through clear-sighted analysis of what is gained and lost in decisions and choices made individually and collectively. As a society, we all will still need to make trade-offs to suppress the virus in the long term. Those decisions will affect us all. For example, the measures to reduce deaths and protect health services have created risks and impacts elsewhere, including increased waiting list times and people becoming reluctant to seek medical help, as well as impacts on mental health, child development and education

In terms of mortality, the pandemic is now forcing us to consider what sorts of deaths, and whose deaths should we be most concerned about, as well as the values that underpin such judgments. Untimely or unexpected deaths are something to be avoided – but at what cost?’

In considering many of these issues, the approach by government has often been top-down. At the heart of future policies informing the covid-19 recovery must lie serious and genuine attempts to engage a range of perspectives, including the wider public in identifying what is important to them. Understanding how publics judge and respond to risks, and the diverse values that influence these judgments, is crucial in shaping effective and ethical pandemic policy.’

The pandemic has seen not only the tragic deaths caused directly by the virus – 130,000 in the UK and the 3 million worldwide – but also the illness caused by long-covid.

There have been indirect impacts on health too, due to postponed treatments, and to people avoiding health and care systems, leading to delayed diagnosis and treatment. There have also been mental health impacts, resulting from anxiety, loneliness and isolation. We are going to be living with the wider impacts of covid-19 for a long time and we need to consider what priorities and values should guide us through this next phase and into the future.

A series of thought provoking articles has been written, entitled living and dying with covid:

• The tough choices ahead
• Not all deaths are equal
• Ethical complexity and health/health trade-offs
• When every life counts equally, how should we count deaths?
• Resolving the hard questions of living with covid-19 – the need for public deliberation

For more information on the UK Pandemic Ethics Accelerator and to follow on twitter @PandemicEthics_.