Apologies in the time of the great pandemic

As I write this essay, more than 100 people on Guam and almost 1.5 million people around the world have died from the virus. Many who died were lonely and afraid, unable to touch the hand of someone they love as they took their last choking breath. In America, a bewildering state of anger and fear reigns after a still unresolved presidential election. The future seems dark.

In a world yearning for love, the coronavirus has exposed our false securities. Money, power and technology in the hands of those reluctant to work well with others has brought our planet’s richest nations to their knees

Youthful observers for time immemorial will remark about the varied ways that various countries have responded to this pandemic. Our world’s inability to work together will, I fear, be quite evident. For all our flamboyant hyper-connectivity, we have been made plainly aware of the disjointed, mistrustful and chaotic world order that has thus far thwarted efforts to flatten the curve.

In a time of personal darkness, the melancholic Minnesota poet Bob Dylan confessed, “In the fury of the moment I can see the master's hand… In every leaf that trembles, in every grain of sand.” Dylan observes that we must accept pain and vulnerability as our human legacy.

The molecular reality is that the 50 nanometres SARS-CoV-2 virion is bigger than we are. In this hour of our greatest need, humanity is challenged to accept the salvation of humility.

According to Yale public health scholars, quarantine is one of the most ancient, most effective and most abominable methods of controlling communicable disease outbreaks. While in recent times the use of quarantine has been more humane and scientifically based, the historical association with exile and death and the morally negative connotation of sacrifice of a few for the benefit of others remain a reason to avoid quarantine as a default public health measure.

Quarantine and isolation are the most intrusive of public health powers. These harsh actions involve deprivation of an individual’s liberty in the name of public health. Although these civil liberties are protected by both universal and regional human rights declarations and conventions, large-scale public health threats can require extraordinary measures by the government. Coercive public health powers such as quarantine and isolation can be legitimately justified if the public health interests of society are carefully balanced against the freedom of the individual. To pass the balancing test, the benefits to the public should outweigh the burdens or harms that a quarantine may place on individuals.

It is the ethical duty of Guam’s public health doctors to first do no harm. The principle of nonmaleficence directs all physicians toward non-harming behavior or inflicting the least harm possible to reach a beneficial outcome

According to the World Health Organization, potentially harmful consequences that may result from implementing forced quarantine need to be identified and managed, along with policies to maintain essential health services; protect access to food, water, essential goods and services; protect incomes; support families and communities; and ensure human rights for all.

Close coordination of public health and social services is also needed to ensure everyone knows how to seek testing or medical attention, to find and test suspected cases quickly, isolate and treat patients effectively, trace and quarantine contacts timely, and to ensure safe discharge and appropriate post-hospital care to protect others in the community setting. To be effective, public health and social measures require the engagement of all members of society.

Rather than condemn self-reliant citizens for chafing at a restrictive societal lockdown, Public Health must coordinate with a business sector that wants to survive with minimal government intervention. In the face of its own spectacular administrative and bureaucratic shortcomings, Public Health should avoid blaming the victim. The demonization of both sides is unhelpful. We need each other. GovGuam cannot escape its failures and wrong-headed selfish decisions. The business community too needs to recognize its own shortfalls in terms of collaborative planning and participatory accountability.

Politics has always been someone else’s problem. The failure of the Guam Memorial Hospital and the island’s public health infrastructure were out of sight and out of mind until this pandemic came and punched everybody in the face. Voting for competent leaders had become too much of a hassle for busy business people. We are all now reaping the harvest of bad-minded decisions.

In a world yearning for security, let us take heart that love is patient, love is kind. Love does not delight in evil but rejoices with the truth. Love always protects, always trusts, always hopes, always perseveres. Love never fails. We are called to focus on what individuals and communities can do rather than on what not to do. We can all take action to use our talents to help others who need assistance. Rather than burying our heads in the sands of quarantine and isolation, we can all accept personal responsibility and champion the role each person plays in preventing disease and saving lives.

Our lives and our love for each other should be like gifts to be shared, not treasures to be fearfully hidden in the soil.

If we carefully acknowledge the dignity of each human person, we can take the death spawned by this virus and turn it into a new spirit of human connectedness. If the pandemic teaches us anything, it is that we all need each other. The artificial isolation created by social distancing has only served to magnify the already rampant loneliness, disconnectedness, and despair that existed in our broken world.

A very wise man recently observed, “No one can face life in isolation… We need a community that supports and helps us, in which we can help one another to keep looking ahead. How important it is to dream together. By ourselves, we risk seeing mirages, things that are not there. Dreams, on the other hand, are built together, Let us dream, then, as a single human family, as fellow travelers sharing the same flesh, as children of the same earth which is our common home, each of us bringing the richness of his or her beliefs and convictions, each of us with his or her own voice, brothers and sisters all.”

Dr. Vince Akimoto practices Family Medicine at the American Medical Clinic. Send feedback to akimotovince@yahoo.com.