Eubios Journal of Asian and International Bioethics EJAIB Vol. 30 (4) May 2020 www.eubios.info ISSN 1173-2571 (Print) ISSN 2350-3106 (Online) Official Journal of the Asian Bioethics Association (ABA) Copyright ©2020 Eubios Ethics Institute (All rights reserved, for commercial reproductions). Contents page Wearing Masks in COVID-19 Wearing Masks in COVID-19 Pandemic, the Pandemic, the Precautionary Precautionary Principle, and the Relationships between Individual Responsibility and Group Solidarity 129 Principle, and the Relationships -Darryl Macer between Individual Responsibility Japan’s management of COVID-19-Nader Ghotbi 133 Ethical implications of ‘Rationing’ vs ‘Rationalization’ and Group Solidarity - Maria Patrão Neves 134 Recognitive and redistributive claims in -Darryl Macer, Ph.D., Hon.D., MPH COVID-19 outbreak - Rogelio P. Bayod 136 President, American University of Sovereign Nations and Relationships between Sri Lankan culture, diets and Director, Eubios Ethics Institute, Japan, New Zealand & COVID-19 disease control- Omalpe Somananda 143 Thailand A search for a COVID-19 cure in Siddha medicine 148 Email: [email protected] - Dhastagir Sultan Sheriff Healing mind & body by Mantras, Ayurveda & Yoga 150 Abstract - Lakshmi Vyas This paper argues that a number of medical professionals, How not to face coronavirus: the case of Spain 152 medical authorities, governments and the World Health - Manuel Lozano Rodríguez Organization, have acted unethically during the COVID-19 Who is the most vulnerable during a pandemic? The epidemic and pandemic by advising members of the public social model of disability and the COVID-19 crisis 158 not to wear masks to protect their own health and the - Christopher Ryan Maboloc health of those around them. Although by April 2020 most Cybercrime pandemic - Marites V. Fontanilla 161 authorities have changed their advice to recommend or 3ndstage COVID-19 spread can be contained with HITT even compel citizens to wear face coverings and masks (hydrate, isolate, train, & test) and virtual contact 166 when in public, we need to examine the question of failed - Osama Rajhkan moral responsibility and the accountability for this COVID-19 and Healthcare professionals: The principle erroneous advice. of the common good - Randy A. Tudy 170 Negotiating the “Good Death”: Saying Goodbye in the Failure to apply the ethical principles of non- Time of COVID-19 - Zehra Edisan 175 maleficence and the precautionary principle The Economics of COVID-19 in the Philippines178 The precautionary principle is widely recognized in - Leandro S. Estadilla international law, yet it was not used during the COVID-19 Social Cohesion, Trust, and Government Action Against crisis by most governments, presidents, chief medical Pandemics - Marlon Patrick P. Lofredo 182 officers, national medical associations and even the World COVID-19 Debates in Thailand 189 Health Organization (WHO). They have failed to apply this - Ananya Tritipthumrongchok principle to a very simple public health measure that Commentary on Tritipthumrongchok 190 everyone can do to protect themselves and their - Leonard H. Le Blanc, III community, wearing face covers and masks. At last we can We need to work together to find a cure and vaccine see by April 2020 a change of heart in these so-called wise for COVID-19 - Mei Lu 190 people to change their previous paternalistic Ozamiz Politics in the Time of COVID-19 Pandemic 191 recommendations not to wear masks or face coverings, to - Gerry Arambala now please wear face coverings or even face a penalty if Role of information and communication technology during you do not wear face coverings in some countries. I wish to the COVID-19 Pandemic- Dennis L. Alfaro 195 address the question of moral responsibility for this Ordering Renewal 196 erroneous advice that was provided by many medical Editorial address, and all correspondence to: professionals and medical associations. I would go so far as Prof. Darryl Macer to suggest that these persons have blood on their hands Email: [email protected] and should be disturbed in their sleep at night. Tens of 130 Eubios Journal of Asian and International Bioethics 30(4) (May 2020) thousands of lives have been lost because of their coronavirus. There have been some medical voices against recommendations not to wear masks. the voices of authorities not to wear masks. Burch (2020) wrote, “Despite hearing that face masks “don’t work,” you Actually many people thought that they should wear probably haven’t seen any strong evidence to support that masks, and most in East Asia just went ahead to wear claim. That’s because it doesn’t exist.“, and also provided masks, but in Western countries, and in many other some easy to use guidelines on how to make more effective countries around the globe, people were specifically face coverings. As Wei et al. (2020) wrote, “The possibility advised not to wear masks. This was counter to scientific of presymptomatic transmission of SARS-CoV-2 increases the evidence despite the false claims to advise people not to challenges of COVID-19 containment measures, which are wear masks. For example, Jefferson et al. (2011) in a predicated on early detection and isolation of symptomatic Cochrane Review of dozens of studies already had shown a persons.” decade ago that ordinary masks were effective and Even three weeks after Singapore, the American recommended to wear masks. Wu et al. (2014) had already Medical Association President said, “there is “little benefit presented evidence from the SARS epidemic in Beijing that to wearing a mask”, and “the CDC does not recommend that use of face masks by the public reduced risk of infection people wear face masks to protect themselves from significantly for those who used them. It is no surprise that respiratory viruses.” This includes COVID-19” (Berg, 2020a; the community transmission of SARS-CoV-2 would also be 21 Feb). The American Medical Association (2020) reduced by use of masks and face covers, since it worked “Statement on CDC’s recommendation for public on cloth in the SARS-CoV-1 epidemic. masks” on 3 April, 2020 accepted the public use of masks, Fortunately, we can see some dramatic change of heart and also it was reported that some healthcare institutions in the USA which has the highest number of infections and had been refusing to allow physicians from wearing their deaths from COVID-19. For example, on 29 February, the own mask when the physicians had made a medical U.S. surgeon general Dr. Jerome Adams tweeted in capitals judgment that their own mask was safer than the ones the “STOP BUYING MASKS” and said that masks do not offer institution had provided to them (Berg, 2020b). There any benefit to the average citizen. On 3 April 2020 the U.S. were reports that some institutions only had enough Centers for Disease Control and Prevention recommended masks to provide one mask a day to their professionals. In that Americans wear "cloth face coverings fashioned from some countries, there were reportedly even less masks. household items or made at home from common materials There are still other authorities that remain against ... as an additional, voluntary public health measure." general mask use, such as European Centre for Disease There have been criticisms of WHO by many persons Prevention and Control (2020) who wrote in their “Using about many things, but I question how they could ignore face masks in the community” statement, “There is no scientific evidence and be so reluctant to have people wear evidence that non-medical face masks or other face covers a face cover. In the WHO statement, “There is limited are an effective means of respiratory protection for the evidence that wearing a medical mask by healthy individuals wearer of the mask” At the same time they state, “For in the households or among contacts of a sick patient, or communication purposes, it is important to emphasize that among attendees of mass gatherings may be beneficial as a the people who use face masks in the community want to preventive measure. However, there is currently no evidence protect their fellow citizens in case they are infected. They that wearing a mask (whether medical or other types) by do not want to unknowingly spread the virus, and wearing healthy persons in the wider community setting, including a mask should not be misconstrued that they want to universal community masking, can prevent them from protect themselves from others. Wearing a mask is not an infection with respiratory viruses, including COVID-19.” act of selfishness and should be promoted as an act of (WHO, 2020a). They start to admit some use for masks, solidarity.” Perhaps this is a way for medical authorities to however, “We can certainly see circumstances on which the save their public face while not further causing the deaths use of masks, both home-made and cloth masks, at the of citizens. community level may help with an overall comprehensive response to this disease.” Individual responsibility and group solidarity Actually in 2019 WHO (2019) issued advice to wear It has been quite a contrast to look at the policies masks in times of an epidemic and pandemic in WHO announced in different countries over whether people guidance on “Non- pharmaceutical public health measures should wear masks to protect themselves, and/or others for mitigating the risk and impact of epidemic and from infection during the time of COVID-19. This is a very pandemic influenza”. That statement recommends face simple example to illustrate the evolution of individual mask use in the community for asymptomatic individuals responsibility and group solidarity, although it is related to in severe epidemics or pandemics in order to reduce rather diverse cultural traditions around the world. transmission in the community; this is based on Personally, I found it very interesting because I lived in mechanistic plausibility for the potential effectiveness of Japan for several decades and am totally used to seeing this measure.