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Health disparities from pandemic policies: reply to critics
  1. Nancy S Jecker1,2
  1. 1 Department of Bioethics & Humanities, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2 CUHK Centre for Bioethics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong
  1. Correspondence to Dr Nancy S Jecker, Department of Bioethics & Humanities, University of Washington School of Medicine, Seattle, WA 98195-7120, USA; nsjecker{at}

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In ‘Does zero-COVID neglect health disparities?’ we made the case that strict zero-COVID policies implemented during the coronavirus 2019 disease (COVID-19) pandemic raise health equity concerns so serious that these policies are not ethically sustainable.1 Zero-COVID, which has dominated many Pacific Rim societies, sets zero deaths from COVID-19 as a goal, and aims to reach it by forcefully containing transmission through short-term lockdowns, followed by stringent find, test, trace and isolate methods.

Since the paper appeared in 2021, the Omicron variant and subvariants took hold, making a strict zero goal unattainable and leading many countries to abandon it. Careful ethical analysis of zero-COVID’s impact remains crucially important, however, not only because the novel coronavirus continues to surprise us, but also to ensure lessons learnt from this pandemic are carried forward to future pandemics.

Lessons learnt from Singapore

In ‘Zero-COVID and health inequities’,2 Schaefer argues that it is possible to pursue zero-COVID yet offset any negative impacts on disadvantaged groups. Citing Singapore, where zero-COVID led to outbreaks in crowded and unsanitary migrant workers dormitories, Schaefer notes the government offset these effects, setting up less densely populated ‘quick build dormitories’ that caused daily case counts to drop, even while zero-COVID remained …

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  • Contributors The author is the sole individual responsible for the conception and analysis of the work; drafting the work or revising it critically; final approval of the version to be published; and is accountable for all aspects of the work.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.