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COVID-19: Politics, Inequalities, and PandemicDisaster Preparedness and Social Justicein a Public Health EmergencyHarold A. PollackUniversity of ChicagoAbstractThe United States is now experiencing public health catastrophe on a scalenot seen for more than a century. COVID-19 puts into stark relief the mutual obliga-tions that reflect interdependence among participants in a common society. Drawingon the work of Amartya Sen concerning famine and related challenges, the authordiscusses the accompanying implications for social justice. Social justice in catastro-phe requires strong social insurance structures and legal protections for the most vul-nerable people, who would otherwise lack economic resources and political influenceto protect their essential interests. Social justice also requires greater and more sus-tained attention to disaster preparedness and public health infrastructure—both ofwhich are characteristically neglected, in part because the public health enterprise isidentified with politically weak and often stigmatized populations.KeywordsCOVID-19, public health, disaster preparedness, social justiceIn April 2020, MSNBC journalist Chris Hayes posted a sardonic tweet:Tyranny is the government telling you you can’t go to a hair salonbecause there’s a plague. Freedom, on the other hand, is the governmenttelling you you have to go back to work at your plague-stricken porkprocessing plant alongside workers who might be sick. (Hayes 2020)One might assume Hayes was joking. He wasn’t. He was providing asuccinct meditation on the relationship between positive and negativefreedom in defending our most essential interests in the midst of a publichealth catastrophe.Journal of Health Politics, Policy and Law, Vol. 45, No. 6, December 2020DOI 10.1215/03616878-8641457Ó2020 by Duke University PressDownloaded from by gueston 02 December 2020
Thus far in America, the COVID pandemic has taken more than 130,000lives and caused trillions of dollars of economic damage, with no certainend in sight.Aspects of the catastrophe could not have been predicted. Yet compar-ing America’s body count and economic devastation to that experiencedby Germany or South Korea, it’s clear that our poor immediate responseand weak public health infrastructures hastened disease spread. Weaksocial insurance compounded the damage; the lack of social protectionsfor workers and a safety net for those in deepest need made the resultingeconomic, social, and health harms even worse than they would other-wise be.The most devastating harms fall on the most vulnerable. As of thiswriting, African Americans account for almost two-thirds of knownfatalities in Chicago. Five of Chicago’s six zip codes with the highestCOVID mortality rates are segregated South Side communities that arealmost entirely African American. Nursing home residents account for avastly disproportionate number of fatalities (Nadolny and Kwiatkowski

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