the pandemic's hero and heroine in white gown essay

Hail the warriors in white gowns

Widely praised as heroes for boosting the country's recovery rate from Covid-19, Thai health workers battling at the frontlines are the Post's person of the year

PUBLISHED : 29 Dec 2020 at 04:00

NEWSPAPER SECTION: News

WRITER: Apinya Wipatayotin and Anchalee Kongrut

In every crisis, there is a hero. And for the annus horibilis 2020, no one deserves the "Person of The Year" title more than the "Warriors in White Gowns" -- a term which the public use to praise medical workers and over a million health volunteers on the frontlines of looking after the ill.

These health workers have been a buttress in the war against Covid-19. The war started in Thailand on Jan 4 -- the day when the Department of Diseases Control opened its Emergency Operation Center (EOC).

The early days of the battle were married with problems -- a shortage of surgical masks amid collective fear and panic among people. Health workers managed to work calmly and stoically, risking their health on the frontlines.

Their sacrifice and grace under fire became a major source of hope and trust that somehow the country could survive the pandemic. People listened to the Public Health Ministry's advice.

On March 29, people across the country paid tribute to the warriors in white gowns by giving them a big round of applause for five minutes, expressing appreciation for their hard work.

According to the Global Covid-19 Index (GCI) released in July, Thailand is among nations with the highest Covid-19 recovery rate.

The performance of our healthcare workers did not only win the hearts of ordinary Thais.

In November, Tedros Adhanom Ghebreyesus, director of the World Health Organization (WHO), praised Thailand as "an excellent example" of fighting the coronavirus.

In a tweet on Nov 14, the WHO director wrote: "Thailand is an excellent example of how #COVID19 can be contained with a comprehensive approach -- even without a vaccine. Bravo."

It was no accident, according to WHO's director. The country's impressive performance was the outcome of the country's consistent investment in public health over the past few decades. The investment paid off when it counted the most.

The decentralised public health care system enables medical workers, nurses and volunteers to reach every community. The best example is perhaps Mae Sot Hospital. In November, the district faced a partial lockdown as doctors managed to trace over 10,000 at-risk people and contain the disease from spreading.

But the secret weapon was village health volunteers. The Ministry of Public Health, served as coordinator and messenger between community villagers and state health officials. During Covid-19, these volunteers helped the ministry monitor Covid-19 in communities and educated people on how to protect themselves from the disease.

In May, the ministry launched a nationwide campaign, sending over one million village health workers to knock on 13 million houses, to educate locals about Covid-19 and monitor the disease at household level.

The ministry since May has contracted local manufacturers to supply masks and other items items to make sure health workers would not be affected by a shortage of protective equipment.

It has also ordered Favipiravir, one of the drugs used to treat Covid-19 patients.

In mid-year, the ministry order vaccines developed by the team from the University of Oxford and the pharmaceutical firm, AstraZeneca. It also secured a contract to produce the vaccine formula locally in Phathum Thani, for sale to Asean nations.

But the warriors in white gowns did not only fight the disease. While health workers work at the frontlines, doctors at the ministry are trying to win the war on information.

Amid mass panic and misinformation, the Centre for Covid-19 Situation Administration (CCSA) opened in April, launching daily press briefings on Covid-19.

The CCSA recruited professionals to work as volunteers -- professors in mass media and communications, and corporate PR executives to help the doctors with scripts and presentation.

Another noteworthy move was the decision to choose Taweesilp Visanuyothin as spokesman.

A psychologist at the Department of Mental Health, he knows how to deal with public fear and frustration and how to inspire trust among the public. Now, the CCSA is regarded as an authoritative and reliable source of information on Covid-19.

Apparently, the warriors in white gowns have won the war on information. The war against Covid-19 is far from over. After several months in which infection rates were low, the health workers returned to the battlefield this month as infections spiked.

The number of cases now exceeds 6,000 cases in total, with a total of 60 fatalities and only three seriously ill patients on a respirator.

The infection rate looks formidable, yet health workers calmly follow the playbook -- tracing, testing and containing risk areas.

It is hard to know when Thailand will win the war against Covid-19. But with the warriors in night gowns at work, Thais know they are in good hands.

A medical team from Mongkutwattana General Hospital collects swab samples from an elderly man at a mobile clinic in Pin Charoen 2 community in Don Muang district. Apichit Jinakul

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Who are the real-life heroes in the time of COVID-19?

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By Gustavo Gonzalez

On World Humanitarian Day (WHD), 19 August, we celebrate and honor frontline workers, who, despite the risks, continue to provide life-saving support and protection to people most in need. On this day, we also commemorate humanitarians killed, harassed, and injured while performing their duty. This year’s theme is “Real-Life Heroes”.

But, what does it mean to be a hero? What does it take to help those in need, the poor and at-risk communities, those who are most vulnerable when a disaster strike? Why should we hold up as heroic the deeds of those who everyday continue to extend a helping hand?

As I write this, I am mourning the death of a UN colleague. He died last Friday, struck down by COVID-19, at the age of 32. As a team member of the UN’s Migration Agency, he showed exemplary dedication and commitment to the situation of migrants amidst this pandemic.

He was a true frontline hero, and he is not alone.

In these extraordinary times, and despite the very real danger to themselves, Filipino front line workers, like my fallen colleague, everyday put their own safety and well-being aside to provide life-saving support and protection to people most in need.

In the Philippines, every day since the beginning of the year, humanitarian workers have stood on the front lines dealing with the challenges arising from COVID-19 and other disaster events, like the displacement from the Taal Volcano eruption, the damage wrought by Typhoon Ambo, as well as continuing relief efforts in Marawi City and responding to those affected by the Cotabato and Davao Del Sur earthquakes. Despite the many risks, humanitarians continue to do their work, diligently and selflessly providing assistance to those who need it most.

Through years of responding to various emergencies and capitalizing on national expertise and capacity, the humanitarian community in the country has embraced a truly localized approach by recognizing what at-risk communities themselves can do in these challenging times. The private sector in the Philippines has also stepped up in sharing its resources and capabilities, joining with other humanitarian actors to support affected local governments and communities.

As we give recognition to local real-life heroes, we also need to protect and keep them free from harassment, threats, intimidation and violence. Since 2003, some 4,961 humanitarians around the world have been killed, wounded or abducted while carrying out their life-saving duties. In 2019 alone, the World Health Organization reported 1,009 attacks against health-care workers and facilities, resulting in 199 deaths and 628 injuries.

The COVID-19 pandemic has unveiled an important number of vulnerabilities as well as exposed our weaknesses in preventing shocks. It has also shown that the magnitude of the challenge is exceeding the response capacity of any single partner or country. It represents, in fact, one of the most dramatic calls to work together. The success of this battle will greatly rely on our capacity to learn from experience and remain committed to the highest humanitarian values. Our real-life heroes are already giving the example.

On 4 August, a revised version of the largest international humanitarian response plan in the country since Typhoon Yolanda in 2013 was released by the United Nations and humanitarian partners in the Philippines. Some 50 country-based UN and non-governmental partners are contributing to the response, bringing together national and international NGOs, faith-based organizations as well as the private sector.

COVID-19 might be today’s super-villain, but it does not deter our real-life heroes from doing their job and tirelessly working to find ways to combat the threat and eventually beat the invisible nemesis. We mourn the thousands who have lost their lives to the virus across the globe, including my colleague whom I have spoken of.

At the same time, we join Filipinos in upholding—in the midst of great adversity-- the tradition of celebrating the best of human kindness, generosity, social justice, human rights, solidarity and Bayanihan spirit. We celebrate what makes our front liners and humanitarian real-life heroes. We salute them for continuously putting their lives on the line, despite the risks and uncertainties.

Their efforts must not be overlooked or forgotten.

Mabuhay ang Real-life Heroes! Happy World Humanitarian Day!

Gustavo Gonzalez is the United Nations Resident Coordinator and Humanitarian Coordinator in the Philippines

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Nurses on the front lines: A history of heroism from Florence Nightingale to coronavirus

Dean of the Solomont School of Nursing, UMass Lowell

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Leslie Neal-Boylan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Nurses are heroes of the COVID-19 crisis. May 12 is International Nurses Day, which commemorates the birthday of Florence Nightingale, the first “professional nurse.” The World Health Organization also named this year the “ Year of the Nurse ” in honor of Nightingale’s 200th birthday.

To nurses everywhere, this day and this year have great significance. Nurses, who are being recognized as heroes, have long awaited recognition as health care professionals in their own right and not ancillary to physicians. It’s wonderful to be recognized now in the context of coronavirus, but nurses have always been at the forefront – during war, epidemics and other times of disaster.

I have been a nurse for 40 years and a nurse practitioner for 17 of those years. An active clinician, researcher, scholar and educator, I currently serve as dean of the Solomont School of Nursing at the University of Massachusetts Lowell. Throughout my career, nurses have typically been relegated to a secondary role, and if mentioned at all, we are described as assisting doctors. Nurses today are still asked why they didn’t become doctors instead. Aren’t we smart enough?

Many people don’t realize that nursing and doctoring are entirely different professions with different purposes. We are proud to work alongside doctors and other health professionals, but we have never worked behind them. Not all nurses work at the bedside, but we all touch the lives of patients.

Many nurses have doctoral degrees. They conduct research that advances the quality of patient care. Nurses change health care policy . For example, nurses play a significant role in health care reform and advise Congress on proposed health care rules and regulations. They also guide organizations regarding health care technology and care coordination and sit on executive boards of health care organizations. Nursing is both an art and a science.

The role of the nurse has evolved, but some things haven’t changed. Nurses have always cared for the sick, the well and the dying. We promote health and prevent illness. We interpret what is happening so that patients understand it. We are there for the entire patient experience from birth to old age, from wellness to illness, and throughout age and illness toward a peaceful and dignified death.

Our history provides many examples.

In 1854, Florence Nightingale brought 38 volunteer nurses to care for soldiers during the Crimean War. The cause of the conflict focused on the rights of Christians in the Holy Land and involved Russia, the Ottoman Empire, France, Sardinia and the United Kingdom. Male nurses provided care as far back as the Knights Hospitaller in the 11th century. But prior to Nightingale’s involvement, male and female nurses consisted of untrained family members or soldiers who cared for the ill and infirm.

Nightingale was the first to organize nurses and provide standardized roles and responsibilities for the profession. As such, she is credited with founding modern professional nursing . She was also an expert statistician, collecting data on patients and what did and didn’t work to make them better . Nightingale and her nurses improved sanitation, hygiene and nutrition . They provided care and comfort. Their work had a major impact on the survival of soldiers.

The American Civil War in the 1860s brought thousands of trained nurses to the battlefront, risking their lives to care for soldiers on both sides of the conflict. The most famous were Dorothea Dix , an advocate for indigenous populations and the mentally ill; Clara Barton , founder of the American Red Cross; and Louisa May Alcott , the author of “Little Women.”

Nurses again answered the call with the yellow fever epidemic of 1878 , rushing from all over the country to Tennessee. The epidemic ultimately killed 18,000 people, and many nurses died while caring for the sick.

The U.S. recruited more than 22,000 trained nurses to treat Americans overseas and back at home from 1917 to 1919 during World War I. The war brought death from combat to about 53,000 Americans, while about 40 million civilians and military died worldwide. Time after time, nurses have left the warmth, comfort and safety of their homes to care for others.

Nurses were also among the millions who died from the 1918 influenza pandemic. Fifty million people died worldwide . This pandemic is probably most comparable to what we are experiencing today with COVID-19. But epidemics, such as polio, off and on from 1916 to 1954; the global pandemic of influenza A, 1957-1958; swine flu, 2009-2010; Ebola, 2014-2016; and Zika, 2015-2020, have also required constant nursing care.

I remember the AIDS pandemic, which began in 1981. I was a visiting nurse and saw many patients in their homes, from homeless shelters to penthouse apartments. Everyone suffered not only because of the physical and mental effects of the disease but also because of the stigma. People, even their families, were afraid to touch patients, kiss them or be near them. It was a lonely time for these patients. I watched them deteriorate and die. Nurses were often the only ones to hold the hands of these patients, so they wouldn’t die alone.

Nurses were also there during 9/11. They were among the courageous first responders who risked their lives to save others. Many have chronic diseases because of their exposure to Ground Zero .

Every year, nurses are voted first among the professions the public trusts the most, according to Gallup. We work hard to earn and maintain that trust. You will find us caring for people in their homes, in public health departments, in nursing homes and skilled care facilities, in rehabilitation hospitals, in prisons and correctional institutions, caring for the mentally ill and providing health care advice over phones and computers. Nurses work wherever there are people.

What do we ask in return? It’s simple. We don’t consider ourselves heroes, but we do deserve respect. Public images of the nurse in a sexy uniform or as a handmaiden to a doctor are wrong and insulting. We are professionals. Once the COVID-19 crisis is over, please don’t forget that we are always here for you. Always have been. Always will be.

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The Heroism of Health Workers in the Coronavirus Crisis

Readers acknowledge the risks that doctors, nurses and many others are taking and offer their gratitude.

To the Editor:

Your Covid-19 coverage highlights the plights and heroic efforts of the countless health care workers on the front lines.

My husband — a recent kidney transplant recipient — and I have been struck by the mind-blowing dedication of his team. We spoke with one of my husband’s physicians yesterday, aghast at his description of the treacherous working conditions and amazed at his unswerving commitment.

To all the health care workers out there — doctors, nurses, technicians, medical staff, administrators, food service workers, pharmacists, security guards, our military deployed to set up hospitals and deliver aid — our nation owes you our thanks and our lives.

On March 30, National Doctors Day, could we all join together in a moment of solidarity, and take one minute, say at noon Eastern time, to stop what we’re doing, and just cheer, applaud, bang some cans, wherever we are, for all the selfless people who are endangering themselves and their loved ones for all of our benefit — then post a photo via social media? These heroes deserve our recognition and our deepest gratitude.

Ariane Brandt South Salem, N.Y.

I am a first-year medical student at the Yale School of Medicine. Now that graduating medical students from all over the country know where they are going for residency, many of them just want to get started.

On Wednesday, it was reported that New York University’s Grossman School of Medicine would allow its fourth-year students to graduate early. Other medical schools in the country should follow suit. These are students who are well trained, have already taken care of patients, are itching to go to bat for patients and can relieve many of the pressures that are about to crush our hospital systems.

Shin Mei Chan New Haven, Conn.

She rises at 5:15 a.m., arrives in the Covid-19 unit by 7:15. Receives the handoff information from the night shift. She washes down, dons the yellow gown, shoe covers, hair cover, the N95 mask, gloves and the eye shield and enters the negative pressure room.

Her distraught patient is coughing uncontrollably. She administers a breathing treatment along with some Tylenol and fluids, checks her oxygen saturation, delivers a message from her family and reassures her that she will get better. She leaves and repeats the process with her next patient.

She does this for 12 hours. She goes home and disinfects before she greets her family, has some dinner and goes to bed. Rises at 5:15 and repeats the process, trying not to be discouraged by the patients who go on ventilators or don’t survive.

The nurses never say no, they are always there, eight, 12, sometimes 15 hours a day, and then they do it again the next day and the next. They are the front line.

Michael Dewar Guilford, Conn. The writer is a cardiac surgeon at the Yale School of Medicine.

Re “ New Type of Outbreak Hoarding: Doctors Prescribe for Themselves ” (front page, March 25):

Physicians and all medical professionals are taking an enormous personal risk, for themselves and their families, in caring for the sick right now. My daughter, a physician, and all those she works with do not have all the personal protective equipment required. In Italy about 10 percent of those infected are medical professionals.

Physicians and nurses are now being asked to work even if exposed to Covid-19, as long as they are asymptomatic. I know they find the idea of taking this infection home to their families and communities intolerable. My daughter will no longer see me or her grandparents.

As a retired physician, I put myself on the New York State volunteer list, but wondered how I would face treating patients without an N95 respirator mask. I have not prescribed hydroxychloroquine for myself or family members, but I do not begrudge physicians and other medical personnel who have. It may help them continue to fight Covid-19, even if only psychologically, and we need them to keep fighting!

Connie DiMari New York

As a member of the veterinary profession, I suggest that equipment, masks, gowns and gloves could be used by our human counterparts in medicine.

Further, perhaps there’s a place for doctors, technicians and nurses who care for beloved pets in helping to care for patients during this crisis. There isn’t a veterinarian who can’t put in an IV catheter or adjust a ventilator. All of us have been trained and use such techniques every day, and we could be useful in these trying times of staff shortages.

Seth A. Koch Philadelphia

At 86, I am absolutely fine with dying — although I’m healthy and active and would not turn down another five or 10 years. So if I wind up with Covid-19, give the ventilator to someone else.

What bothers me is that if our national leadership had just a fraction of Gov. Andrew Cuomo’s brain, they would follow his very rational advice to send available ventilators to New York until the curve begins to bend, and then ship them to the next crisis area. Under that system, San Francisco would get an adequate supply in time for my neighbor and me both to survive.

Fran Moreland Johns San Francisco The writer is the author of “Dying Unafraid” and on the board of End of Life Choices California.

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• Volume 46, Issue 8
• ‘Healthcare Heroes’: problems with media focus on heroism from healthcare workers during the COVID-19 pandemic
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• http://orcid.org/0000-0001-9416-9509 Caitríona L Cox
• The Healthcare Improvement Studies (THIS) Institute , Cambridge CB2 0AH , UK
• Correspondence to Dr Caitríona L Cox, The Healthcare Improvement Studies (THIS) Institute, Cambridge CB2 0AH, UK; caitriona.cox{at}nhs.net

During the COVID-19 pandemic, the media have repeatedly praised healthcare workers for their ‘heroic’ work. Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term ‘hero’ in such discussions. The challenges currently faced by healthcare workers are substantially greater than those encountered in their normal work, and it is understandable that the language of heroism has been evoked to praise them for their actions. Yet such language can have potentially negative consequences. Here, I examine what heroism is and why it is being applied to the healthcare workers currently, before outlining some of the problems associated with the heroism narrative currently being employed by the media. Healthcare workers have a clear and limited duty to treat during the COVID-19 pandemic, which can be grounded in a broad social contract and is strongly associated with certain reciprocal duties that society has towards healthcare workers. I argue that the heroism narrative can be damaging, as it stifles meaningful discussion about what the limits of this duty to treat are. It fails to acknowledge the importance of reciprocity, and through its implication that all healthcare workers have to be heroic, it can have negative psychological effects on workers themselves. I conclude that rather than invoking the language of heroism to praise healthcare workers, we should examine, as a society, what duties healthcare workers have to work in this pandemic, and how we can support them in fulfilling these.

• clinical ethics
• applied and professional ethics
• journalism/mass media

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://doi.org/10.1136/medethics-2020-106398

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Introduction

In recent weeks praise for ‘Healthcare Heroes’ has been plentiful in the media, with The Mirror even launching a campaign for all healthcare workers to receive a medal for their work. 1 2 Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term ‘hero’ in such discussions.

The challenges faced by healthcare workers in the current pandemic are substantially greater than those encountered in their normal work, and it is understandable that the language of heroism has been evoked to praise them for their actions. Yet such language can have potentially negative consequences.

The question of what is expected of healthcare workers in a pandemic—in particular with regard to what level of personal risk they should shoulder—is a complex one. Hollow dependence on the narrative of healthcare workers as ‘heroes’ oversimplifies the issue, providing a potentially damaging and morally vacuous evaluation of an important topic. Here, I will examine what heroism is and why it is being applied to the healthcare workers in the present situation, before outlining some of the problems associated with the heroism narrative currently being employed by the media.

What is heroism?

The term hero is widely used and has been applied to a range of fictional and real figures, and consequently it is difficult to reach a precise definition that adequately reflects its common usage. A number of elements have been proposed as necessary for actions to be considered heroic. 3

Since Urmson’s 1958 seminal paper, most accounts consider heroic actions to be supererogatory. 4 5 Supererogatory actions are morally excellent actions that go beyond the duty of the agent: they are actions which are good, but not strictly required. 6 Supporters of the concept of supererogation have used a ‘two-tier’ model of ethical guidance for action to differentiate what one must do (the obligatory) and what one can only be encouraged to do (the supererogatory). 5

Although all heroic actions are supererogatory, not all supererogatory actions are necessarily heroic. Other elements are generally required to make an action heroic, which help to set heroism apart from other prosocial activities, such as giving money to charity (which are altruistic, not heroic). 3 Heroism typically involves a voluntary engagement with an acknowledged degree of personal risk to help others. 3 The risk does not have to involve physical peril, but may involve ‘personal sacrifice in other dimensions of life’, such as serious financial consequences or loss of social status. 3 Both having the choice to act in a certain way and recognising the possible risks/costs are important—someone who has been forced into acting, or acts blithely without any awareness of the hazard, does not act heroically.

A full discussion of the moral and ethical status of heroism, and indeed the philosophical debate surrounding supererogation, is beyond the scope of this paper. For now, let us consider heroic actions to be voluntary prosocial actions, associated with an acknowledged degree of personal risk, which transcend the duty of the agent.

Heroism in the current pandemic

Even outside of a pandemic, there are ways in which the normal actions of healthcare workers could fit the above description of heroism. Healthcare workers voluntarily act to help others in the face of recognised personal risk when they are routinely exposed to infectious diseases in a variety of settings. An accident and emergency nurse risks contracting hepatitis through a needlestick injury, while a physician might be exposed to multidrug-resistant tuberculosis as part of their work. These personal risks are an accepted part of working in certain healthcare roles, so are not encountered unknowingly. Healthcare workers doing their everyday jobs have not, however, been widely lauded as heroes in the media in recent years: these risks have largely been viewed as simply ‘part of the job’. What has changed in the current pandemic to prompt a sudden focus on heroism? Is there something substantially different about the act of working in the COVID-19 pandemic which justifies the change in narrative?

Several historical epidemics have given rise to work examining the duty of healthcare workers to treat patients in the face of personal risk. In particular, the HIV/AIDS epidemic in the 1980s resulted in robust debates regarding the grounding and extent of a physician’s duty of care to patients. 7 8 Later, the 2003 severe acute respiratory syndrome (SARS) outbreak further demonstrated the need to explore conflicts between professional and personal obligations. 9–12 Most of these discussions concerning risk and obligation focused on the concept of ‘duty of care’, or ‘duty to treat’, weighing up the risk to individual healthcare workers against their duty to their patients.

In the COVID-19 pandemic, the risks to healthcare workers are appreciably greater than those encountered in normal practice. In addition to risk of contracting the infection, other costs include ‘physical and mental exhaustion, the torment of difficult triage decisions, and the pain of losing patients and colleagues’. 13 The emotional cost of having to live away from vulnerable family members for extended periods of time while working has also been acknowledged. We might thus argue that although some personal risk is inherent in working in healthcare, these risks are so amplified currently that descriptions of heroism are justified. Moreover, the advice for the public to stay at home to protect themselves contrasts sharply with the requirement for healthcare workers to continue attending work to care for patients, which has emphasised the concept of healthcare workers making a significant sacrifice by continuing to work. The widespread use of militaristic language in the coverage of the pandemic has further fostered the image of front-line staff acting heroically in the ‘battle’ against the virus.

It is thus not surprising that many have reached for the superlative ‘heroic’ in describing the actions of healthcare workers. Yet while these descriptions of ‘healthcare heroes’ may be superficially fitting, the continuing dominance of the hero narrative in the media is in several ways unhelpful.

Heroism stifles meaningful discussion about the duty of care and its limits

A significant problem with the dominant heroism narrative is that it stifles meaningful, and much needed, discussion about under what obligations healthcare workers have to work. The question of what can reasonably be expected of healthcare workers in a pandemic is best addressed through an examination of their duty of care, including what grounds it and what its limits are. Media focus on heroism does not afford sufficient examination of these questions.

It is uncontroversial to state that healthcare professionals have a duty of care to their patients. This duty of care is a ‘special’ positive moral duty, which arises from the relationship between the healthcare worker and the patient. 14 Special duties have two key characteristics: (1) typically they are role related, and are signified by an overt acceptance of the duty, and (2) they can obligate people to incur greater risk in performing the duty than we might expect others to. 14 Yet the duty of care is neither limitless nor fixed. 15 Sokol has been particularly critical of the concept of duty of care, noting that ‘in the medical context, is often invoked as a sort of quasi-biblical commandment, akin to “do not lie” or “do not murder”.’ 16 While it is intuitively appealing to rely on duty of care to justify what healthcare workers should be expected to do during pandemics, the phrase alone is too nebulous to be useful: relying on it can be ‘ethically dangerous by giving the illusion of legitimate moral justification’. 16 If we accept that healthcare workers have a special positive duty to treat patients of emerging infectious disease, even at some personal risk—a ‘duty to treat’—we must critically examine both what grounds this duty and what its limits are.

Grounding the duty to treat has proved challenging: ‘a solid ethical basis for the health professional’s duty to treat victims of… infectious disease, even at some level of personal risk, has proved elusive’. 17 A number of different accounts have attempted to describe the basis for the duty to treat, the most compelling of which are social contract models. 14 According to these models, healthcare workers have a duty to treat which is grounded in a social contract, the result of a ‘negotiation between the medical profession and the community at large’. 17 Healthcare workers have access to certain privileges as a result of their position in society (such as financial renumeration, relative self-regulation, trust and admiration from laypeople) and in return they have a duty to treat which may entail accepting a degree of personal risk. 14 17–19 Clark argues that healthcare professionals who enjoy such benefits, but do not fulfil their duty to treat, are essentially ‘free riders’. 18

Narrow social contract models, which focus exclusively on the contract between doctors and society (and thus exclude non-professional but essential health workers), have been criticised for being too limited to adequately address the response required by the healthcare sector as a whole to a pandemic. 12 Reid argues that attempts to ground the duty to treat should address the broader question of what sort of society we want to live in, a question which cannot be viewed as a simple negotiation between any one professional group and a community. 12 In asking, whether we would ‘prefer to live in a society that provides healthcare to people with infectious disease… or in a society that practices a form of quarantining of the ill without treatment, leaving them to die in isolation’, Reid recognises a broader social contract which is applicable to all those involved in healthcare, not just doctors. 12

It is clear that the duty to treat is not limitless. Healthcare workers are not duty bound to do absolutely everything in their power to benefit their patients at any level of personal risk: for example, as Sokol points out, few would argue that doctors are morally obligated to donate their kidney to a patient. 16 The idea that the duty to treat is limited, even in the current pandemic, is evidenced by the fact that healthcare workers with medical conditions which make them higher risk for suffering serious COVID-19-related disease have been advised to avoid patient-facing roles. For these healthcare workers, working with patients would thus represent an unacceptable level of personal risk, and would exceed what is required by the duty to treat.

Defining the limits of the duty to treat is a ‘daunting task, strewn with philosophical and logistical difficulties’. 16 Indeed, one working group concluded that they ‘could not reach consensus on the issue… particularly regarding the extent to which healthcare workers are obligated to risk their lives’. 11 If the duty to treat is most firmly grounded in a broad social contract between healthcare workers and society, consensus on what degree of personal risk should be undertaken in different circumstances must come from robust discussion between different stakeholders in society. A crude narrative which focuses on all healthcare workers as heroes stifles such discussion, as it does not properly recognise that the duty to treat is limited.

The importance of acknowledging reciprocity

Reciprocity is of significant importance to social contract theories: in return for accepting personal risk in fulfilling their duty to treat, healthcare workers expect reciprocal social obligations. Healthcare institutions are obligated to support workers and acknowledge their work in difficult conditions. The need to provide personal protective equipment (PPE) to minimise risk of illness among healthcare workers has been highlighted by a number of authors. 9–11 15 20 Other proposed reciprocal duties that healthcare institutions have to their employees include clear communication regarding expectations and risks involved; adequate support, training and resources to perform their duties; counselling and psychological support; support and compensation for their families if they die; and access to treatment or vaccination if it becomes available. 15 17 20 21 The general public, who must play a role in supporting the healthcare system, ‘both during an epidemic and in times where there is no crisis’, also have reciprocal obligations. 12 Reid notes that the public play a role in supporting a healthcare system when they pay taxes or vote for governments that support the healthcare system. 12 In times of pandemic, the public also fulfil their obligations to healthcare workers by following public health guidance—for example, by adhering to social distancing measures, or by taking actions to minimise the spread of infection such as covering their mouth when coughing.

A public narrative that concentrates on individual heroism fundamentally fails to acknowledge the importance of reciprocity. Individual heroism does not provide a firm basis on which to build a systematic response to a pandemic: there must be recognition of the responsibilities of healthcare institutions and the general public. In the current pandemic, issues have been repeatedly raised regarding the availability of PPE for healthcare workers. 22 The requirement for employers to provide PPE to minimise the risk to healthcare workers is reflected by the attitudes of workers themselves—97.2% of healthcare workers in one study agreed that their employer was responsible for offering PPE. 23 Media coverage which praises heroism among healthcare workers diverts attention away from the critical importance of ensuring that reciprocal social obligations to healthcare workers are fulfilled; as Reid notes, ‘the obligation to noble self-sacrifice seems incompatible with insisting on proper protective equipment.’ 12 It has been noted that during the SARS epidemic, the hero narrative proved a politically convenient tool for deflecting attention away from governmental errors: ‘by calling health professionals “heroes”, policy makers in government wanted to escape from their guilt of policy mistakes.’ 9 Indeed, a response based on individual supererogatory action neglects the responsibility that the government and healthcare institutions have in supporting workers, and in creating and maintaining the systems required to deliver healthcare. The hero narrative fails to remind the public and healthcare institutions of their own moral duties, as in its focus on individual healthcare workers’ selfless sacrifice it does not recognise that their duty to treat is irrevocably tied to reciprocal societal obligations.

Negative impact on healthcare workers

The overuse of the concept of heroism in the media could also have a negative psychological impact on healthcare workers themselves, through the implication that all healthcare workers have to be heroic. We are, by definition, not obliged to perform supererogatory acts; as Singer et al 11 note, it seems ‘unreasonable to demand… heroism as the norm’. 11 There is thus a fundamental problem in describing all healthcare workers as heroic. We cannot ask all healthcare workers who go to work to accept personal risk beyond what is reasonably expected of them, as it is simply too demanding; we cannot, in short, expect heroism.

It is important to acknowledge that some healthcare workers may feel that the level of personal risk that they are currently being expected to accept in working is beyond what they ‘signed up’ to. Empirical data on healthcare workers’ attitudes to personal risk and duty reflect the fact that not every worker feels comfortable with accepting such risk; an American study found that only 55% of physicians agreed that ‘physicians have an obligation to care for patients in epidemics even if doing so endangers the physician’s health’, while a British study reported that 26.0% of healthcare workers disagreed that ‘All HCWs have a duty to work, even if high risks involved’. 23 24 In modern healthcare, the risk of exposure to infectious disease is not ubiquitous, and healthcare workers in certain roles may argue that significant occupational exposure to pathogens is not an integral part of their normal job. 14 23 As ‘the risks of treating infectious diseases are simply not obvious in or central to some fields in the way that the risk of fighting fires is obvious in and central to the field of firefighting’, we cannot assume that all those working in healthcare were prepared for the high levels of personal risk that might be incurred through working in a pandemic. 14 The heroism narrative leaves little room for acknowledgement of emotions such as fear or confliction regarding contradictory duties.

Fear and anxiety among healthcare workers who are facing personal risk must be acknowledged and addressed. This might be facilitated by moving away from labelling all healthcare workers as ‘heroes’—which places pressure on them to act in ways which are beyond reasonable expectation—and towards a discussion about what expectations are reasonable within a social contract model. The fact that healthcare professionals themselves have expressed discomfort with being labelled as ‘heroes’ further emphasises that the media’s use of the term can have a negative impact on those it is being bestowed on. 25

Recognising the difficult and incredibly valuable work performed by healthcare workers during the current COVID-19 pandemic is an important part of society’s response to it. We should, however, strive to do this without invoking the language of heroism, which emphasises ideas about self-sacrifice but does not adequately recognise the importance of reciprocity, or that there are limits to the levels of personal risk that we can expect healthcare workers to shoulder. Although the concept of individual heroism is appealing, its use could also have negative psychological consequences for healthcare workers themselves.

There have undoubtedly been many individual acts of heroism from healthcare workers in recent weeks and months, and I do not wish to devalue these; rather, I argue that we should be cautious about centring the narrative on heroism. Healthcare workers have a clear and limited duty to treat during the COVID-19 pandemic, which can be grounded in a broad social contract and is strongly associated with certain reciprocal duties that society has towards healthcare workers. This model of duties and reciprocal obligations is likely to be helpful in guiding our response to the pandemic. Rather than praising all healthcare workers as heroes and clapping them every Thursday, we need to critically examine, as a society, what duties we think healthcare workers have to work in this pandemic, what the reasonable limits to these duties are and how we can reciprocally support them.

Acknowledgments

CLC thanks Dr Zoe Fritz for providing helpful comments on previous versions of this paper.

• Clap for our Carers
• ↵ Selfless and exhausted - why NHS heroes deserve medals as coronavirus fight is laid bare - Mirror Online . Available: https://www.mirror.co.uk/news/uk-news/selfless-exhausted-nhs-heroes-deserve-21769301 [Accessed 1 Jun 2020 ].
• Franco ZE ,
• Zimbardo PG
• Singer PA et al
• Francis LP , et al
• Simonds AK ,
• Orentlicher D
• ↵ Doctors lacking PPE ‘bullied’ into treating Covid-19 patients | World news | The Guardian . Available: https://www.theguardian.com/world/2020/apr/06/nhs-doctors-lacking-ppe-bullied-into-treating-covid-19-patients [Accessed 11 Apr 2020 ].
• Wilson S , et al
• Alexander GC ,
• ↵ Why we shouldn’t be calling our healthcare workers ‘heroes’ | Charlotte Higgins | Opinion | The Guardian . Available: https://www.theguardian.com/commentisfree/2020/may/27/healthcare-workers-heros-language-heroism [Accessed 1 Jun 2020 ].

Contributors CLC is the sole contributor to the work.

Funding The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge is funded by The Health Foundation.

Competing interests None declared.

Patient consent for publication Not required.

Provenance and peer review Not commissioned; externally peer reviewed.

Data availability statement There are no data in this work

Read the full text or download the PDF:

Other content recommended for you.

• Healthcare workers’ perceptions of the duty to work during an influenza pandemic S Damery et al., Journal of Medical Ethics, 2009
• Doctors during the COVID-19 pandemic: what are their duties and what is owed to them? Stephanie B Johnson et al., Journal of Medical Ethics, 2020
• Psychological impact of repeated epidemic exposure on healthcare workers: findings from an online survey of a healthcare workforce exposed to both SARS (severe acute respiratory syndrome) and COVID-19 Lai Gwen Chan et al., BMJ Open, 2021
• Pandemic and the human factor Piotr Szawarski, Postgraduate Medical Journal, 2022
• Relational ethical approaches to the COVID-19 pandemic David Ian Jeffrey, Journal of Medical Ethics, 2020
• What healthcare professionals owe us: why their duty to treat during a pandemic is contingent on personal protective equipment (PPE) Udo Schuklenk, Journal of Medical Ethics, 2020
• Should healthcare workers be prioritised during the COVID-19 pandemic? A view from Madrid and New York Diego Real de Asua et al., Journal of Medical Ethics, 2021
• Balancing health worker well-being and duty to care: an ethical approach to staff safety in COVID-19 and beyond Rosalind J McDougall et al., Journal of Medical Ethics, 2020
• Training and education of healthcare workers during viral epidemics: a systematic review Leizl Joy Nayahangan et al., BMJ Open, 2021
• Rapid cycle system improvement for COVID-19 readiness: integrating deliberate practice, psychological safety and vicarious learning Albert Kam Ming Chan et al., BMJ Simulation and Technology Enhanced Learning, 2020

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December 7, 2021

Heroes or victims? Public perception of essential workers in the pandemic

by Brian Flood, University of Illinois at Chicago

Essential workers on the front lines of the COVID-19 pandemic have been praised—and rightfully so—as heroes since the very beginning of this global crisis. But how are they faring? Does the perception of essential workers as heroes overshadow their own suffering?

The pandemic has infiltrated lives across the world for almost two years and a new study from the University of Illinois Chicago College of Business Administration evaluates public perceptions of essential workers.

The goal of the study, which is published in the Journal of Applied Psychology , was to compare the implications of portraying essential workers as heroes (i.e., working on the frontlines of the pandemic) versus victims (i.e., suffering from inadequate support and protection).

"The concern with the widespread heroism narrative is that as essential workers are portrayed predominantly as heroes rather than as victims, this may inadvertently lead third parties such as the general public to overlook their suffering. Our cultural construction of a hero is someone who is willingly making self-sacrifices. Therefore, in calling essential workers heroes, we may go down the slippery slope of taking for granted their sacrifices and suffering," said Zhenyu Yuan, UIC assistant professor of managerial studies and lead author on the paper.

Through a series of surveys, Yuan and his colleagues tested whether portraying essential workers as heroes would desensitize observers regarding the workers' difficult work situations.

The researchers found that portraying essential workers as heroes led to lower levels of perceived injustice, sympathy and outrage, compared with acknowledging essential workers as victims of inadequate support. Further, observers who considered essential workers as heroes were less likely to take political action to support them.

"Our findings suggest that portraying essential workers as heroes creates the risk for observers to overlook their sacrifices and suffering. What we ultimately want to emphasize from this research is that in addition to portraying essential workers as heroes, we should take effective measures to support them. Otherwise, the uplifting heroic stories will not do much to help improve their work conditions," Yuan said.

The researchers hope the findings can help lead to a more balanced and empathetic understanding of essential workers, but also bring about resourceful support for them and others operating in different occupational and family roles during the COVID-19 pandemic and beyond.

"At a broader level, we hope to provide a cautionary note regarding the cultural practice of normalizing individuals in certain occupations (e.g., essential workers in the COVID-19 pandemic ; teachers paying for equipment out of their own pocket) and roles (e.g., moms as superwomen) as heroes and expecting them to make personal sacrifices, as such subtle cultural perceptions may contribute to inequality and only add to their burden," the researchers write.

Journal information: Journal of Applied Psychology

Provided by University of Illinois at Chicago

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Meet the everyday heroes of the pandemic

Volunteers at the North Enfield Foodbank Charity in the UK unload donations. Image:  REUTERS/John Sibley

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Stay up to date:, global health.

• Volunteers are becoming heroes of the coronavirus pandemic.
• In Poland, they are keeping hard-pressed medics supplied with coffee and lunch.
• In New York, they are packing food for people who can no longer afford to buy it.
• In Australia, a bookstore is delivering by bike to isolated people.

Amid all the suffering and anxiety caused by the coronavirus pandemic, volunteers across the globe are showing courage and resilience in helping some of the most vulnerable.

From keeping people supplied with basics during lockdowns, to helping the elderly and confused protect themselves, here are three stories of heroism during the crisis.

1. Feeding the hungry in a city under lockdown

New York City has the highest number of confirmed cases of COVID-19 in the United States, exceeding even those at the outbreak’s epicentre in China’s Hubei province.

Even in normal times, New York City has an estimated 1.2 million people who are short of food. City Harvest usually delivers basics to people who can't afford to buy food in five of the city’s boroughs. But the New York lockdown threatened to halt their vital work.

Undaunted, volunteers are continuing to pack food for distribution, sorting fresh produce such as corn and cabbage - but working spaced out to avoid spreading infection.

"It's important to serve the community, to serve other people," one of the volunteers, Kent Gasser, told Reuters.

"And there's always a need."

Chief Operating Officer Jen McLean says she sees the number of hungry people growing every day.

“What I've seen is an outpouring of people wanting to help. I know we all feel the love right now. We just need to keep our distance so that we can get this food packed and out to people that are relying on it."

2. Delivering coffee and walking the dogs

Streets in the Polish city of Wroclaw are deserted as people obey instructions to stay home . But the calm is deceptive. In the city’s hospitals, medical staff are working flat out to help those suffering with COVID-19.

Volunteer Robert Wagner is delivering coffee, energy drinks, water and packed lunches to paramedics and doctors working overtime.

“We are trying to support medical professionals, working a dozen or so hours a day to protect us against coronavirus," he says.

After Joanna Cieslik's restaurant was ordered to close, along with all the city’s other cafes and restaurants, she decided to cook nourishing dishes and deliver them free to those most in need, including the elderly, sick and homeless.

“We organized crowdfunding, thanks to which we can deliver meals to the most deprived persons free of charge,” Cieslik says.

Marta Listwan created a group on Facebook called "Visible Hand" that coordinates volunteer efforts, including walking dogs for people who can't leave their homes. More than 17,000 people have signed up so far.

Responding to the COVID-19 pandemic requires global cooperation among governments, international organizations and the business community , which is at the centre of the World Economic Forum’s mission as the International Organization for Public-Private Cooperation.

Since its launch on 11 March, the Forum’s COVID Action Platform has brought together 1,667 stakeholders from 1,106 businesses and organizations to mitigate the risk and impact of the unprecedented global health emergency that is COVID-19.

The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.

As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.

3. Pedalling books to help people in quarantine

As the UN warns of the mental health effects of the coronavirus pandemic , one Australian bookstore has found a novel way of getting books to people in isolation.

With most shops closed and people self-isolating at home, Gleebooks is using a free bicycle delivery service to get books to customers stuck in their homes.

"Books are a nice way of travelling without having to go anywhere," says the store’s cyclist Nerida Ross.

"I think there's a lot of anxiety. People are pretty uncertain so they're just really grateful to still be able to access the things that give them joy, without having to leave the house," says Ross.

With many schools closed, the store is selling more children’s activity and craft books.

“We're learning a new way of being, and I think reading is a really big part of that for people."

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Inspiring acts

Incredible people caring for those in need during COVID-19.

When I was a kid, my image of a hero was largely inspired by my dad’s collection of early Superman comics. I read them all. A “hero” was somebody who had supernatural powers like flying, laser vision, or the strength to bend steel.

As humans, of course, we’re all pretty limited in our physical powers. We don’t fly. We can’t see through walls. But what’s unbounded in us is our ability to see injustices and to take them on—often at great risk to ourselves.

My work in global health and development has introduced me to many extraordinary heroes with this kind of superpower. And I’ve had the honor of highlighting many of them on this blog : An epidemiologist who helped eradicate smallpox . A doctor working to end sexual violence in Africa. A researcher working to end hunger with improved crops. Just to name a few.

Why do we need heroes?

Because they represent the best of who we can be. Their efforts to solve the world’s challenges demonstrate our values as a society and they serve as powerful examples of how to make a positive difference in the world. And if enough people hear about their actions, they can inspire others to do something heroic too.

If there’s ever been a time that we need heroes, it’s now. The COVID-19 pandemic has created unprecedented health and economic challenges, especially for the most vulnerable among us. The good news is that many people from all walks of life are doing their part to help them. Health care workers. Scientists. Firefighters. Grocery store workers. Aid workers. Vaccine trial participants. And ordinary citizens caring for their neighbors.

Here are portraits of a few individuals from around the world working to alleviate suffering during this pandemic. I hope their stories inspire you just as much as they have me.

To these heroes and heroes everywhere, thank you for the work you do!

1. One million bars of soap and counting

For the last four years, Basira Popul has been a dedicated polio worker in Afghanistan, traveling from home to home to help vaccinate children and bring an end to the crippling disease.

Basira Popul knocks on the door of a house during home visits, distributing soap and educating families about the COVID-19 pandemic.

When the COVID-19 pandemic hit, social distancing restrictions forced the polio workers to pause their vaccination campaigns. But that didn’t stop their efforts to improve the health of the communities they serve. Instead of vaccinating for polio, Basira and thousands of her colleagues are now distributing bars of soap and giving hygiene lessons to curb the spread of the virus.

Basira demonstrates proper handwashing to children in the Surkh-Rōd District, Nangarhar Province, Afghanistan.

Basira speaks with a mother about proper sanitation, hygiene, and handwashing to prevent the spread of COVID-19.

They have raised awareness of the coronavirus throughout the country and given out more than one million bars of soap to help keep families in Afghanistan safe.

2. It’s a hot and uncomfortable job, but she loves it

As a COVID-19 tester in Bangalore, India, Shilpashree A.S. (Like many people in India, she uses initials referring to her hometown and her father’s name as her last name.) dons PPE, including a protective gown, goggles, latex gloves, and a mask. Then, she steps inside a tiny booth with two holes for her arms to reach through to perform nasal swab tests on long lines of patients.

Shilpashree A.S., a COVID-19 tester and lab technician, tests a patient who exhibits COVID-19 symptoms, from within a booth at the Jigani Primary Health Center in Bengaluru, India.

She has a critical job during this pandemic, but it comes with many hardships. “It’s hot and uncomfortable,” Shilpashree said of the hours she spends dressed in layers of protective gear inside the booth.

Shilpashree and other health workers get organized to carry out tests on the side of the road in Bengaluru, India.

Patients line up at the Jigani Primary Health Center for COVID-19 testing in Bengaluru, India.

The challenges continue after work. To prevent the spread of the coronavirus, she is not allowed to have contact with her family. For the last five months she’s only been able to visit with them on video calls. “I haven’t yet seen my children or hugged them,” she said. “It is like seeing a fruit from up-close but not eating it.” Still, there is no other job she would rather be doing right now. “Even though this involves risk, I love this job. It brings me happiness,” she said.

After a long day of testing, Shilpashree inputs the test results into a centralized database.

3. Trial benefits

Scientists around the world are racing to develop a coronavirus vaccine. There are more than 150 vaccine candidates in development and dozens of trials underway. All these trials need volunteers willing to step forward and help test whether the vaccine is effective and safe. One of those volunteers is Thabang Seleke from Soweto, South Africa.

Thabang Seleke plays with his youngest child in front of his home in South Africa after returning from the clinic where he is participating in Africa’s first COVID-19 vaccine trial.

Thabang is participating in the first African trial of the ChAdOx1 nCoV-19 coronavirus vaccine, which was developed by the Jenner Institute at the University of Oxford. It is also undergoing trials in the UK, U.S., and Brazil. The South Africa trial involves 2,000 volunteers within the Soweto area of Johannesburg, and is being run by Shabir Madhi, Professor of Vaccinology at the University of the Witwatersrand in Johannesburg.

Thabang, who lives in Soweto, South Africa, takes a local taxi to visit the clinic where researchers will monitor his symptoms and immune responses during the vaccine trial.

Thabang has blood and swab samples taken during each visit to the clinic to make sure he remains COVID-19 negative and there are no negative side effects from the vaccine.

Thabang double checks his vaccine trial paperwork after finishing his clinic visit.

Professor Shabir Madhi, who is managing the South African vaccine trial, shows Thabang how to fill in his diary card where he will log his symptoms and any side effects he may experience from the vaccine.

In South Africa, more than 600,000 people have been diagnosed with COVID-19 and more than 13,000 people have died from it since March. Thabang heard about the trial from a friend and stepped forward to join to help bring an end to the coronavirus in Africa and beyond. This trial, Thabang said, “will benefit the whole world.”

Thabang poses with his family outside their home in Soweto.

4. The best of humanity at a time of crisis

Sikander Bizenjo, founder of Balochistan Youth Against Corona, smiles with children in an isolated tribal settlement in Naal, Balochistan, Pakistan, after distributing food assistance to the community.

When COVID-19 spread into Pakistan, Sikander Bizenjo knew where the pandemic would have the biggest impact: on the poorest areas of his country, including places like his home province of Balochistan. More than 70 percent of the population in this arid, mountainous region in southwestern Pakistan lives in poverty and struggles to gain access to education and health care.

Balochistan Youth Against Corona volunteers pack ration bags for the food distribution drive.

A young child stands inside their home after receiving a ration bag and soap from Balochistan Youth Against Corona.

Sikander had moved away from Balochistan to Karachi, where he is now a manager at a business school. But he knew he needed to do something to help his home during the pandemic. After reaching out to local government officials and aid organizations, he learned that many families lacked food and that health facilities had shortages of medical equipment. So he founded a group called the Balochistan Youth Against Corona, which raises funds for monthly food rations for 10,000 households in Balochistan as well of personal protective equipment, masks, face shields and hand sanitizers for frontline health workers.

Sikander works on the distribution drive from his grandfather’s home in Naal, Balochistan.

Sikander speaks to villagers about the importance of soap and handwashing to prevent the spread of COVID-19 while distributing soap packets to them.

The support from other volunteers and donors has been overwhelming, he said. “I’ve seen the very best of humanity come out of this pandemic. People have been supporting us. People have been so kind and generous,” he said.

5. Tuning into better health with Sister Banda

If you have a question about COVID-19 in Zambia, you’ll want to tune into FM 99.1 Yatsani Community Radio. You’ll get advice on how to prevent the spread of the coronavirus from Catholic nun and social worker Sister Astridah Banda.

Catholic nun and social worker Sister Astridah Banda prepares to record her COVID-19 Awareness Program on Yatsani Community Radio in Lusaka, Zambia.

Sister Banda is not a doctor, but she is a passionate public health advocate. When the coronavirus arrived in Zambia, she noticed that most of the public health bulletins about social distancing, masks, and handwashing were being written in English. While English is an official language in Zambia, many people speak one of Zambia’s seven local languages and they were missing out on this critical information. Sister Banda wanted everyone to have access. So, in March, she approached Yatsani Community Radio and asked to start broadcasts where she could translate health bulletins into Zambia’s local languages and provide other critical news on the coronavirus. Her show, which airs several times each week, is produced in a talk show format with various guests who discuss specific health topics and answer questions from callers.

When she’s not on the air, Sister Banda gives lessons to community leaders in Lusaka, Zambia on how to prevent the spread of COVID-19, including good hand washing practices.

Sister Banda (right) with Sister Christabel Kazembe preparing face masks for community distribution in Lusaka, Zambia.

It now reaches more than 1.5 million people, creating a community of listeners looking out for one another to get through this pandemic. “The whole pandemic has brought humanity together,” she said. “We realize that our life is actually short and we need to spend most of it building on what is important. And these are relationships. Getting in touch with one another, being there for each other.”

6. “The answers lie within each of us”

When the first cases of COVID-19 were reported in the Navajo and Hopi Reservations, Ethel Branch grew alarmed that her community didn’t have what it needed to deal with the virus.

A building near the highway depicting mask awareness in the time of COVID-19 on the Navajo reservation in Cameron, Arizona.

The Navajo and Hopi Reservations have many elderly people living without electricity or running water who would need support. She decided she should try to do something about it. Ethel, a former attorney general for the Navajo Nation, resigned from her job at a law firm. She created a GoFundMe page and built an organization called Navajo Hopi Solidarity to help bring relief to the elderly, single parents, and struggling families. To date, she has raised over $5 million. Other community members also found ways to help, including Wayne Wilson and his son, Shelvin, who deliver water to dozens of families in need.

Ethel Branch, founder of Navajo Hopi Solidarity, a COVID-19 relief organization, poses with her 6-month old son in Flagstaff, Arizona.

Many parts of the Navajo Nation don’t have access to water. Wayne Wilson and his son Shelvin bring water to vulnerable families throughout the reservation.

Ethel’s organization has assisted 5,000 families across the reservations. She works with young volunteers from the reservations to deliver food to those in need. “It’s been really amazing. The teamwork, people just stepping forward and making things happen,” she said. “The answers lie within each of us. Each of us has the ability to make choices and to take action and have a positive impact on our community.”

Volunteers for the relief organization Navajo Hopi Solidarity deliver food to families in need in Chinle, Arizona.

7. A long journey to better women’s health

Even before COVID-19, Laxmi Rayamajhi’s job providing birth control services in the remotest areas of Nepal was never easy.

Laxmi Rayamajhi hikes to provide family planning services at Bela, Panchkhal Municipality-10, Kavrepalanchok, Nepal.

As a community health worker for Marie Stopes International, she hikes for hours over hazardous terrain, crossing rivers and landslides to reach the villages she services. But the pandemic has created new obstacles. A national lockdown, supply chain disruptions, and overwhelmed health facilities have all made it more difficult to deliver sexual and reproductive health care services to women in Nepal. And many women won’t visit local health facilities to seek care because they fear they will be infected with the coronavirus.

Laxmi talks to local women about family planning and reproductive health.

Laxmi counsels one of her clients at a remote health post in Nepal.

These healthcare challenges are being experienced by women throughout the world. According to one estimate, if these disruptions continue, 49 million additional women in low- and middle-income countries will go without contraceptives over the next year, leading to 15 million additional unplanned pregnancies. Still, Laxmi and thousands of care providers like her are working tirelessly to overcome these obstacles.

Laxmi inserts a long-lasting contraceptive implant in a client visiting a remote health post in Nepal. The implant prevents pregnancy for up to 5 years.

Laxmi continues to make her long journeys through Nepal to remote health posts to provide care to women in need. For those not comfortable seeing her in-person, she now provides phone consultations. “With my efforts, if women’s health gets better, and creates a healthy impact in our communities, I am grateful,” she said.

Meet more of my heroes in the field

Meet some of the heroes who are fighting poverty and saving lives.

Lost crops like fonio could help us fight climate change and malnutrition.

We already know how to save millions of newborn lives.

Here are a few pictures from my latest visit to this amazing country.

This is my personal blog, where I share about the people I meet, the books I'm reading, and what I'm learning. I hope that you'll join the conversation.

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What's the best state for you », 12 photo essays highlight the heroes and heartaches of the pandemic.

Pictures piece together a year into the COVID-19 pandemic.

Photos: One Year of Pandemic

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A boy swims along the Yangtze river on June 30, 2020 in Wuhan, China.

A year has passed since the World Health Organization declared COVID-19 a pandemic on March, 11, 2020. A virus not visible to the human eye has left its mark in every corner of the world. No single image can define the loss and heartache of millions of global citizens, but photojournalists were there to document the times as best they could. From the exhaustion on the faces of frontline medical workers to vacant streets once bustling with life, here is a look back at photo essays published by U.S. News photo editors from the past year. When seen collectively, these galleries stitch together a year unlike any other.

In January of 2020, empty streets, protective masks and makeshift hospital beds became the new normal in Wuhan, a metropolis usually bustling with more people than New York City. Chinese authorities suspended flights, trains and public transportation, preventing locals from leaving the area, and placing a city of 11 million people under lockdown. The mass quarantine invokes surreal scenes and a grim forecast.

Photos: The Epicenter of Coronavirus

Photojournalist Krisanne Johnson documented New Yorkers in early March of 2020, during moments of isolation as a climate of uncertainty and tension hung over the city that never sleeps.

Coronavirus in NYC Causes Uncertainty

For millions of Italians, and millions more around the globe, the confines of home became the new reality in fighting the spread of the coronavirus. Italian photojournalist Camila Ferrari offered a visual diary of intimacy within isolation.

Photos: Confined to Home in Milan

Around the world, we saw doctors, nurses and medical staff on the front lines in the battle against the COVID-19 pandemic.

Photos: Hospitals Fighting Coronavirus

As the pandemic raged, global citizens found new ways of socializing and supporting each other. From dance classes to church services, the screen took center stage.

Photos: Staying Connected in Quarantine

In April of 2020, photographer John Moore captured behind the scene moments of medical workers providing emergency services to patients with COVID-19 symptoms in New York City and surrounding areas.

Photos: Paramedics on the Front Lines

The COVID-19 pandemic has disproportionately impacted undocumented communities that often lack unemployment protections, health insurance and at times, fear deportation.

Photos: Migrants and the Coronavirus

Aerial views showed startlingly desolate landscapes and revealed the scale of the pandemic.

Photos: COVID-19 From Above

With devastating death tolls, COVID-19 altered the rituals of mourning loved ones.

Photos: Final Farewells

In recognition of May Day in 2020, these portraits celebrated essential workers around the globe.

Photos: Essential Workers of the World

In May 2020, of the 10 counties with the highest death rates per capita in America, half were in rural southwest Georgia, where there are no packed apartment buildings or subways. And where you could see ambulances rushing along country roads, just fields and farms in either direction, carrying COVID-19 patients to the nearest hospital, which for some is an hour away.

Photos: In Rural Georgia, Devastation

In January of 2021, as new variants of the virus emerged, Pfizer-BioNTech, Moderna and other vaccines led a historic global immunization rollout, offering hope.

Photos: COVID-19 Vaccinations

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Tags: Coronavirus , public health , Photo Galleries , New York City , pandemic

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The Hero’s Journey in the Time of COVID

Why stories of a hero’s adventures may resonate during the current pandemic..

Posted August 30, 2020

In only seven months, we have watched the dissolution of our familiar world. The viral outbreak has fractured our social order and dismantled the scaffolding which has held our society intact. Institutions we have come to rely on for our well-being—health care, education , government itself—are altered in ways we couldn’t have predicted.

We wonder how our future will look. Some of us even wonder if we will be alive in the future. What will survive? Will there be restaurants? Movie theaters? Malls and sports arenas? Will our children have human teachers, or will tele-teaching and tele-medical visits become the norm? Social instability appears to be chronic and unfixable and our psyches are suffering greatly. How could we not be swept up by feelings of abandonment, worry, anger , fear , hopelessness, helplessness, disorientation and loss, or numbed out and grieving? If any of these feelings ring true for you, you’re not alone.

Where can we find strength and resilience when hardships proliferate and we need to accommodate even more change? One way is to turn inward to our heroic self who seeks our greatest potential and guides us toward authentic wholeness. Here’s how depth psychologist Carl Jung described this inner companion: “Inside each of us is another who we do not know who speaks to us in dreams and tells us how differently he sees us from how we see ourselves.”

These days most everyone knows about the hero’s journey, whether they are aware of it or not. Popular culture brims with stories structured around the hero’s journey, including some of our most popular fictional characters like Harry Potter or Atticus Finch. The film industry has notably co-opted the hero’s journey to plot movies like Star Wars , The Lion King , Frozen , and all the James Bond films.

Mythologist Joseph Campbell first wrote about the hero’s journey in 1949 in his book, The Hero with a Thousand Faces . Campbell compared myths from around the world, some dating back thousands of years, and found that many of them shared a common structure, which he called “the hero’s adventure.” On an outer level, Campbell noted a sequence of events each hero/heroine encountered and he outlined their stages: departure and separation in which the hero/heroine leaves their safe world; initiation and ordeal in which the hero faces obstacles and ordeals that test her wisdom and skills; and the return , in which, having successfully overcome hardships, the hero returns to where she started, changed by her experience. On an inner psychological level, the hero’s journey depicts a maturation process of discovering one’s potential and becoming one’s true self; it is a portrait of profound transformation.

Hard times spur us to embody our hero-self. As Campbell and others discovered, many classic fairytale motifs as well as myths begin with a statement of misfortune, then progress through challenge and struggle, and finish in triumph. These stories chart the call to a higher purpose that catapults the hero/heroine out of the ordinary world into the unknown where she is tasked with a series of tests and tribulations and ultimately secures a treasure or elixir for herself and the collective world.

The Brothers Grimms' version of “Little Brother and Little Sister” illustrates how the initiating journey starts with misfortune:

Little Brother took his little sister by the hand and said, “Since our mother died we have had no happiness ; our step-mother beats us every day, and if we come near her she kicks us away with her foot. Our meals are the hard crusts of bread that are left over; and the little dog under the table is better off, for she often throws it a nice bit. May Heaven pity us. If our mother only knew! Come, we will go forth together into the wide world.”

Likewise, “The Knapsack, the Hat, and the Horn” begins:

There were once three brothers who had fallen deeper and deeper into poverty, and at last their need was so great that they had to endure hunger, and had nothing to eat or drink. Then said they, “We cannot go on thus, we had better go into the world and seek our fortune.”

In both stories, bad luck leads to good fortune as it does in “The Six Swans”:

Once upon a time, a certain king was hunting in a great forest, and he chased a wild beast so eagerly that none of his attendants could follow him. When evening drew near he stopped and looked around him, and then he saw that he had lost his way. He sought a way out, but could find none. Then he perceived an aged woman with a head which nodded perpetually, who came towards him, but she was a witch ...

In each story, we hold our breath as the hero faces impossible odds that seem unsurmountable and deadly. We read on, hoping against hope that some unseen force or influence will save the day. As in fairytales, so in life, but the helpers that come to our aid are not good fairies or friendly animals, they are our own brilliant but latent resources, instincts stirred to assist us.

Like dreams, these tales and their variants express the universal experiences of our inner worlds. The life of the soul comes to us through story. When we dream or dream our way into a tale, we are being shown the archetypal images latent in our souls that are bound by neither time nor place. To be in touch with this deep personal resource allows us to be lifted from the familiar and every day to view our lives from a God’s-eye perspective—and to see that the wasteland of today may be only a stage in the renewal of a new world.

What images are currently emerging in your dreams that speak of inner fears and challenges? Do you feel yourself abandoned by our government and leaders? Do you see yourself as a child lost in a wood, or freezing to death on a snowy evening ignored by the happy celebrants who pass you by, as in Hans Christian Andersen’s “The Little Match Girl”? Do you feel unseen in a society that doesn’t seem to care? Do you dream you have an impossible task to complete and not enough time? Do you arrive too late to take the exam or your driver’s test? Have you missed the train, forgotten your suitcase, misplaced the ticket, or can’t start the car? Do you dial for help only to discover your phone battery is dead? These are dream images of difficult beginnings, the conflict, or misfortune that sets you on the path. Carl Jung summed up the mystery and importance of dreams when he wrote, “A dream is a product of nature, the patient has not made it, it is like a letter dropped from Heaven, something he knows nothing of.” (ETH Lecture V 23, Nov1934. Page 156.)

Did you have a favorite fairytale growing up? (Preferably not the Disney version, which has usually been altered quite a bit from the original.) If “Rapunzel” or “The Frog King” or “Jack and the Beanstalk” enraptured you then, reread the story and note what stands out for you. What emotions do you feel? Is there something in your life now that has a similar theme? Does a different fairytale capture your attention ? Ask yourself how this particular tale affects you now.

Many of us are now managing anxiety , depression , anger, and fear through psychological and spiritual support. Working consciously with a creative channel by dream journaling, reading, or writing your own fairytale, or simply thinking about the stages of the hero’s journey can complement more conventional ways of managing difficult feelings. They could even bring fresh insights and creative solutions and restore energy to our feelings of “battle fatigue.”

The more you honor and stay in contact with feelings and images that arrive unbidden and give them space, the more they will share their wisdom with you. This is what Jung discovered during his decades-long exploration of soul and psyche. “The privilege of a lifetime,” he writes, “is to become who you truly are.”

Dale M. Kushner, MFA , explores the intersection of creativity, healing, and spirituality in her writing: her poetry collection M ; novel, The Conditions of Love ; and essays, including in Jung’s Red Book for Our Time .

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Viral Heroism: What the Rhetoric of Heroes in the COVID-19 Pandemic Tells Us About Medicine and Professional Identity

Affiliations.

• 1 Department of Psychiatry and Human Behavior and the Center for Bioethics and Medical Humanities, University of Mississippi Medical Center, Jackson, MS, USA. [email protected].
• 2 Department of Philosophy, Millsaps College, Jackson, MS, USA. [email protected].
• PMID: 33550499
• PMCID: PMC7867860
• DOI: 10.1007/s10730-020-09434-4

Throughout the COVID-19 pandemic the use of the term "hero" has been widespread. This is especially common in the context of healthcare workers and it is now unremarkable to see large banners on hospital exteriors that say "heroes work here". There is more to be gleaned from the rhetoric of heroism than just awareness of public appreciation, however. Calling physicians and nurses heroes for treating sick people indicates something about the concept of medicine and medical professionals. In this essay, I will examine three aspects of the social role of medicine exposed by the language of heroism. One, if a hero is someone who goes above and the call of duty, then does that mean exposing oneself to risk of infection is no longer a duty of physicians (as it used to be)? If so, does that mean the "profession" of medicine is much like any other business? Two, physicians and nurses are not the only "heroes" this go-around. Anyone deemed essential to the US "infrastructure" is designated by the US government as having "special responsibilities" to remain at their posts for the public good, which explicitly puts physicians in the same category as sewage workers and grocery store cashiers. Three, what does it mean to belong to a profession that does (or does not) have self-sacrifice and risk-taking as part of its mission-especially a profession that rarely gets called upon to practice these obligations?

Keywords: COVID-19; Heroism; Pandemic; Professional duties; Utilitarianism.

• COVID-19 / epidemiology
• COVID-19 / therapy*
• Health Personnel*
• Professional Role*
• Professional-Patient Relations*
• Self Concept*
• Social Values
• United States / epidemiology

Heroes: What They Do & Why We Need Them

A commentary on today's heroes, heroes and villains of 2020’s two pandemics: covid-19 and racism.

First, there was the March arrival of a murderous virus called COVID-19 that infected roughly 100 million people worldwide, killing 2 million of them. This deadly virus wreaked havoc on world economies and the emotional and physical well-being of billions.

Second, the US was subjected to the graphic killing by police of George Floyd in Minneapolis along with news of the home invasion murder of Breonna Taylor in Louisville. Both deaths set off a firestorm of protest against institutionalized racism.

The purpose of our book, Heroes and Villains of 2020’s Two Pandemics: COVID-19 and Racism , is to showcase how the two pandemics of COVID-19 and racism brought out the best, and the worst, of human nature. The authors of this book, all students at the University of Richmond, review theory and research in heroism science. They then apply the science to an understanding of the heroes and villains who surfaced in response to the two pandemics.

Allison, S. T., Behar, H., Huxtable, V., Kenny, I., Palfreyman, G., Popovich, E., & Saltzman, K. (2021). Heroes and villains of 2020’s two pandemics. Richmond: Palsgrove.

About the Authors

Scott T. Allison is Professor of Psychology at the University of Richmond where he has taught and conducted research for 35 years. He has published over 100 articles on positive social behavior, leadership, and heroism. His books include H eroes, Heroic Leadership, Heroic Humility, Handbook of Heroism, The Romance of Heroism, and The Heroic Leadership Imperative . His work has been featured in media outlets such as National Public Radio, USA Today, the New York Times, the Los Angeles Times, Slate Magazine, MSNBC, CBS, Psychology Today, and the Christian Science Monitor. He received the University of Richmond’s Distinguished Educator Award and the Virginia Council of Higher Education’s Outstanding Faculty Award.

Grace V. Palfreyman is an undergraduate student at the University of Richmond. Born and raised in New Jersey, she will graduate with a B.A. in Psychology. Grace is a division 1 swimmer here at the University, and pretty much spends her free time painting her nails, as well as her friends’ nails, and figuring out her next meal. Her life goal is to travel to every continent, and use the knowledge she has from psychology courses to help people in other countries.

Victoria M. Huxtable is an undergraduate student at the University of Richmond. A Maryland girl, she will graduate with a B.A in Psychology and Health Care Studies. Victoria plays on the Women’s Soccer Team where she constantly learns important values about teamwork and self-discipline. She has a great passion for working with children and also loves volunteering at events for people with disabilities.

Elizabeth M. Popovich is an undergraduate student at the University of Richmond. A New Jersey girl, she will graduate with a major in Psychology and a minor in Sociology. In her free time, Elizabeth enjoys reading, hanging out with her friends, and volunteering at local schools in Richmond. On campus, she is a CAPS intern at the Wellness Center. In the future, Elizabeth hopes to go to graduate school to study further study the field of Psychology.

Kayla R. Saltzman is a Senior at the University of Richmond, and will graduate with degrees in Psychology and Leadership Studies. She plans to continue her studies in order to receive her MSW and work for prevention and rehabilitation for at-risk youth and youth within the juvenile justice system. Kayla loves her family and friends, her dog, the Earth, and music.

Hannah Behar is an undergraduate student at the University of Richmond where she will graduate with a B.S. in Psychology and minor that she is unsure of yet. Hannah loves to sing and is a part of the Off the Cuff Acapella group on campus. Although she is not completely sure yet, she hopes to one day work in a field that focuses on children and/or teenagers mental health.

Isabelle J. Kenny is an undergraduate student at the University of Richmond where she will soon graduate with a B.A. in Rhetoric and Communications Studies and minors in Psychology and Journalism. She is CAPS intern at the Wellness Center on campus and an active member of her sorority Kappa Kappa Gamma. In her free time Isabelle enjoys spending her free time with close friends in Richmond!

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