Globe Op-Ed: Dr. Paul Farmer Urges “Merciful and Humane” COVID Responses

Posted on Mar 19, 2020

Jean Bosco Bigirimana, right, on the way to a home visit in Rwanda
Jean Bosco Bigirimana (right), oncology program manager for Partners In Health in Rwanda, gets help from a community member with carrying food supplies to a cancer patient in northern Rwanda during a home visit in 2016. Cecille Joan Avila / Partners In Health

Dr. Paul Farmer stressed the importance of social support for COVID-19 patients and the critically ill Thursday, writing in The Boston Globe that “outbreak responses must be merciful and humane” in order to be effective, particularly in resource-limited settings around the world.

“People must have food, supplies, safe shelter, of course, but also help with home-bound children as well as paid sick leave,” Farmer wrote in an opinion piece. “Social support includes safe and rapid transportation to hospitals for the critically ill, since COVID-19 can be a disease with a strong and unpredictable course. Strong social support, including the assurance that one’s loved ones will have access to quality care if they do fall ill, is the secret sauce of effective outbreak control.”

Dr. Paul Farmer
Dr. Paul Farmer, PIH co-founder and chief strategist 

Farmer is co-founder and chief strategist of Partners In Health, and the Kolokotrones University Professor and chair of the Department of Global Health and Social Medicine at Harvard Medical School.

Describing what he called “expert mercy,” Farmer said responses to the global coronavirus pandemic must combine interventions to save the sick and slow the spread of disease with compassionate, humane care, across cultural and societal settings.

“We learned during the West African Ebola outbreak (2014-16) that social distancing is almost impossible in settings of food insecurity or crowded slums,” he wrote.  

PIH works in 11 countries around the world, working with national governments and international partners to strengthen health systems, from local communities to district hospitals. As PIH mobilizes and implements its COVID-19 response plan, Farmer’s Globe piece noted that strong medical infrastructure will be paramount.

“When you’re coughing and short of breath, expert mercy is an oxygen mask or a mechanical ventilator,” he wrote. “Much of this care requires hospital beds, and their availability varies substantially even in affluent countries. South Korea has 12.4 hospital beds for every 1,000 people; in the United States, 2.8. If we’re short on ICU beds in the United States, what will that mean for such places as Haiti or Rwanda or Lesotho or Sierra Leone?”

Strong social the secret sauce of effective outbreak control. 

PIH’s four-pronged COVID-19 plan includes widespread testing; free, dignified, high-quality treatment of the sick; accompaniment of government partners through comprehensive, nationwide responses; and contact tracing to control spread of the disease, advise those who have been in contact with COVID-19 patients, and provide the support they need to stay healthy.  

“We know strong health care systems can help manage the surge by slowing the pace at which we need beds and, more important, nursing care,” Farmer wrote. “We know that expert mercy, and the sentiment of fellow feeling that underpins it, will be sorely needed in weeks to come.”

Read Farmer’s full opinion piece here.

Dr. Paul Farmer sharing a friendly moment with one of his staff.

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