The experts in their labyrinth A reflection on the ethics in pandemic times

Experts or opinion leaders in the biomedical field have become enormously relevant in times of the COVID-19 epidemic. Its influence in the particular circumstances of this pandemic raises in a pressing way the possible conflicts of interest that they may have. A conflict of interest is defined by a situation in which the integrity and judgment of a person can be influenced by a secondary interest, and that can divert him from the primary objectives that dictate his action or activity. The issue about conflicts of interest is almost always considered from a utilitarian perspective, that is, how to detect them and avoid their harmful effects. However, in this article we argue the insufficiency of this approach. We defend the need to recover a moral common ground acceptable to all, in this case the Kantian notion of morality and its concept of autonomy. This would allow to immunize against the drifts that conflicts of interests may produce in a society extremely influenced by the mass media and recovering the concept of authority in contrast with the one of simple expert. Copyright (c) 2022 Xavier Vallès, Gerard Carot-Sans.

SARS-CoV-2 contact tracing among disadvantaged populations during epidemic intervals should be a priority strategy: results from a pilot experiment in Barcelona.

OBJECTIVES: The aim of this study was to trace contacts of coronavirus disease 2019 (COVID-19) hospitalised patients and determine the risk factors of infection in urban areas. STUDY DESIGN: Longitudinal analysis of contacts identified from index cases. METHODS: A contact tracing study was carried out in the Northern Metropolitan area of Barcelona, Spain, during the inter-epidemic lapse of May to July 2020, a period of low SARS-CoV-2 incidence. Index cases were notified from the referral hospital. Contacts were traced and followed up for 14 days. Reverse transcription polymerase chain reaction was performed on day 0 and day 14 for contacts. RESULTS: In total, 368 contacts were identified from 81 index cases (median of seven contacts per index case), from which 308 were traced successfully. The median age of contacts was 28 years, 62% (223 of 368) were men. During the follow-up period, 100 contacts tested positive for COVID-19 (32.5% [95% confidence interval {CI} = 27.3-38.0]), with a secondary infection rate of 48.3% (95% CI = 40.8-55.9) among housemates. Clusters of index and respective contacts tended to aggregate within disadvantaged neighbourhoods (P < 0.001), and non-national index cases (N = 28, 34.1%) resulted in higher secondary infection rates compared with nationals (51.0% [95% CI = 41.0-60.9] vs 22.3% [95% CI = 16.8-28.8]; P < 0.001). CONCLUSIONS: Disadvantaged communities experience a disproportionate burden of COVID-19 and may act as infection reservoirs. Contact tracing with a cross-cutting approach among these communities is required, especially during inter-epidemic periods.