The consequences of COVID-19 are being felt by all, but marginalized and more vulnerable communities will suffer more.  Existing disparities in society will be conspicuous and amplified in the midst and aftermath of the current crisis. As the phrase “We are all in this together” becomes a common message in the wake of the pandemic, Dr. Patrick Smith challenges us to think about whether or not we fully realize what this statement may mean in terms of policy and justice concerns. It is critical to focus on the margins in terms of policies— if this is not addressed, we betray our desire to affirm a genuine kind of solidarity. If we really mean “We are all in this together”, then Dr. Smith examines the implications of this statement given the acutely fragmented reality of our society.

Dr. Smith advocates for justice as he speaks about the disproportionate financial and health impacts that many marginalized communities have already and will experience due to deeply-rooted injustices. He offers a prophetic clarion call, perhaps, to those of us who will be formulating policy in healthcare institutions, civic organizations, or government to think through how those on the margins and vulnerable populations will be impacted. During this heightened time, it is imperative for those influencing policy to craft it in a way that it doesn’t just work for the enfranchised mostly. They must work in concrete ways for the “least of these” or for those “whose backs are against the wall.”

“We must also be aware that when crises emerge, the long-term health and economic impact for those who survive is often felt hardest by those who already experience disparities in wealth, overall health outcomes and in access to and benefits of health care. All of this suggests that any pathway forward requires and must be attentive to particular and concrete forms of justice.”

“We must frame ways forward with due attention and even preference for the most vulnerable amongst us. Whether thinking about allocating of scarce resources, safeguarding workers or other vulnerable populations, flattening of the curve of the pandemic, allocating money from the Federal government to American citizens, or supporting various industries, I would suggest this attention to the margins must be the case, not only for government, but also for health care institutions and local civic community groups engaged in mitigation efforts….. But there needs to be, ethically speaking, concerted attention given to these matters and a fully coordinated federal response that has in its scope “the least of these.””

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