COVID and beyond : the ethical challenges of resetting health services during and after public health emergencies

Covid-19 continues to dominate 2020 and is likely to be a feature of our lives for some time to come. Given this, how should health systems respond ethically to the persistent challenges of responding to the ongoing impact of the pandemic? Relatedly, what ethical values should underpin the resetting of health services after the initial wave, knowing that local spikes and further waves now seem inevitable? In this editorial we outline some of the ethical challenges confronting those running health services as they try to resume non-Covid related services, and the downstream ethical implications these have for healthcare professionals’ day-to-day decision-making. This is a phase of recovery, resumption and renewal; a form of reset for health services. 1 This reset phase will define the ‘new normal' for healthcare delivery, and also offers an opportunity to reimagine and change services for the better. There are difficulties, however. Healthcare systems are already weakened by austerity and the first wave of Covid, and remain under stress as the pandemic continues. The reset period is operating alongside, rather than at the end, of the pandemic and this creates difficult ethical choices