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In the past decade, numerous ethical frameworks have been developed to support public health decision-making in challenging areas. Before the COVID-19 pandemic began, members of the authorship team were involved in research programmes, in which the development of ethical frameworks was planned, to guide (a) the use of new technologies for emerging infectious disease surveillance; and (b) the allocation of scarce supplies of pandemic influenza vaccine. However, as the pandemic evolved, significant practical challenges emerged that led to our questioning the value of these frameworks. We now believe that a normative instrument, such as a framework, cannot adequately or reliably provide the ethical guidance that needs to be incorporated into public health decision-making during natural disasters or infectious disease emergencies. Recently it has been suggested that there are potentially more dynamic, flexible, and effective ways to navigate decisions involving complex considerations entailed in policies and practices during a public health emergency. In this paper, we first outline the key functions of a public health ethics framework, before describing why we believe it would not be fit for purpose during a crisis. We end by considering whether proposed alternative methods to promote ethical public health decision-making goals have the potential to meet these objectives., (© 2023 The Authors. Bioethics published by John Wiley & Sons Ltd.)

Vaccination plays an important role in pandemic planning and response. The possibility of developing an effective vaccine for a novel pandemic virus is not assured. However, as we have seen with SARS-CoV-2 vaccine development, with sufficient resources and global focus, successful outcomes can be achieved in a relatively short period. However even when vaccine is available it will initially be scarce. When one becomes available, how should it be distributed? In this paper we explicate how ethical thinking that is carefully attuned to context is essential to decisions about how we should conduct vaccination in a pandemic where demand exceeds supply. We focus on two key issues. First, setting the aims for a pandemic vaccination programme. Second, thinking about the means of delivering a chosen aim. We outline how pandemic vaccine distribution strategies can be implemented with distinct aims, e.g. protecting groups at greater risk of harm, saving the most lives, or ensuring societal benefit. Each aim will result in a focus on a different priority population and each strategy will have a different benefit-harm profile. Once we have decided our aim, we still have choices to make about delivery. We may achieve at least some ends via direct or indirect strategies. Such policy decisions are not merely technical, but necessarily involve ethics. One important general issue is that such planning decisions about distribution will always be made under conditions of uncertainty about vaccine safety and effectiveness. However, planning how to distribute vaccine for SARS-CoV-2 is even harder because we understand relatively little about the virus, transmission, and its immunological impact in the short and long term., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Recent deliberations by Australian public health researchers and practitioners produced an ethical framework of how decisions should be made to distribute pandemic influenza vaccine. The outcome of the deliberations was that the population should be considered in two categories, Level 1 and Level 2, with Level 1 groups being offered access to the pandemic influenza vaccine before other groups. However, the public health researchers and practitioners recognised the importance of making space for public opinion and sought to understand citizens values and preferences, especially First Nations peoples. Methods: We conducted First Nations Community Panels in two Australian locations in 2019 to assess First Nations people's informed views through a deliberative process on pandemic influenza vaccination distribution strategies. Panels were asked to make decisions on priority levels, coverage and vaccine doses. Results: Two panels were conducted with eighteen First Nations participants from a range of ages who were purposively recruited through local community networks. Panels heard presentations from public health experts, cross-examined expert presenters and deliberated on the issues. Both panels agreed that First Nations peoples be assigned Level 1 priority, be offered pandemic influenza vaccination before other groups, and be offered two doses of vaccine. Reasons for this decision included First Nations people's lives, culture and families are important; are at-risk of severe health outcomes; and experience barriers and challenges to accessing safe, quality and culturally appropriate healthcare. We found that communication strategies, utilising and upskilling the First Nations health workforce, and targeted vaccination strategies are important elements in pandemic preparedness and response with First Nations peoples. Conclusions: First Nations Community Panels supported prioritising First Nations peoples for pandemic influenza vaccination distribution and offering greater protection by using a two-dose full course to fewer people if there are initial supply limitations, instead of one dose to more people, during the initial phase of the vaccine roll out. The methodology and findings can help inform efforts in planning for future pandemic vaccination strategies for First Nations peoples in Australia. [ABSTRACT FROM AUTHOR]

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Background: The world is threatened by future pandemics. Vaccines can play a key role in preventing harm, but there will inevitably be shortages because there is no possibility of advance stockpiling. We therefore need some method of prioritising access.Main Text: This paper reports a critical interpretative review of the published literature that discusses ethical arguments used to justify how we could prioritise vaccine during an influenza pandemic. We found that the focus of the literature was often on proposing different groups as priorities (e.g. those with pre-existing health conditions, the young, the old, health care workers etc.). Different reasons were often suggested as a means of justifying such priority groupings (e.g. appeal to best overall outcomes, fairness, belonging to a vulnerable or 'at risk' group etc.). We suggest that much of the literature, wrongly, assumes that we are able to plan priority groups prior to the time of a particular pandemic and development of a particular vaccine. We also point out the surprising absence of various issues from the literature (e.g. how vaccines fit within overall pandemic planning, a lack of specificity about place, issues of global justice etc.).Conclusions: The literature proposes a wide range of ways to prioritise vaccines, focusing on different groups and 'principles'. Any plan to use pandemic vaccine must provide justifications for its prioritisation. The focus of this review was influenza pandemic vaccines, but lessons can be learnt for future allocations of coronavirus vaccine, if one becomes available. [ABSTRACT FROM AUTHOR]

Simple Summary: The majority of the UK's leisure horses are kept at livery yards, under the oversight of a livery yard manager or owner. Livery yard managers/owners therefore have a major impact on the potential wellbeing of horses within each yard, but their role has not been previously studied. This study used the COVID-19 pandemic as a lens to view the priorities and decisions of livery yard managers at a time when everything was already subject to change. Yard managers/owners of 24 very diverse yards were interviewed over a period of nine months, repeating interviews quarterly. Discussion forum threads on relevant topics about livery yards during COVID-19 were also collected. These data were analysed using a qualitative approach called Grounded Theory. The results showed that running a yard required a careful balance between conflicting priorities, which made change difficult within each individual yard culture. During the pandemic, maintaining usual horse care routines and standards was prioritised above human health and the business model of the yard, and above horse–human relationships. However, each yard adopted individual approaches to managing human health alongside maintaining equine management. These findings are important for future initiatives which aim to support livery yard management and change. Approximately 60% of the UK's leisure horses are kept at livery yards under the management and oversight of a livery yard owner or manager (LYO/M), yet their role has received little research attention. This study used the COVID-19 pandemic as a lens through which to view LYO/Ms' decisions around equine care and management at a time when changes to usual practice were necessary. Qualitative research methods were used. Up to 3 interviews were conducted with 24 different LYO/Ms over nine months (n = 48). Discussion threads from open-access UK discussion fora were also analysed. All data were anonymised and analysed using a Grounded Theory methodology. Prior to the pandemic, equine care and management practices varied greatly across yards, and yard cultures were a product of LYO/Ms' construction of good equine care, their business model, and the need to balance human and equine contentment. The role of the LYO/M was to maintain an equilibrium between those interlinked factors. During the pandemic, LYO/Ms adopted new measures designed to influence the movement of horse owners and other people on yards to minimise the risk of COVID-19 transmission. During this time, LYO/Ms reported prioritising equine wellbeing by limiting change to equine routines and management wherever possible. Instead of altering equine management, there was an expectation that the lives of humans would be moulded and re-shaped to fit with the government COVID-19 guidelines. These results highlight the importance of routines, traditions and cultures in each individual yard. Maintaining the standard of care for the horse was prioritised regardless of who provided that care. [ABSTRACT FROM AUTHOR]

Simple Summary: This investigation explored the impact of the COVID-19 pandemic lockdown and following alert levels on pets in New Zealand. Pet owners were surveyed during the last week of the first Alert Level 4 lockdown (highest level of restrictions) and then three months later during Alert Level 1 (lowest level of restrictions). During lockdown, just over half of those surveyed thought that their pet's wellbeing was better than usual, and most owners could list at least one benefit of lockdown for their pets. These included more company, play and exercise. Owners expressed that they were concerned about their pet's wellbeing after lockdown, with pets missing company/attention and separation anxiety being major themes. The Alert Level 1 survey indicated that owners continued to play with their pets more but that higher levels of exercise were not maintained. Just over one-third of owners took steps to prepare their pets to transition out of lockdown. The results indicate that pets may have enjoyed improved welfare during lockdown due to the possibility of increased human-pet interaction. The steps taken by owners to prepare animals for a return to normal life may enhance pet wellbeing long-term if maintained. The influence of the COVID-19 pandemic on human-pet interactions within New Zealand, particularly during lockdown, was investigated via two national surveys. In Survey 1, pet owners (n = 686) responded during the final week of the five-week Alert Level 4 lockdown (highest level of restrictions—April 2020), and survey 2 involved 498 respondents during July 2020 whilst at Alert Level 1 (lowest level of restrictions). During the lockdown, 54.7% of owners felt that their pets' wellbeing was better than usual, while only 7.4% felt that it was worse. Most respondents (84.0%) could list at least one benefit of lockdown for their pets, and they noted pets were engaged with more play (61.7%) and exercise (49.7%) than pre-lockdown. Many respondents (40.3%) expressed that they were concerned about their pet's wellbeing after lockdown, with pets missing company/attention and separation anxiety being major themes. In Survey 2, 27.9% of respondents reported that they continued to engage in increased rates of play with their pets after lockdown, however, the higher levels of pet exercise were not maintained. Just over one-third (35.9%) of owners took steps to prepare their pets to transition out of lockdown. The results indicate that pets may have enjoyed improved welfare during lockdown due to the possibility of increased human-pet interaction. The steps taken by owners to prepare animals for a return to normal life may enhance pet wellbeing long-term if maintained. [ABSTRACT FROM AUTHOR]

Simple Summary: On 11 March 2020, the World Health Organization declared coronavirus disease (COVID-19) outbreak a global pandemic and an ongoing public health emergency. In the United Kingdom, quarantine and social distancing measures were implemented with immediate effect on 17 March 2020, resulting in a rapid change to the way owners managed and interacted with their horses. We surveyed 6259 horse owners to evaluate the impact of COVID-19 on themselves and their horses. The majority of horse owners were visiting and riding their horses less, with increased restrictions experienced by owners who kept their horse at private livery yards. Whilst social distancing and visiting restrictions were in place at livery yards, nearly half were not providing hand sanitization or disinfection protocols for shared areas/equipment to prevent the spread of the virus between owners. Horse owners expressed concern that equine health and welfare would be negatively affected by the restrictions put in place and of financial consequences as a result of the pandemic. The majority of respondents also felt their own mental health and wellbeing was being adversely affected by not being able to visit/interact as they normally would with their horses. Equestrian influencers and national bodies should engage with increased communication and education to support horse owners through the pandemic in the short, medium, and long-term. COVID-19 was declared a global pandemic on 11 March 2020; the United Kingdom (UK) implemented quarantine measures shortly afterward, resulting in rapid changes in how owners managed and interacted with their horses. This study provides a rapid analysis of the initial impact of the COVID-19 outbreak on the management of UK leisure and competition horses. A 17 question online survey was distributed via equestrian social media sites to ascertain the impact of COVID-19 on horse and yard management and on human–horse interactions. Frequency analysis combined with Chi-squared and thematic analyses identified the impact of COVID-19 on UK horse owners. Major changes within horse management and horse–human interactions were reported for the majority of horse owners (>65%), regardless of the establishment type or region. Social distancing and visiting restrictions were implemented at most yards, but nearly half were not providing hand sanitization or disinfection protocols for the shared areas/equipment to prevent cross-contamination between users. The financial impact of the pandemic combined with restricted access to veterinary professionals resulted in owners expressing concerns that horse health and welfare may be compromised as a result. Horse owners also felt that the reduced opportunities for horse–human interactions were negatively affecting their mental health and wellbeing. [ABSTRACT FROM AUTHOR]