Continued Confinement of Those Most Vulnerable to COVID-19

Countries deciding on deconfinement measures after initial lock-downs in response to the COVID-19 pandemic often include the continued confinement of those most vulnerable to the disease in these plans as a matter of course. Such continued confinement, however, is neither innocuous nor obviously justified. In this paper, we examine more systematically the requirements for the protection of vulnerable persons, the situation in institutions, legal implications, requirements to sustain vulnerable persons, and self-determination. Based on this exploration, we recommend that continued confinement cannot be the only measure in place to protect vulnerable persons. Protections are needed to enable participation in the public sphere and the exercise of rights for persons particularly vulnerable to fatal courses of COVID-19. The situation in long-term care homes warrants particular caution and in some cases immediate mitigation of lock-down measures that have isolated residents from their caregivers, advocates, and proxies. Vulnerable persons should retain the choice to place themselves at risk, as long as they do not impose risks on others. Vulnerable persons who choose to remain in confinement should be protected against loss of their jobs or income, and against the risk of discrimination in the labor market. Risk and crisis communication stresses the importance of listening to the people and setting up participatory approaches. Associations and lobbies representing the views of groups of those particularly vulnerable to COVID-19 (e.g., the elderly, those with diseases placing them at particular risk) should be consulted and involved in outlining deconfinement measures. Moreover, most vulnerable persons are autonomous and competent and should be allowed to voice their own opinion.