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Back in March 2020, the early days of the Covid pandemic in the US, the conservative writer David Brooks was looking to the past for insight into how we might respond to the emerging public health crisis. The Spanish Influenza pandemic of 1918 seemed an obvious parallel – of course, the scientific knowledge we can bring to bear on our pandemic would be nearly unrecognizable to those combatting the flu a century ago, but surely we could learn something from our fore-runners about how our society could respond at the individual or community level. Disaster brings out the best in people – isn’t that a common-sense principle?

Brooks concluded, pessimistically, that pandemics tend to up-end so-called common-sense, and defy taken-for-granted ideals. “One of the puzzling features of the 1918 pandemic,” Brooks found, was that

when it was over, people didn’t talk about it. There were very few books or plays written about it. Roughly 675,000 Americans lost their lives to the flu, compared with 53,000 in battle in World War I, and yet it left almost no conscious cultural mark. Perhaps it’s because people didn’t like who they had become. It was a shameful memory and therefore suppressed. In her 1976 dissertation, “A Cruel Wind,” Dorothy Ann Pettit argues that the 1918 flu pandemic contributed to a kind of spiritual torpor afterward. People emerged from it physically and spiritually fatigued. The flu, Pettit writes, had a sobering and disillusioning effect on the national spirit.

Back in the spring of 2020, at the beginning of something we couldn’t understand, the scope of which we couldn’t (or wouldn’t) imagine, we could have collectively resolved: “no matter what comes, we will help one another.” Indeed, we all said as much out loud: at the level of government, industry, neighborhood – not to mention craven advertising – we all asserted that, “in these unprecedented times, we’re all in this together.” We might not have been ready to control the virus, but we figured that at least we could control our ethical response, to learn from history, and do right by one another.

After fourteen months, 33 million cases and nearly 600,000 deaths in the US, 165 million cases and 3.4 million deaths worldwide, we have the epidemiological know-how to control the virus, which should feel like victory…even as our ethical failures confront us at every turn, making it impossible to alleviate suffering effectively and equitably.

The pandemic certainly didn’t create inequality. Racial violence, gun violence, police violence, corruption; the perversion of democratic principles to disenfranchise voters, deny reproductive freedoms, and generally control, exploit, and suppress the bodies of pretty much anyone who isn’t rich, white, straight, and male – these threats to human rights aren’t new. Not to mention the ongoing violence we’ve been perpetrating against the planet itself and the consequent existential peril that confronts all of us. The health of the planet, and the health of communities, has been faltering for some time now.

But what is new is that the urgent and drastic response demanded by Covid “has laid bare…the contours of global inequality” while also forcing us to confront the connectedness of varieties of harm (Coll). Those with the fewest resources, the least access to care, have been the ones hardest hit by the pandemic In the US, people of color, migrant workers, those incarcerated in the prison system, the homeless – all these groups have experienced disproportionate rates of infections and deaths (Kendi). Women have left the workforce or missed out on work opportunities as the labour of caring for children has fallen largely on their shoulders. Poorly paid workers with few or no benefits (child care, health care, paid time off) feel no choice but to work when they’re sick, to put off getting vaccinated because they can’t afford to lose the hours, and don’t have the space or privacy to quarantine and avoid spreading infection to others. And beyond the borders of the US, similar forms of inequality are drivers of the spread of Covid, compounded by economic and political imbalances affecting vaccine supply and delivery, all exacerbated by malevolent and incompetent political leadership.

The fantasy that any one person’s or family’s or nation’s suffering is their sole responsibility – their fault, their moral failing – evaporates in the face of undeniable evidence that health and disease are functions of systems, each part of which is dependent on the others. Inequality isn’t separate from health, and in fact is a direct cause of illness, whether physical, psychological, social, or ecological. We can’t manage Covid without managing all of the “social determinants of health”: freedom from discrimination; a living wage and labour protections; adequate access to health care, affordable housing, and education (Maxmen); and, a necessary addition, protection from environmental catastrophe.

And yet, as fundamental as this holistic understanding of human wellness might be to public health, our societies are not good at turning theory into practice. Quite simply, promoting the social determinants of health is an expense that we aren’t yet willing to incur. And when I say “we,” I mean that in the broadest sense. If we really value those social determinants of health, we can’t overlook the fact that “social” implicates each of us, and demands that we act to meet our responsibilities to one another.

Crucially, it’s a malevolent illusion that responsibility begins and ends with each of us in isolation. The “individualization of responsibility” diverts attention from the ways in which government and corporate power exerts influence over our wellbeing (McKibben). We must hold those bodies accountable…and that’s where we can’t escape the imperative to act, to become activist, at the individual level.

It should be the welcome duty of each of us to care for one another through our own behaviors, especially the choices we make about health at all levels, personal, communal, and ecological. Except, worn down by economic pressures, discrimination, the erosion of community ties, and active manipulation by the businesses that dominate our lives, we lose sight of how interconnected we are. As environmental activist Bill McKibben, citing Sally Weintrobe, finds, selfishness makes more sense than care: “the uncaring part [of our psyche] wants to put ourselves first; it’s the narcissistic corners of the brain that persuade each of us that we are uniquely important and deserving, and make us want to except ourselves from the rules that society or morality set so that we can have what we want”  – and so that we don’t have to expend resources we don’t believe we can spare.

Look at the reactionary refusal of the simplest measures to mitigate the spread of Covid here in the US: wearing a mask, avoiding crowds, getting vaccinated – the pandemic has made it clear that the duty of care is not welcome to far too many of our neighbors. And that is “just” the pandemic, “just” in one country – the inability or unwillingness to look after one another undermines support for all manner of public health measures, from choices about individual risk, to choices about who will govern us and how our governments will share resources with less prosperous nations.

So: infection rates and deaths are declining as the vaccination effort progresses. Inequality and inequity, however, are less easily defeated. Vaccination might protect some of us from one kind of illness; but the wellness of individuals, communities, and the planet is still very much in question. What can any one of us do to make healthy change happen?

As with the pandemic, as with the climate emergency, as with social inequality (because they’re all part of the same pathology) – we have the remedies, the tools; what we really need is the willingness to use them. Our best strategy seems too simplistic to work, and yet, what choice do we have? Those who are already voting, protesting, and doing the work of education and care must, no matter how tired they are, keep at it. The rest of us need to help: to exert ourselves, to listen, to learn, to do more than what we wish were our share of the work. AND: we need to make a lot of noise about these efforts – teaching, writing, story telling, amplifying on social media, setting examples, so that not caring stands out as the exception it ought to be, so that it becomes normal, inescapably vital, to be an activist for care.