All posts by meanderer007

Pee Brains of southern Manitoba rise again: When Distrust turns to animosity

 

I have tried to be more moderate in my condemnation of my fellow citizens of southern Manitoba. But sometimes that is very hard.

 I have been writing about how distrust in government and its institutions can lead to serious harms, but what happens when distrust curdles into animosity?

When it comes to Covid-19 there really should not be any more surprises in the Southern Health District of Manitoba (where I live). If someone had written a novel with these facts it would have been dismissed as too ludicrous to be believable. The Winnipeg Free Press has reported that Dr. Donna Neufeld of Winker (no relation) said in her region of the district people gathered to set fire to boxes of KN95 masks the province was freely giving out to anyone who wanted them. These masks were in such high demand because we had been told they were the best and with the Omicron variant  we should use the best.  Even though others (like me) were anxious to get such masks, these people gathered like a cult and had a mask burning party.

The  masks  were in such high demand that the province quickly ran out of them. as a result, some of the citizens there decided to burn them so no one could use them. This was an act of much more than vandalism. It puts lives of others deliberately at risk. Dr. Neufeld also told the reporter about a person who smuggled Ivermectin (horse and cow de-wormer) into the hospital so it could be given secretly to a Covid-19 patient by someone who thought they knew a lot more about medicine than the medical team, presumably by virtue of conducting extensive “research” on line. Why bother going to medical school for 7 years training when a couple of hours on the internet will give you all the knowledge you need?  This of course was doubly dangerous, because doctors prescribing medications of course need to know what other drugs their patients take.  Little wonder that the medical community in Winkler has felt a “collective angst,” according to Dr. Neufeld. Wouldn’t you feel that if you lived here?

Of course, Southern Manitoba does not have exclusive rights to crazies. I heard recently that in the US people who are vaccine hesitant have been willing to replace Vaccines with urine. I kid you not. I am sure the Internet researchers will soon be advising the Pee brains of Winkler to drink that instead of injecting vaccines.

I have been preaching that the sleep of reason brings forth monsters, as Goya said. Does anyone disagree? Sometimes I think that someone raised the northern seaboard and all the nuts and bolts rolled down to southern Manitoba. What a place to live.

 

We can’t Afford to get this wrong

 

With the arrival of the omicron variant, the Covid crisis is getting much worse in Manitoba, Canada, and everywhere. I have a lot of confidence in Manitoba’s Public Health professionals, but I fear they might be making a mistake. Or perhaps Manitoba’s political leaders are not taking their advice. I hope my fears are misplaced.

Recently, a number of intensive care physicians in Manitoba begged the province to impose stricter restrictions on Manitoba in order to establish a “circuit breaker” for the spread of the omicron virus. The same thing happened during the 3rd wave of the pandemic they proved to be right. Shortly after that, the province had to send 57 patients from Manitoba’s Intensive Care units to Ontario and Saskatchewan. Those physicians were right; Manitoba’s public health team were wrong. Are we going to experience the same thing again?  If so things will be much more challenging than last time as there is a good chance that those two provinces will not be able to help as this time Manitoba is going through the 4th wave at about the same time as them. As Dr. Roussin has said over and over again, “We can’t afford to get this wrong.”

 

Some have said Manitoba is relying too much on the number of admissions to hospitals, because those admissions typically rise 10 days or so after the virus hits. The second problem is this time with omicron the virus is spreading so rapidly cannot Manitoba wait for the proper numbers to be given? This what Carol Sander of the Winnipeg Free Press reported,

“Public health officials and Premier Heather Stefanson said this week they’re keeping a close eye on ICU admissions and hospitalizations before ordering a potential lockdown or other ramped-up measures to slow the spread of COVID-19.

Even if ICUs aren’t overwhelmed, vital services Manitobans need in their daily lives will likely be disrupted by Omicron, said virologist Jason Kindrachuk.

The normally reserved University of Manitoba medical microbiologist raised the alarm Thursday about the impact of many essential service workers — from pharmacy, grocery, transit and health to protective services — catching the virus.

What happens if a significant proportion of your work staff are all sick at the same time and unable to work? That now has an impact not only on your operations but also on the ability for people to get the goods and services they need,” said Kindrachuk.

Those things are crucially important for us to consider.”

 

Dr. Kindrachuk, from the University of Manitoba, made another very important point:

 

“We have to appreciate health-care capacity and the importance of preserving that, but we also have to look at other aspects and appreciate that we’re all interconnected.” 

 

We all know how vitally important it is to protect our health care system. That is inarguable. But there are other very important “systems” that also need protection. For example, many systems such as the police system, the educational system, the fire protection system, among many others could fail if too many of the people who work in those systems get sick and can’t work. We must not forget that while concentrating solely on the health care system. Because the new variant spreads so fast, we might not have time to make the necessary adjustments such as unwelcome, but perhaps necessary, further restrictions on the movement of people.

The NDP in Manitoba have been criticizing the province for being too slow to react, at the same time as the base of the Conservative Party is likely telling it the restrictions are already too onerous and not necessary. This is how Sanders described the issue:

“By waiting to see if ICU admissions rise before imposing more restrictions, the Progressive Conservative government is “rolling the dice with Manitobans’ lives,” said NDP house leader Nahanni Fontaine. Why wait until we get to the point where we’re goinng to have to contemplate sending people out of province? the MLA said.”.

 

During the third wave of the pandemic, overwhelmed Manitoba ICUs had to send 57 pandemic patients out of province for care. Now that neighbouring provinces are struggling with hospitalizations, that may not be an option.

 

“Ontario is in their own mess,” Fontaine said. “The reality is that there are consequences to sitting on the fence and doing nothing until the last minute — and the consequences are Manitobans’ lives.”

 

Who is right? A lot hangs on it. Another outside expert seems to be siding with the NDP on this issue. He is an outspoken law and public health Prof. Amir Attaran in Ottawa and this is what he said,

“Given Manitoba’s ICU capacity, soaring COVID-19 cases and unvaccinated pockets of the population, Attaran estimates the province will run out of critical care capacity early next week. Manitoba can’t count on outside help this time with the super-infectious Omicron wave hitting most of Canada right now, he added. “Every province, very soon, will be slammed for ICU beds,” said Attaran. “Nor can Manitoba expect the military to bail it out, either. Other provinces will be making the same request… We really are in it together this time.”

 

Some think the Conservative government is pandering to its base. I don’t believe that. I believe they are listening to their Public Health team of professionals. I trust those professionals. I hope my trust is not misplaced. Dr. Roussin is right—we can’t afford to get it wrong.

What does Fairness have to do with it?

 

Dr. Ayoade Alakija a special envoy to the WHO and co-chair of the African Vaccine Delivery Alliance, recently threw a wet blanket on my enthusiastic optimism that we are in the down stretch of Omicron.  Christiane Amanpour asked Dr. Alakija if there was light at the end of the tunnel. Was the pandemic nearing the end? Dr. Alakija said, there was room for

“cautious optimism but it depends where in the world you are sitting and where in the world you live. Yes, there is potential optimism for those who are tripled vaxxed, who are getting booster doses like the US, UK, EU and other parts of the world, and maybe those people can call it a mild illness, but for  those of us in Africa, and for those of us in the low income countries of the world it is absolutely not the beginning of the end, it is more the end of phase I than of Phase II I would say.”

 

By now it is sadly apparent that we actually are all of us in this together, though the richer part of the world has not been heeding this advice. In our haste to get our own populations vaccinated, we have largely forgotten that variants can be developed in the poor parts of the world where the vast majority of people are not fully vaccinated. We will never be safe, until everyone is safe. Dr. Alakija pointed out the current WHO figures for the beginning of the year 2022:

Americas–60% fully vaxxed

Europe–56% fully vaxxed

South East Asia–39% fully vaxxed

Africa–7% fully vaxxed

 

But things are more complicated than that.  Now people in the west are saying fully vaccinated means 3 jabs. In Africa less than 1% are fully vaccinated on that definition. To make things even worse, some are even saying 4 jabs. As a result, she said,

“We could be breeding a super variant in a place like South Africa when the reality of fully vaccinated has now shifted from 2 doses to 3 doses, so Africa is not 7% fully vaccinated but rather less than1% fully vaccinated!”

Africa is a great place for a new variant to evolve! And by now we surely recognize that any new variant will never stay in Africa and we are entirely incapable of keeping it out of our country. In days it will travel from there to here (wherever “there” is ).

 Western politicians, and their citizens have been loath to admit this, to the peril of those citizens. It is not enough to protect ourselves. We need to protect everyone to protect ourselves and our loved ones.

We have to remember that Omicron came from South Africa and Delta came from India. While we were scrambling to protect ourselves, we forgot that this would not be good enough. We don’t know where the next variant will come from and whether or not it will evade our natural protections for those who caught an early variant or whether or not it will evade our vaccines.

Dr. Ayoade Alakija also pointed out how the world’s public health infrastructure was shown to be woefully inadequate, not just in the poor parts of the world, but in places like the UK and US (and Canada) I would add, where we are struggling to provide enough test kits or N95 masks. Chris and I got 10 N95 masks, which are now recommended, this week. We have been told we should all have these. But all we got was 10 and now we are learning they have run out! The philosopher George Santayana once said something like, those who fail to learn from history are doomed to repeat it. I guess that describes us. As Dr. Alakija said,

“Right now people are holding on to slim tiny threads of hope, because we want this to be over. It is not over. It is not over because we have not vaccinated the world. It is not over because people in Africa and Latin America and parts of Asia do not have tests, so they are unable to test and are unable to stay home when they are unwell because there are not economic mitigation measures. It is not over because life in Washington D.C. at the moment is worth far more than a life in Abuja or a life in Sao Paolo is worth less than a life in Brussels. It is not over because we have gross inequity all over the world in vaccines, treatments, and diagnostics…who will stand up? Who will take the wheel at this critical moment world history? President Biden has been trying to take some moral leadership but there hasn’t been enough crowding around. This is a global event of historical proportions that is going to define many of our lives for a long time to come. Public health plus global solidarity is the only way that we’re going to get out of it. We need to act with urgency. We need to act together and we need to act now.”

Until the west learns the truth of this, the coronavirus will stick around to pester us, and perhaps, stick around until it evolves into something much more deadly than we have seen so far. There is absolutely nothing to say this can’t happen. It can. Like everyone else, I want this to end soon, but I recognize that my hopes will not bring it about it. We need to act now.

What does fairness have to do with it? Everything.

 

Who is the Boss?

 

Our previous Premier of Manitoba, Brian Pallister was soundly criticized for many things, often justifiably. But there was at least one thing I trusted about him. He said that when he got scientific advice from the public Health Team in Manitoba he always took that advice. They knew best he said. Brent Roussin, the Chief Medical Officer of Health backed the Premier up on that.

Our new Premier promised she would be different than Brian Pallister. Most of us thought she meant she would be better. Now I am not so sure.

I was surprised to listen to the press conference she held together with the Deputy Chief Medical Officer of Health, Dr. Jazz Atwal, this week. A reporter asked Dr. Jazz Atwal directly if his department had recommended more strict measures be taken. To my surprise, Premier Stefanson immediately jumped in and interrupted to answer the question that had been directed at Dr. Atwal. But she did not answer the question. She skated around it instead. She started talking about how Manitoba already had among the strictest measures in place in the country. She added they got advice from many sources, businesses, doctors and others so that “it’s not just falling at the feet of (Manitoba) Public Health.” Like a master politician she dodged the question and as politicians are taught, when you are asked a question you don’t like, answer the one you wanted to be asked instead.

However, the reporters were persistent. They interrupted the Premier to repeat the question to Dr. Atwal. Had their department recommended stricter measures? This time Dr. Atwal gave an answer. Although it was not a complete answer either, he did make it plain what happened. Dr. Atwal said, “We do provide recommendations to government,” but left it up to the government to comment on whether or not it accepts them.”

 

It was telling that the Premier did not jump in to assure us that they always followed the advice of the Public Health team as Pallister had done. I know in a Democratic society the publicly elected representatives have the final say. That is how it should be. However, when they choose to ignore the advice of their own experts I think they should tell us that is what they are doing and then explain why, so we can make our own decisions about the wisdom of what the government has done.

For weeks now Manitoba physicians have been calling on the government to ramp up restrictions and bring in “circuit breaker” measures. I was surprised Dr. Roussin and his team were not doing that. Now I know why.  He was probably overruled by the Premier and Cabinet and no one told us about it. It looks to me like they took the advice of business people rather than the Public Health team.

Manitoba shreds the Public Trust

As faithful readers of this blog will know, I have been posting about the lack of trust among people of lower incomes in particular because they have felt abandoned by their government, the political leaders, and political elites.  Then just as I thought I was done for now on this subject Manitioba’s premier demonstrated how true this is.

I was shocked to read the Winnipeg Free Press yesterday. The paper reported on our new Conservative Premier as follows:

“As the Omicron variant roars across the province, Manitoba’s premier conceded the public—and not the government—must be responsible for limiting its spread. “This virus is running throughout our community and it’s up to Manitobans to look after ourselves,” Premier Heather Stefanson told reporters on Wednesday.”

 

I don’t deny that Manitobans must take responsibility for their own health. Failure to do so leads to all kinds of harms, but that does not mean we should be abandoned by our government for that too leads to serious harm, for all of us. This is exactly what Anita Sreedhar and Anand Gopal said in the New York Times:

“Over the past four decades, governments have slashed budgets and privatized basic services. This has two important consequences for public health. First, people are unlikely to trust institutions that do little for them. And second, public health is no longer viewed as a collective endeavor, based on the principle of social solidarity and mutual obligation. People are conditioned to believe they’re on their own and responsible only for themselves. That means an important source of vaccine hesitancy is the erosion of the idea of a common good.”

 

The Premier of Manitoba made it clear that this is exactly how she feels about Covid-19. We are on our own! It’s no wonder many Manitobans no longer believe in the common good and as a result the trust so necessary in a democracy has been shredded. It appears that this is what our Premier wants. She wants us to go at it alone.

 

What she is forgetting is that will have consequences for everyone. We all benefit from the public trust when it is robust. Then we are all prepared to do our part. Take vaccines, listen to sound advice from trusted experts, and chip in for the good of all. The Premier is forgetting that we all need to look after each other, particularly in a time of pandemic. We want others to take vaccines not just for their benefit, but our benefit too. They won’t do it if they feel abandoned. Then we when need them it will suck to be us.

 

Are We There Yet?: The Brilliant Dr Brilliant

 

Many of us are deeply tired of the Covid pandemic. We can’t wait for it to be over. As Nietzsche pointed out however, desire is a big enemy of truth. We must not give in to it. Hoping doesn’t make it so.

We are in the midst of record Covid-19 numbers in Canada, the United States and Europe so why would we ask if the pandemic is drawing to a close?  Well, mainly of course, because we want that so much. But there is a little bit more to the issue than that. There is some modest room for modest optimism.

Some recent studies point to the new variant, Omicron, which started out in Africa and from England, as being somewhat less severe or virulent. South Africa already claims that it has passed the peak of its infections without a major surge of hospitalizations.  Wonderful news right?  Yes, but….

In the world of Covid things are never as simple as they might appear to be. This is one of those times. Dr. Fauci has already said, he hopes that the US will follow a similar pattern to South Africa and England. That pattern is one of dramatic surge, rapid fall-off, and fewer serious cases of Covid-19.

The epidemiologist Dr. Larry Brilliant is, of course, a brilliant commentator on Covid-19. But he always gives us the truth, even when we don’t like it. He helped the WHO to eradicate smallpox. Christiane Amanpour asked Dr. Brilliant if he was seeing the end of the tunnel?  The brilliant Dr. Brilliant pointed out that,

“South Africa is not a case study that represents the same issues for the United States or most of Africa for that matter, with a 25% vaccination coverage but almost everyone who has had a prior infection and with less than 6% of the population who are over 60. It doesn’t have the same demographics that we have here, so I think we need to look at the UK, Germany, and unfortunately we will also have a chance to look at the East Coast very quickly…We really are at a crossroads. It is possible that we could go down the left side or the right side of the crossroad and in fact end up with Omicron becoming a virus like a cold.”

However, there is another path that probably is equally likely and that is that while Omicron might infect 5, 6, or 7 billion of us. When it did that, that would mean those many people are harbouring hundreds of millions, or billions of viruses all replicating 3 or 4% of the time having a mutation and those mutations leading to a new variant. Unfortunately because as Dr. Ayoade Alakija of the WHO said, less than 8% of the people in low income countries have any protection. Then indeed we might end up with super variants that come back to us or to the rest of the world.

Dr.  Alakija the key thing about Omicron is that we don’t know if it will be a good precedent for us or not. There are too many variables and we will have to wait for facts on the ground to know.  So is it mild? “Perhaps”, she said, “until it chooses not to be.” We cannot say that our peak will follow as quickly as it did in South Africa. “In South Africa it is summer and people have gone to their summer homes, offices have been closed while people go on holidays, they also put in place some health measures very quickly. As she said “I do not share the optimism of the world that Omicron is mild. People are tired and sick and tired of Covid and they want it to be over but Covid is clearly not sick and tired of us.”

Some like Bill Gates is “hopeful” that Covid-19 will become endemic in most places and that “in a couple of years, my hope is that the only time you will really have to think about the virus is when you get your joint Covid and flu vaccine every fall.” Dr. Brilliant says that is also what he hopes for and says it is an “entirely plausible scenario” but no one can say it is very likely yet. The problem is that modern science has never seen a virus that spreads as rapidly as Covid. Until we know if the next variant is able to over infect people who had Omicron we will not which of these 2 paths is more likely. So we can hope, but hopes don’t pay for the groceries.

Dr. Brilliant also said he can’t say the impact on people will be less than the Delta. We will still see major disruptions in travel, in schools, and “we need to be more respectful. We’ve been wrong every single time with this virus. We don’t yet know which of these two scenarios is more likely.”

Darn–that was not quite what I wanted to hear.

Health is a Common Good

 

So how do we get public trust? We earn it.

Anita Sreedhar and Anand Gopal said in their New York Times article that the history of the vaccines in the US is relevant here.  In the US where vaccines have been available for as long as vaccines have been around, when vaccines for smallpox, a very deadly disease, were first introduced, In the US in the early 20th century, efforts to vaccinate people met with some strong (virulent?) opposition. But attitudes of people changed sharply after World War II. In the 1950s the government had a hard time keeping up with the demand and, this may seem shocking to us now, by the late 1970s nearly every state had laws mandating vaccinations for schools and there was very little opposition.  Why was that?  That is the big question. A Public good demanded strong public policy.

 This was the time when big government was appreciated!  That seems like forever ago doesn’t it? Governments in the west brought in ambitious social programs for things like Medicare, Old Age Security and things like that. They called it the welfare state. People loved these benefits of government. In the mid-‘60s in the US there were a number of social programs targeted at helping poor people, even black people. In the US President Johnson declared War on Poverty and pursued what he called “the Great Society.” Specific government programs sought to achieve greater public health among the poor and were very popular. As Sreedhar and Gopal said about some of the organizations created under these programs, “they embodied the idea that public health is effective only when community members share in decision making.” They demonstrated  an appreciation that health care was a common good! And that made all the difference.

As Sreedhar and Gopal said,

“The experience of the 1960s suggests that when people feel supported through social programs, they’re more likely to trust institutions and believe they have a stake in society’s health. Only then do the ideas of social solidarity and mutual obligation begin to make sense.”

 

The types of social programs that best promote this way of thinking are universal ones, like Social Security and universal health care. Universal programs inculcate a sense of a common good because everyone is eligible simply by virtue of belonging to a political community. In the international context, when marginalized communities benefit from universal government programs that bring basic services like clean drinking water and primary health care, they are more likely to trust efforts in emergency situations — like when they’re asked to get vaccinated.

 When such attitudes are present, and when the common good is respected, and not disparaged, as it has been disparaged now for about 4 decades, people trust the government and their institution’s.  They are not suspicious of them and then don’t sneer at them as they do now. The world is then a different place. I would say, then the world is a better place. And that attitude helped to make the world a better place. As Sreedhar and Gopal concluded:

“If the world is going to beat the pandemic, countries need policies that promote a basic, but increasingly forgotten, idea: that our individual flourishing is bound up in collective well-being.”

 

The pandemic has made starkly clear how important it is to have a feeling of common purpose and a respect for the common good. We now are starting to appreciate the enormous importance of such beliefs for their absence makes the most important enterprises—public enterprises—impossible.

America, and to a lesser extent Canada, and the world, will have to realize that 40 years of conservative policies that included reductions in basic social services while their incomes stagnated and while the rich people have seen their incomes rise enormously, will exact a terrible price on society. Ripping the social fabric of a country does not come without costs. In fact, it comes with enormous costs. That can even come back to haunt the rich who benefited from the reduced taxes. Perhaps they even gained less than they lost! Sometimes it takes something like a pandemic to make it clear that we need each other. We actually are in this together. If we can’t get the poor to participate in important social programs like vaccinations, we will all be stuck with a hefty bill.

Yes, social programs cost money; so does ripping them to shreds.  We should remember not to be cycnics. For as  Oscar Wilde said, “the cynic knows the cost of everything and the value of nothing.”

A Shared reality is Necessary for Trust

 

The pandemic has made it clear that the cost of people not trusting the government is enormously high. That does not mean we should not critically examine everything they tell us.

This is the root of the problem in many parts of the world, particularly areas of great inequality of economic wealth, such as the United States, where the upper income classes and the lower income classes often don’t share the same reality. The world does not look the same from the penthouse as it does from the doghouse. Or homeless shelter. That is why they look so differently at vaccines. As Anita Sreedhar and Anand Gopal pointed out in their New York Times article:

 “As the emergence of the Omicron variant shows, vaccine mandates in the United States are not enough to solve this problem. Hesitancy is a global phenomenon. While the reasons vary by country, the underlying causes are the same: a deep mistrust in local and international institutions, in a context in which governments worldwide have cut social services”

 

In the US, unlike Canada and most other countries in the developed world, the people don’t enjoy as many public health services and they have been radically declining for about 40 years. They have only meager socialized health care. As Sreedhar and Gopal drew to our attention in their Times article,

“Research shows that private systems not only tend to produce worse health outcomes than public ones, but privatization creates what public health experts call “segregated care,” which can undermine the feelings of social solidarity that are critical for successful vaccination drives.”

 

Not only in the United States, but all countries where public health care benefits have been declining, such as Canada, feelings of ‘we are in this together’ have sharply declined. Both upper and lower classes don’t really believe this. The upper classes don’t want to be in this together, and the lower classes know very well it is not true.  They see it every day.

According to research by Sreedhar and Gopal in many developing countries people are not as grateful for aid as we in the west might expect. For example, they pointed out, the WHO has spent a lot of money promoting vaccines for polio. These are very worthy programs. We in the west know that. People in developing countries however see such programs as demonstrating mistaken priorities. They see polio as a vague threat. At the same time, they are often going hungry and they don’t see any help for that. Here is what they found:

“We have starvation and women die in childbirth,” one tribal elder told us. “Why do they care so much about polio? What do they really want?” Researchers find these sentiments echoed in poor and marginalized communities around the world.”

 

Interestingly, poor people in rich countries often feel the same way. Distrust is very difficult to overcome. Words won’t do.

The Dominant Ideology Sucks

 

Why do so many people distrust the government and the leading institutions of their country?  That is the question I have been trying to solve in my own meandering and no doubt annoying style.

 

Many people, even poor people, have been sucked in by the dominant ideology.  Such people, for example, say something like this: ‘I am not any-vaccine, I just want to exercise my personal choice.” They see everything through the lens of personal choice. Now I am also big on personal choice and being responsible for my choices, but I don’t want to forget about the common good either. Sreedhar and Gopal  interviewed a woman from the residential complex where Mr. Steed lived, Amanda Santiago and this was her attitude. Anita Sreedhar and Anand Gopal pointed this out in their essay in the New York Times about one of the residents of a lower class housing project in the Bronx: “A growing body of research suggests that Ms. Santiago’s views reflect a broader shift in America, across class and race. Without an idea of the common good, health is often discussed using the language of “choice.” We must remember all such choices, which we are allowed to make, have consequences.

For example, Kyrie Irving is a basketball star. He advocated for personal choice and decided not to take the vaccines. As a result, he is so far missing the entire basketball season, and he is accepting the consequences in lost earnings. He can afford it. In Steinbach we have Pastor Tissen from the Church of God restoration who used the same language of personal choice.

This is what Sreedhar and Gopal say about personal choice:

Of course, there’s a lot of good that comes from viewing health care decisions as personal choices: No one wants to be subjected to procedures against their wishes. But there are problems with reducing public health to a matter of choice. It gives the impression that individuals are wholly responsible for their own health. This is despite growing evidence that health is deeply influenced by factors outside our control; public health experts now talk about the “social determinants of health,” the idea that personal health is never simply just a reflection of individual lifestyle choices, but also the class people are born into, the neighborhood they grew up in and the race they belong to.”

 

Anita Sreedhar and Anand Gopal pointed out some important things about personal choices and Covid-19 when the social determinants of health are ignored:

 “Vaccine uptake is so high among wealthy people because Covid is one of the gravest threats they face. In some wealthy Manhattan neighborhoods, for example, vaccination rates run north of 90 percent.

For poorer and working-class people, though, the calculus is different: Covid-19 is only one of multiple grave threats.”

 

For people who live in poor areas such as the Bronx, Covid is not as big a threat as they face every day from other sources such a drug related crime, hostile police, racism, and unreasonable landlords, to name just a few. In such a context Covid is not really that scary and as a result vaccine hesitancy is not irrational.  Sometimes distrust is rational.

As a result, attitudes to Covid are quite naturally different between the lower and upper classes in such neighbourhoods. As Sreedhar and Gopal said,

“Most of the people we interviewed in the Bronx say they are skeptical of the institutions that claim to serve the poor but in fact have abandoned them. “When you’re in a high tax bracket, the government protects you,” said one man who drives an Amazon truck for a living. “So why wouldn’t you trust a government that protects you?” On the other hand, he and his friends find reason to view the government’s sudden interest in their well-being with suspicion. “They are over here shoving money at us,” a woman told us, referring to a New York City offer to pay a $500 bonus to municipal workers to get vaccinated. “And I’m asking, why are you so eager, when you don’t give us money for anything else?” These views reinforce the work of social scientists who find a link between a lack of trust and inequality. And without trust, there is no mutual obligation, no sense of a common good.”

 

The cost of distrust is enormously high, as we have been discovering.  We really should not be surprised that so many people distrust the government so much that they refuse to take lifesaving vaccines. The world’s elites are paying a big price for allowing the poor to feel abandoned. Unfortunately, so are the rest of us.

 

Low Vaccination Rates hide a profound social weakness

 

Anita Sreedhar is a primary care physician with a degree in public health and she works in the Bronx. Anand Gopal is a sociologist from my second favorite University, Arizona State University. He is also an excellent journalist who covers international conflicts such as the war in Afghanistan. They have conducted research for 5 years to learn to better understand vaccine resistance. Again, from before the arrival of Covid-19. This is what they discovered:

“We’ve found that people who reject vaccines are not necessarily less scientifically literate or less well-informed than those who don’t. Instead, hesitancy reflects a transformation of our core beliefs about what we owe one another.

Over the past four decades, governments have slashed budgets and privatized basic services. This has two important consequences for public health. First, people are unlikely to trust institutions that do little for them. And second, public health is no longer viewed as a collective endeavor, based on the principle of social solidarity and mutual obligation. People are conditioned to believe they’re on their own and responsible only for themselves. That means an important source of vaccine hesitancy is the erosion of the idea of a common good.”

 

People think they are on their own, because they have largely been left on their own. They know they can’t trust anyone else. It is all on them.

In the Unites States there has been a powerful anti-vaccine movement since long before Covid-19.

I remember one day I was at a conference at my beloved Arizona State University, and at dinner when I was chatting with the woman sitting beside my wife and I.  She seemed intelligent. After all she was an adult like me participating in a university conference with some of the top professors around the world. Both of us did not really belong there. We were ordinary citizens, but the university encouraged people like us to attend such conferences. That is why I like that university so much. I was surprised that she wanted to talk about vaccines which one of the professors had talked about as an aside. She told me she disagreed strongly with what he had said. She said  he was dead wrong when the professor said the vaccine myth that they caused autism had been debunked. (It had). But she strongly disagreed and assured me the science was firm that vaccines did in fact cause autism. (She was wrong).

 She was part of a growing movement of vaccine distrust that is particularly virulent in the US, but has reached as far as Canada, in particular, southern Manitoba.

Many reasons have been given for the anti-vaccine attitudes. Some have blamed online misinformation campaigns, others have blamed our tribal culture, and even fear of needles. Race has also been a factor. At first white Americans were twice as likely to get vaccinated in large part for historical reasons, such as the Tuskegee syphilis experiments on African Americans orchestrated by the government to their serious detriment. There was good reason for their suspicions and mistrust. Interestingly, that gap between whites and blacks has narrowed considerably since then. Many African Americans have been convinced to take the vaccines despite their suspicions.

All of these factors are significant, but Sreedhar and Gopal found a more significant factor. That was college attendance. “Those without a college degree were the most likely to go unvaccinated,” they said.  Why would that be. As the two said in their Times article, “Education is a reliable predictor of socioeconomic status, and other studies have similarly found a link between income and vaccination… It turns out that the real vaccination divide is class.”

Class is the culprit. And that makes a big difference as I shall try to show.