Category Archives: Epidemics/Pandemics

Good Facts Make Good Ethics

 

When it comes to Covid-19 the facts are not clear nor free from controversy. It would be nice if we could delay having to make  decisions until all the fact are known, but in a pandemic we don’t have that luxury. Some things must be decided now, on the basis of the best facts available.

We must also admit that the “facts” are constantly changing. Covid-19 is a novel disease. It was unknown to science until a little more than a year ago. When it first became known, the scientists had to give advice based on minimal knowledge. Most of it was on conjecture based on other similar diseases such as SARS and the common flu among others. Now they have a lot more knowledge, but it is still mainly preliminary knowledge. So we don’t really have good facts. And good facts are needed to arrive at good ethics.

Some people were annoyed when scientists at first said, masks were not recommended because they were unlikely to prevent disease spread. They based that on the basis of things they had learned from earlier similar infectious diseases. Later scientific evidence accumulated that the scientists were wrong in their earlier prediction and they quickly changed their advice. As a result some governments made masks mandatory in some situations. Scientists did what they should do. They changed their scientific advice based on better science and more facts. To have done otherwise would have been malfeasance. Only religious leaders can be expected to give infallible advice forever!

In applying the principle of John Stuart Mill I enunciated yesterday, we must acknowledge that imposing restrictions on people as the authorities have done during this pandemic  is a severe curtailment of freedoms people are ordinarily free to exercise. It even amounts to an interference with religious rights guaranteed by our Charter of Rights and Freedoms.  Is such a restriction justified?

First, an infringement on a fundamental freedom is not justified if there is a better way. The impairment of the right must be the most minimal impairment needed to prevent the harm. If I am not at risk of likely spreading the dangerous Coronavirus  the people or the government, they elect are not justified in restricting my freedom of movement. The default position is liberty. I am free to do what I want unless the government proves that my actions will likely create an unreasonable risk of serious harm to others. The onus of proof must be on the government. The government does not have to prove this beyond a reasonable doubt. It is sufficient if it can establish, on a balance of probabilities, that my actions will likely lead to serious harm.

The harm avoided by imposition of restrictions cannot be a trivial one either. The avoidance of trivial harms to not justify interference with fundamental freedoms. For example, such restrictions would not be justified to avoid the common flu. The government must also establish that reasonable alternatives, which would have less effect on my fundamental freedoms are not available. In other words, it must prove that curtailment of my freedom does not exceed the most minimal curtailment that would be sufficient to avoid the harm. If the restrictions are not necessary to achieve the public good, such as freedom from a serious disease, then the governmental restrictions are not justified.

The imposed harm by the government  (e.g compulsory vaccinations) must also be effect at avoiding the harm it is trying to avert (e.g. serious illness). If they are not effective the infringement of freedom is not justified.

Using these principles how do they related to the facts on the ground? First are the vaccines effective at reducing risk of serious harm? There is growing evidence that the vaccines (all of them) are very effective at reducing the risk of serious illness. They are not as effective at stopping minor illness, but we can live with that. We want to avoid the serious illness and death.

To begin with, one must also weigh the harm inflicted on the people who would have chosen not to get vaccinated. The large weight of scientific evidence is that most harms resulting from the vaccination are extremely minor if not non-existent. No more reasonable harm that impairs our freedom less than compulsory vaccinations has been discovered.

Secondly, recent studies have shown that all the vaccines approved so far are about 95% effective at preventing serious illness. Most people who took the vaccines did not become seriously ill and did not die. Even if 1 person in 20 dies after the vaccination, or gets seriously ill any way, the benefits to the majority greatly outweigh the detriments to the minority who would have chosen not to be vaccinated had they been free to do so.

Currently scientific evidence is still in a state of flux as more information becomes available. For example, there have been new variants of the virus that have resulted from mutations. These appear to be more contagious and, in some cases, also more severe. As a result, dealing with this virus demands even more diligence. Some people get annoyed by this. They call it flip flopping. This unfair. This is how science, unlike theology, works.

I will continue this analysis in tomorrow’s blog.

 

An Ethical Approach to Vaccine Passports

 

Would it be fair to opening up society in a time of pandemic only to those with Passports (or other documents) that could satisfy us that allowing people who have had one of the vaccines for Covid-19 or had the “benefit” of having contracted the disease and developed sufficient antibodies? In either case, presumably it is safe to let these people wander around, more of less freely, while we continue to curtail the freedoms of those who don’t have such a passport.

First, it is clear, that current health restrictions in Canada are fundamentally restrictive and a substantial interference with our freedom of movement and freedom to gather as we see fit. Clearly this violates a constitutional right, as I have argued in an earlier blog post. Ordinarily such prohibitions could not be justified in a free and democratic society. But these are special circumstances? Are they special enough to provide the justification?

I think a good place to start my answer to this very interesting question is the classic book On Liberty, by John Stuart Mill. Mill recognized in 1859 that people had the right to fear “the tyranny of the majority” which, he said, “is now generally included among the evils against which society requires to be on its guard.” In other words, Mill argued there are limits on what a majority is entitled to do. As he said,

“There is a limit to the legitimate interference of collective opinion with individual independence: and to find that limit, and maintain it against encroachment, is as indispensable to a good condition of human affairs, as protection against political despotism.”

To Mill as to many lovers of freedom, all that makes life valuable requires there to be reasonable limits or restraints on the actions of other people, either directly or through their elected representatives. Mills posed a clear answer to what he considered those reasonable limits. Mill said that there was one very simple principle that provided an answer to what are the reasonable limits. He elegantly put it this way:

“…the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant. He cannot rightfully be compelled to do or forebear because it will be better for him to do so, because it will make him happier, because in the opinion of others, to do so would be wise, or even right. These are good reasons for remonstrating with him, or reasoning with him, or persuading him, or entreating him, but not for compelling him, or visiting upon him any evil in case he do otherwise. To justify that, the conduct from which it is desirable to deter him must be calculated to produce evil to some one else. The only part of the conduct of any one for which he is amenable is to society is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.”

This is the fundamental principle of classic  liberalism. The principle is often called the principle of autonomy. In simplified terms, this means that everyone should be free to do whatever he or she wants, without hindrance, unless the exercise of that freedom will harm others.

With some limitations, not relevant to this discussion I accept that principle. How is to be applied to the question at hand. To do that we must look at the facts, as best we can, for as Professor Schafer said, good facts produce good ethics.

In my next blog posting I shall show how this principle applies to the Covid-19 Passport.

Are vaccine passports fair?

 

As part of a project since I retired (more or less), Christiane and I have been attending various activities under the general heading of continuing education or learning for life. We have been taking all kinds of courses at various venues—from the University of Manitoba to McNally Robinson Booksellers. Many of them have been truly amazing. It probably doesn’t show, but Christiane and I have learned a lot.

Recently we latched on to a new venue, the Rose and Max Rady Jewish Community Centre. This is a gem! It has all kinds of programs. Our first venture was a concert of music from 2 of Manitoba’s finest French musicians who played classic French Canadian music, including some wonderful country tunes. Our next venture was a lecture by my guru, Arthur Schafer, a professor of philosophy at the University of Manitoba and director of the Centre for Professional and Applied Ethics at the University of Manitoba. We participated via Zoom in a delightful talk by Professor Schafer on the subject of the ethics of vaccine passports. I is surprising how many ethical issues arise during a pandemic.

Professor Schafer pointed out to us that Israel has recently imposed what it calls a Green Passport. In Israel the rules of confinement imposed by Covid-19 requirements apply to everyone with very exceptions. One of the exceptions is that holders of green passports are entitled to move about freely as they wish, except that in public places they must wear a mask to protect others. The Green passport gives a record of one’s immunizations, including the date taken, and whether or not one has contracted Covid-19 to such an extent that antibodies have been produced in that person. If you have such a passport you can almost go anywhere you like free of encumbrances.

Other countries are now considering the same thing, including Canada. In some places they call it Vaccine Passport in others an immunity certificate, but the effect is always more or less the same. Special privileges are given to those with the Passport. Is this a good idea? Is it fair? Is it just?

Unlike Canada, in Israel 50% of the people have already received vaccinations . So, 50% of the people can do basically what they want, and the rest have to wait until they get their vaccine shot.  But the other 50% have to stay home and suck socks. Is that fair?

In Israel, as in other countries, some people object to vaccinations or are reluctant to take them, on religious or cultural grounds. Advocates for the program in Israel say it encourages people to take the vaccine. Opponents say the program is coercive, unfair, and unreasonable. Does the government have the right to coerce people to take the vaccine? What about people who can’t take the vaccine for medical reasons? Pregnant people are warned against taking the vaccine since there is currently insufficient evidence that the vaccine is healthy for a human fetus.

Now an incentive would be a good thing if the vaccine will protect our health system from being overwhelmed and posing a huge risk to many people and to protect our society and its citizens from devastating harm of the disease itself. These are both significant dangers. So avoiding them or mitigating them are a serious public good.

I ask you, is this reasonable or justified? What do you think? Tomorrow, I will give my views in my next post and I don’t want to influence anyone just yet.

Please give me the benefit of your opinions.

Billionaires do Great; Poor people suffer

 

While billionaires like Jeff Bezos have seen their wealth explode (again) during the Covid—19 pandemic, poor people have suffered the most (again). Poor people are feeling the brunt of the ill effects of the pandemic. Funny how that happens.

I recently  heard a very interesting interview with Mariana Mazzucato Professor of Economics at University College in London. She  wrote a book called The Value of Everything. I assume the title is a reference to a famous  quote by Oscar Wilde, that “a cynic knows the cost of everything and the value of nothing.” I actually have used that line to describe some conservatives I know. With some justification I might add.

 

At the time she was speaking on the television show she said that just as 8 million case of Covid-19 have been experienced in the US, 8 million people have dropped down below the poverty line. At about the same the average wealth of billionaires had gone up by 25%. More than a million people had died and 38 million people infected (at the time of the interview). Many more since then, of course.  According to the Gates Foundation at the time 37 million people around the world had been pushed from poverty into extreme poverty! That means they earned less than $1.90 per day. Meanwhile the rich are getting much richer. Meanwhile conservative politicians think everything is fine and no changes are needed. That is what my own member of Parliament, Ted Falk believes.  with enthusiasm he believes that. In fact any suggested changes must mean the crypto-communists are trying to turn our country into a communist hell.  

Why does it have to work that way? The short answer is that it doesn’t have to work that way, it works that way only because we allow it to work that way.  We keep electing politicians like Ted Falk. That is the system the well to do, together with their political minions, want to conserve. That is the essence of modern conservatism. Everything is fine for us, so everything is fine.

Don’t listen to smug Conservatives

 

The Canadian Prime Minister, Justin Trudeau, has been severely criticized by conservative politicians including even my own Member of Parliament, Ted Falk, for suggesting that we should take advantage of the Covid-19 crisis to reset our economy and make it fairer. To conservatives, who by definition love the status quo because it has allowed them and their cronies to prosper, they ask ‘why change what is perfect?’  Any contrary suggestions are viewed by them with deep suspicion for it can only mean those nasty liberals and socialists want to use Covid-19 as an excuse to take over the economy.

Here is a statement by Trudeau that triggered hysteria from my political representative. It was a statement by our Prime Minster Justin Trudeau as follows:

“This pandemic has provided an opportunity for a reset…This is our chance to accelerate our pre-pandemic efforts to reimagine economic systems.”

 

Here is the response of my fear filled Member of Parliament to such a suggestion:

“For Justin Trudeau, COVID-19 is an opportunity to impose his radical “reset” agenda. Mr. Trudeau’s speech seemed a clear indication that Canada was on board with whatever the UN was recommending…  Justin Trudeau’s consistent willingness to sell out Canadian sovereignty to unelected UN bureaucrats should be a cause for great concern for all Canadians.   With our economy in tatters, it is almost unfathomable the level of delusion it would take to think that following the UN’s lead into some sort of global eco-socialist utopia is the answer to our economic woes—unless of course, you’re Justin Trudeau.”

 

Falk of course dredges up old tropes that the Conservatives in the US see as dastardly.  We could ignore that, but there is a larger question here that should be addressed. Are the economy and social system  so great that they  cannot be improved upon? Let’s take a look how others besides comfortable white businessmen, like Ted Falk are doing.

First, and most important, is the stunning impact of Covid-19 on seniors in long-term care facilities. For now, I will look at Manitoba, but the issues occur everywhere in Canada. In fact, I want to look at one main facility—the Maples—a privately owned and operated facility in Winnipeg. It was the scene of a horrific outbreak of Covid-19 that shocked our province. In a private long-term care facility of about 200 residents, in November of 2020 the outbreak led to the severely short-staffed facility asking Health Manitoba for help to deal with the critical outbreak. At first that call went unheeded. That led to 56 residents dying before it was adequately dealt with.  That is more than 25% of their residents who lived there! In fact, at one time 8 residents died in 48 hours! 26 died in 28 days! For years in Manitoba the care of senior’s has been outsourced to companies like Revera Inc., the private operator of the Maples, to presumably save on costs so that the province could avoid increases in funding for about a decade. Does that really save money? Is it worth the savings if they are real?

Then there are indigenous people in Manitoba. The indigenous people in Canada are typically the ones hardest hit by any widespread catastrophe. Canadians have come to expect that.

The chief and council of Pauingassi First Nation shut down their band operations, closed schools, prohibited public gatherings and required residents to stay home after they declared an outbreak of COVID-19 earlier last month. The small and remote First Nations community has less than 500 people living on the reserve. Recently almost a quarter of them, 118 people, tested positive for covid-19. After they tested positive many of them had to leave for Winnipeg where they could get treatment unavailable on the reserve.

This shows what has been happening in northern Manitoba as during the past few weeks regularly more than 50% of the new covid-19 cases were discovered on northern First Nation reserves even though only 10% of Manitoba’s total population is indigenous! As of February 19, 2021, 2/3rds of Manitoba’s total Covid-19 sufferers were indigenous. As well 1/3rd of Manitoba’s Covid-19 patients in Manitoba were indigenous and 1/3rd of Manitoba’s patients with the most severe effects in Intensive Care Units were indigenous.

Why is that?  Probably the cause of this disparity is that so many indigenous people are poor in comparison to average Manitobans. As a result, they have less access to quality care and live in housing that is frequently severely overcrowded. In Manitoba, there is almost a 20-year difference between the average age of people who die from Covid-19 that are indigenous and those who are not. Indigenous people die younger from Covid-19 and in comparison to non-indigenous people, they die in droves.

Yet at the same time 2/3rd of Manitoba First Nation communities were Covid-19 free. Imagine what would happen if more contracted it. In my opinion the reason so many are Covid-19 free is that they are so remote. If they were not so remote more of them would have Covid-19 and then inevitably, the consequences would be disastrous in each of those communities. These are troubling statistics and point to some serious inequities in Canadian society. Inequities that smug politicians like my Parliamentarian Ted Falk are loath to notice. He is worried instead about the UN leading us to eco-socialism thanks to our leftie Prime Minister.

Are we all in this together or is it time time for a platitude adjustment?

 

Bill Maher said on this on  his television show,

“the next person who tells me we’re all in this together must work a shift at Grub Hub. Half the country is home in their comfy clothes ordering take-out and the other half is out in the cold delivering it. So stop it with the ‘in it together bull shit.’ We’re in this together is another ‘Thank you for your service.’ Just something we can say to people doing the dirty work so we can feel better about not doing it ourselves. And even before the pandemic hit, America was well into the ‘gig-economy’ which sounds sort of hip like you’re in a rock band except you’re not in a rock band, you’re delivering hot chicken. And it doesn’t cover your rent.”

 

He is right about one thing. This platitude is getting tired. It would be nice if people actually believed it. But not many do. Our actions speak loudly. All kinds of people have done very well in this pandemic. Most of them are well-to-do.  Lawyers have done very well. It’s hard to figure out why that is the case, but it’s true. I heard from my furniture guy that they have never done better. Why are people spending money of furniture? Jeff Bezos has seen his personal net worth climb astronomically during the pandemic. He recently announced his retirement as CEO of Amazon. If he wanted to, he could give each of his 1 million employees a retiring bonus of $105,000 and still have more wealth than he had before the pandemic!

Some corporations for awhile gave their employees a bonus of 50 cents an hour to compensate them for risking their lives so the business could remain afloat. Then they revoked that as soon as they could.

No, we are not really all in this together.  As usual, the rich are benefiting from the disaster while the common people suck socks. Isn’t that the way it always works?

Does it have to work that way? Is there even a good reason that it works that way? What does it say about us that it does work that way? Is there a better way?

 

Capitalism in the time of Pandemic

 

Scott Galloway is an enthusiast for capitalism, just like Michael Zwaagstra a local counsellor here in Steinbach . But that is where the resemblance ends. Zwaagstra recently wrote an article in our local Carillon News and said capitalism was doing just fine and he could hardly wait to get right back to it without any changes. Why change what’s pretty close to perfect? Zwaagstra dismissed any suggestion that anything should change, he liked it exactly the way it was. Of course, those most comfortable with things as they are, tend to feel that way.

Scott Galloway is different. He is also enthusiastic about capitalism, but he believes changes are needed. Badly.  Galloway wrote a book called Post Corona: From Crisis to Opportunity. I heard him interviewed on Amanpour and Company.

Hari Sreenivasan interviewed Galloway and pointed out that in the US more than 250,000 people have already died from Covid-19. (Since then the numbers have doubled.) Sreenivasan pointed out that the disease has exposed some serious weaknesses but has also provided an opportunity to fix some of those weaknesses. Someone once said, we should never waste a crisis. Zwaagstra and the other Panglossians want to do exactly that. Why fix something that is not broken?

Galloway pointed out that before the pandemic there were a lot of people who were optimistic to the point of arrogance. The system was working well for many people, but for others it was disastrous. The pandemic made clear to all that many of the governmental institutions had been woefully underfunded. Galloway is a capitalist, but he recognized the importance of government. His eyes are not shut. The crisis has allowed us to spend more time with our families, it has allowed us to look closely at our educational system. Our health care system needs a close examination in the light of what we have learned from the pandemic. It has shown how ecommerce can work. To him, unlike Zwaagstra, a crisis is a terrible thing to waste.

In health care Galloway believes the greatest shift in stakeholder value is about to occur in the business history of the US. In the US 17% of the GDP is heath care.

As he said,

“It is arguably the largest business in the world clocking in at 3 or 4 trillion dollars a year, but the outcomes have been decreasing. Life expectancy has been going down and mortality is stuck at a certain level. Customer satisfaction is pretty anemic. The medical profession as retail is probably the second worst retail in America behind gas stations. Imagine going to a store for a sunblock and someone sides a plexi-glass gives you a form and says to you ‘Here fill out this paperwork and we’ll see you in 30 minutes! It’s a fairly uninspiring experience. The exciting thing is that 99% of the people who have contracted, endured, and developed anti-bodies for the coronavirus did it without entering a doctor’s office let alone a hospital.”

 

He said that morning he got his Covid-19 test in his kitchen. Things are changing rapidly and sometimes for the better.

“Just as ecommerce took the store to your living room, just as the movie theatre moved into your living room, the doctor’s office, hospitals, and diagnostics moved to your house.”

These things are a sea change. I know I had a doctor’s examination from my cottage at the lake while the doctor was in his office. I had a blemish or spot on my head that worried me. My wife took a photo and emailed it to the doctor who looked at it and said, “I think it’s benign.”  While I wished he could have said that with a little more confidence, the experience with my physician was shockingly good.

As Galloway said,

“This might give us not just an opportunity to reduce costs but to take us off our heels as a nation being reactive and defensive about our health and get on our toes and talk more about primary care. It made people more comfortable with their relationship with their health care provider. Amazon just announced that they would have 24/7 pharmacists available and 2-hour delivery. So, we could see an explosion of innovation in health care. You could arguably say it is the most exciting place to be in our economy post-covid. Regulations have come crashing down. Consumers are now comfortable receiving health care over their hand held instruments in their home.”

 

I admit that describes me. I want to see my doctor from time to time, but often I don’t need to go his or her office. By phone or Ipad often is good enough and saves me a lot of time. My time is valuable too.

In ecommerce it took years for the kind of growth we have seen. I hate what Amazon is doing to small businesses around the world. I hate the thought of giving any more money to the richest man in the world (now he is second). Before the pandemic he was earning $1 million every 50 minutes. All this while he is crushing small business everywhere and while many of his employees wear  diapers because they can’t afford to take a washroom break or they won’t be able to  meet their quotas. Now he is doing much better than that and I have helped him out, as have millions of others. We have done that because we came to realize how convenient it was. For many things we don’t really have to go to a store to look them over. Ordering them from our homes for some is just easier, simpler, and cheaper.  Other businesses will have to learn that we have learned something and if they don’t change, we will change where and how we shop. Not for everything but for many things. Capitalists had better innovate or they will be left on the dust heap.

That does not mean all has been rosy. As Sreenivasan  pointed out,

“It has been a boon for those who could afford it. There has been a blue collar pandemic and a white collar pandemic. For the white collar people it was great. I can get everything from Instacard and Amazon. But if you’re an essential worker that doesn’t really apply to you.”

 

For others not so much. And some of us still care a little bit about fairness. Fairness and competition.

Galloway agreed completely:

“If you’re in the top 10% of income earners there is no change in employment. It means you’re no more vulnerable than you were before the pandemic. There’s a 60% likelihood you can work from home. You can spend  more time with your family. You maybe got 10 hours back a week. If you make less than $40,000 a year, 40% of those people have lost their jobs and less than 10% can work from home. You don’t like to say this out loud, but if you’re in the top 10% and you’re blessed with good health you’re most likely spending more time with Netflix, your kids, and less time commuting, and by the way your stocks are probably up and I would argue that a lot of the stimulus unfortunately hasn’t been about arresting the pandemic, and helping our neediest, it’s been about flattening the curve for rich people. The savings rate in American has never been higher. The Nasdaq has never been higher. If you do a google search for covid and markets you’ll find more articles than if you do covid and mortality. It’s as if as a nation our priorities are reflected in our spending. The velocity of death is unprecedented. More people are dying every day from this than any crisis in history! And that’s meaningful. But what would be profoundly tragic would be if the Nasdaq declines! At least that’s what our spending seems to indicate. We want to save restaurants, but not keep schools open. We seem to want to ensure that the markets are washed in liquidity and people are wanting stimulus, but we aren’t protecting people. We see infection rates rise. And we see our health professionals wanting for PPE equipment. It does definitely seem that we have decided that corporations are people and they are the ones that we have to save.’

 

And remember all of this is not coming from some crazy leftwing extremist. This is coming from a self-described enthusiast for capitalism. He is an insider. He likes the system. Perhaps not as much as Zwaagstra, but he is no bleeding socialist.

Once again Wall Street is doing much better than Main Street. This is always an interesting phenomenon. In my view this will always happen in a system that permits plutocracy, and even worse in a system that encourages plutocracy. If we let the rich rule, they will do what is in their best interests. It really is that simple.

As Galloway said,

“As a nation we suffer from an idolatry of innovators. And we personify companies and believe that it all starts with the shareholders. The shareholder class is the premier class and as long as the economy is strong everything will fall into place. And we measure the economy’s health by these dangerous indices called the Nasdaq where 90% of the stock are owned by the top 10%. The Nasdaq and the Dow are not indicators of the health of our economy they are proxies for how well the wealthy are doing. And–spoiler alert–they’re killing it.”

No one should be surprised by this. We have a system that is designed by the wealthy for the wealthy and inevitably such a system will deliver the goods to the wealthy as our system does so well. It just sucks to be poor.

 

Gross Negligence

 

This past year, while he was president, Donald Trump on national TV, with Dr. Fauci beside him, said this about Hydroxychloroquine a drug that has been approved by the Food and Drug Administration but not for Covid-19 patients except for experimental studies: “It may work; it may not work. I feel good about it. That’s all it is just a feeling.” Coming from the president of the country with a legion of fanatically loyal followers this is an extremely dangerous thing to say. I would go so far as to say it was gross negligence. People believed him and risked their lives. Perhaps some died as a result.

 

Much later, Dr. Fauci said, “the partisanship has been poisonous.” Health issues should not become political footballs. Health issues should be determined by the best science available not feelings. Important societal; issues should be determined by science, data, reasoning and evidence. Not feelings, or hunches, or faith. That is why the United States is in such a difficult position now.