Category Archives: Epidemics/Pandemics

Autonomy: A society of adults

Epidemics/Pandemics, Liberalism

 

One of the things Chris and I like about the Phoenix area of Arizona is the University of Arizona. In particular we found it is nice to be close to a major university. The university had a wonderful array of activities from plays to concerts and above all world class professors and speakers. All open to the public and usually at no cost to us. I am amazed at how many of them we got to hear.  One of those very interesting speakers was Dierdre McCloskey. We heard her speak in 2020.

Deirdre McCloskey is Distinguished Professor Emerita of Economics and of History, and Professor Emerita of English and of Communication, adjunct in classics and philosophy, at the University of Illinois at Chicago. Educated at Harvard as an economist she has written 24 books and numerous articles. This is how she describes herself: a “literary, quantitative, postmodern, free-market, progressive-Episcopalian, ex-marxoid, Midwestern woman from Boston who was once a man. Not ‘conservative’! I’m a Christian classical liberal.” I did not agree with everything she said, but everything was very interesting. She was a very interesting speaker.

She talked to us about innovation. According to McCloskey, “liberty is the theory of adult.  At first that seemed like a strange description.  Eventually I think I caught on. Adults are free. Youngsters are not. Adults have the right to infringe on the rights of young people in their care for their own good and protection, but only while they are in need of such interference. At some stage, minors get to be treated like adults and then have the same freedoms as adults. According to McCloskey, “Liberalism is the theory of the society of adults.” Other theories, such as socialism, treat adults as children. They assume we, or the government, know what’s best for you. She wants a society where adults make their own decisions.  So do I, subject to the qualifications.

McCloskey argues for a very strong autonomy. We should be able to make all decisions about our own welfare on our own terms without interference from others. No one should tell us what to do in other words. That is autonomy. I quite agree that autonomy is a very important social value, but like all values it is not absolute. In some circumstances the public’s right to ensure that its members are given reasonable security and that actions of its citizens won’t harm them unnecessarily. Each of us has a right to live in a healthy and safe society.  Again, like all values, this right must be balanced against other rights as well. I shall try to clarify a test that can help us establish whether or not a particular infringement of a right is justified or not. To do that. I want to turn in my next post to the classic liberal philosopher of all time—namely John Stuart Mill.

Mandates & the Duty to Accommodate

Epidemics/Pandemics, Human rights

Even in considering moral questions it is often useful to consider some legal principles. The law is not always an ass.

In order to establish that one has a right to impose a curtailment of a right on others, the law often requires the imposer, such as the government, to establish that it has made all reasonable efforts to accommodate the other person. I think that is a reasonable principle.

Where a person claims to have a religious right to decline to take any of the Covid-19 vaccines and it is determined that in the circumstances an important freedom, such as the right to security of the person, or the right to dignity, can be overridden in the circumstances, society or the government as its representative, has a duty to provide reasonable accommodation for abridging the freedom. That does not mean it must cave in to all of the demands of the resisters, no matter how unreasonable.  Resisters must be reasonable as well. For example, society could be required to accept an alternative to compulsory vaccination in some circumstances, such as providing that the supplicant for an exemption could be given the right to provide a recent Covid-19 test that reasonably establishes that the applicant is not a carrier of Covid-19. That is the course of action Manitoba has followed in its mandates for Health care workers to be vaccinated or get frequently tested. Other jurisdictions have been harsher. Some have been more gentle. Who is right?  It depends on how important it is to have people vaccinated and how effective the tests are compared to the vaccines.

I think looking at the analogy of expropriation might be helpful. We have a society where each of is entitled to own property to the exclusion of others. That is called the right to private property. It is  a very important right, but that right is never absolute. Government has the right to expropriate private  property (which really means to take it) provided it pays fair value, actually needs the property and follows the rules of fairness. It is always important to remember that any right, no matter how sacred, is not absolute.

Doctors Manitoba has some helpful suggestions for accommodations : “frequent testing, continued use of protective gear and physical distancing or barriers to separate them from other workers.” That seems pretty fair to me.

Such reasonable accommodation could be required to get judicial approval or moral approval for imposing a vaccine mandate.  This could be required if it can be established that the Covid-19 testing was reasonably reliable enough to warrant society being required to accept such a test result and may not require the applicant to get vaccinated as a result.

A government should always make reasonable efforts to accommodate people whose rights are being abridged. Sometimes however, reasonable accommodation just won’t be possible.

 

Vaccine Mandate Exemptions

Epidemics/Pandemics, Human rights

 

It is generally admitted that some people ought to be exempt from taking the vaccine. Manitoba has recently clarified who would be exempt and who would not. The list of acceptable excuses for not getting vaccinated in Manitoba is now quite narrow. For example, a note from a physician is not enough. If one can establish that one is allergic to the vaccines that is a valid excuse for not taking it in Manitoba. Other allergies are not good enough to qualify for exemption.

Only if a qualified medical physician said it would be more dangerous for a person to take vaccine than to risk the possible ill effects of taking the vaccine would a person be permitted to avoid taking the vaccine. I think that is the rationale.

Of course, some of our elected politicians are taking advantage of the exemption rules, or at least are trying to do that. 4 Members of Parliament, including Ted Falk who represents the riding in which I live, is not saying why he is absent from Parliament. Recently Parliament tightened its rule about Members claiming a medical exemption. The new rule requires Members of Parliament to qualify under the stricter Ontario provincial rules and since then 4 Conservative Members have not been able to go to the House of Commons. Mr. Falk is one of them.

Someone  said there are so few qualified medical exemptions that it is virtually impossible for so many Conservative Members to claim the exemption. I heard that it would be as unlikely as winning 4 lotteries! Yet our Member of Parliament continues to not to say whether he is vaccinated or is claiming a medical exemption.  In my view he is not showing much leadership on such an important issue, but frankly I am not surprised. What would have surprised me would have been learning that he was fully vaccinated.

So-called religious exemptions are also not acceptable in Manitoba, even though one church, the Springs Church in Winnipeg that a lot of people from Steinbach attend, attempts to issue religious exemptions, but they have no legal effect. Few religious adherents to my knowledge have even tried to argue for a coherent religious exemption.

I guess it is a bit like heaven. Many want to get in, but some think they can get special exemptions.

 

The question of mandates

Epidemics/Pandemics

 

Many people in Canada and elsewhere are debating whether or not it would be justifiable to mandate that all Canadians get fully vaccinated against Covid-19, unless they have good medical grounds for not taking them.  Saying one does not want to take the vaccine would not be enough. Unless you are entitled to a genuine medical exemption the law would to some debatable extent require you to be vaccinated. To some extent we are already there. The law requires you to be vaccinated to cross the Canadian border. The law now requires some people with some jobs to be vaccinated, or at least be tested regularly.

 

Would such an imposition be morally acceptable in a free and democratic society? What about freedom of security—i.e. that one has the right to determine for oneself what can be placed inside one’s body. For example, one cannot be compelled to take any medical treatment if one is not harming others, even if it is very unwise to decline the treatment and, in fact, even if declining the treatment would likely lead to one’s own death. This is the right of autonomy. It is a very important right. But even this right is not absolute.

First of all, we must realize there is a spectrum of mandates. It is one thing to say to anyone, on penalty of law, you must get vaccinated, no matter what you think of it. If the person does not agree would that person be held down while health officials jab the arm of the resister? That would be an extreme form of mandating a vaccine. Very few of us would say the law should go that far. But some do. On the other hand, to say, on penalty of law, that if you do not get vaccinated you are not entitled to go to a movie theatre, sporting event, cultural event, bar restaurant, etc. is another form of mandating. This type of mandate is a little less extreme. Few of us object to this. But some do. This is a much milder form of mandate, but it is a mandate. I happen to think it is a valid one perfectly justifiable in a free and democratic society. This would withdraw a privilege for one who does not consent to get vaccinated, but it is not as extreme as my first example. Yet both are forms of vaccine mandates.

 

I want to explore this issue farther in future posts. How far can the government go in mandating vaccines? When is a form of mandate morally acceptable? When not? If it is justified how far can we go? I think these are all important questions.

The questions is how far can we go in mandating vaccines and is it justifiable under the Canadian constitution? Is it legal. Is it moral?  Right now these are big questions because of the large number of people that are resisting vaccines. These are people I am calling Resisters. I want to meander through these moral and legal questions.

How far can we Go?

Epidemics/Pandemics

 

Recently, a friend of mine said he wished Canada was more like Germany in opening up its economy. Soon after that,  Germany became the centre of Covid in Europe if not the world. Chancellor Angela Merkel widely hailed as the best leader in Europe in the last half century or longer, said she favored imposing mandatory vaccines on the unvaccinated in Germany. Promptly thereafter the incoming Chancellor echoed her comments. Austria has already imposed vaccine mandates. I have not heard the details, but they are treating the issue seriously. I don’t think my friend will advocate we follow Germany and Austria down that path.

The German Minister of Health made an astonishing remark. He said, “before the end of the winter everyone in Germany will be vaccinated, recovered, or dead!’ Pretty strong views.

Dr. Hans Kluge, the Regional Director of the World Health Organization for Europe said that Europe had to take matters relating to Covid seriously because it was now having more than half of the new Covid cases in Europe.

Meanwhile, in places like Austria where the government is trying to impose a vaccine mandate tens of thousands of people have taken to the street in protest.  The debate there make is likely to be very heated.

Dr. Kluge asked a very pertinent questions” Does anyone have the right to make someone sick avoidably?” Many people say no and want to impose vaccines on people who don’t want to take.  Others think that is too extreme.

I say all of this by way of introduction to the issue I want to discuss.  Recently a friend asked “is it legally permissible to impose a vaccine mandate on people who don’t want to take the vaccine?”   I answered immediately without thinking, “no.!”  It took me about 15 seconds to say, “I change my mind, it is legally permissible to impose vaccines.” That was one of my fastest flip flops ever.  But was my second view correct? What about our constitutional rights? Is it morally permissible in Canada to compel people to take vaccines? Even if it is moral and legal to impose vaccines, is it wise?  I think these are very interesting and very important questions and I would like to tackle them. This will take a number of posts for there are many issues to meander through.

I hope you join me on this journey.

A Covid Wave

Epidemics/Pandemics

We have lived in a world of Covid for nearly 2 years.  That seems hard to believe.  Many of us want our lives back. I am one of those people. Yet, it doesn’t seem I will get it back anytime soon. That makes many people mad. Some people want all restrictions removed. They feel the restrictions penalize the young and healthy  and believe we should concentrate on protecting the vulnerable and letting the rest live. Others think the restrictions are not harsh enough.

Recently a friend of my was very angry with how Canada was dealing with the pandemic. We should learn from Germany he said. They don’t imposed restrictions like we do and they are doing better than we are.  Then–just a couple of days later–I heard Germany was the new hotspot for Covid, the worst place in Europe if not the world for Covid.

One thing I have learned during the pandemic is that it actually does move like a wave.  People see it coming at them, and then as soon as the wave passes they think they are done. It’s over and they are quick to declare. Then the next wave comes over us again and then another. Each wave often seems worse than the one that preceded it.

As Dr. Hans Kluge , the WHO Regional Director for Europe said, said, “too often countries have declared the pandemic over when it was just a wave waiting for the next wave.” Manitoba certainly made this mistake, as ddi Saskatchewan and Alberta,  but so did almost all jurisdictions.

Recently Europe has been hard hit.  Now before we point wagging fingers at Europe we must remember this virus travels in waves throughout the world. We could be next. Manitoba is not yet out of the 4th wave!

We look at one state or one province or one country who is doing poorly in dealing with the virus and we are quick to wag our fingers and often we do it with deep feelings of superiority. Then it becomes our turn as the wave faces us.

Things change quickly. The only constant in the world of Covid is change. We should be used to that by now.

Are Vaccines Useless?

Epidemics/Pandemics

 

Vaccines are not useless, by a long shot!  But the figures we get from the province of Manitoba could be presented more effectively. Their numbers are deceiving. Tom Brodbeck of the Winnipeg Free Press described the problem well:

“If the province wants to show how effective COVID-19 vaccines are at reducing infections and hospitalizations, it should clarify the data it gives to the public. What it releases now in the regular infection and hospitalization reports is misleading.”

Here is the problems. The province displays the stats for Covid-19 cases by stating the total number of new cases and then dividing those into fully vaccinated, partially vaccinated, and unvaccinated.  The number of vaccinated people who get Covid-19 has been rising steadily in comparison to the unvaccinated people. Sometimes almost as many fully vaccinated people have caught the virus as unvaccinated. How can that be?  If you are not careful you might think that means the vaccines are not very ineffective.

What people forget is that the number of Manitobans who have been fully vaccinated has been increasing. I had a friend of mine ask me exactly the same question. It is easy to get fooled. The reason this is misleading is that the province doesn’t give us all the information we need.  Brodbeck explained the issue this way:

“The answer is that the proportion of fully vaccinated people who test positive, or require a hospital bed, is substantially lower than those who are not immunized.

For example, if the province reports 100 new infections and breaks it down between 60 unvaccinated and 40 vaccinated, it doesn’t appear there’s a big difference between the two. But when the proportion of those who are immunized and non-immunized is reported, a far more accurate picture emerges.

The 40 fully vaccinated people infected represent about four per 100,000 immunized people (there are 1.02 million fully vaccinated Manitobans). The 60 people who were not immunized represent about 17 per 100,000 unvaccinated people (approximately 360,000 Manitobans are not fully vaccinated) — just over four times higher than those with a double dose.”

 

Clearly your chances of getting Covid-19 are much higher for the unvaccinated people than the fully vaccinated people. That is because that 60% of new cases for unvaccinated people has a much smaller poor to draw from.

As Brodbeck added,

“It’s the same with hospitalizations. The province provides daily updates on the percentage of vaccinated and unvaccinated people who end up in hospital, including in intensive care wards. On Thursday, public health reported that 51 per cent of active hospitalizations were among the unvaccinated, three per cent were partially immunized and 45 per cent fully vaccinated. From those statistics, it doesn’t appear vaccines provide much protection. But as a percentage of those immunized, they do. The 39 fully vaccinated hospital cases represent four per 100,000 fully vaccinated people. The 44 who were not immunized represent 12 per 100,000 unvaccinated people, three times the rate of those fully vaxxed.”

 

The province is not trying to hide these figures; they are just not doing a very good job of presenting them. If they did a better job more people would understand that vaccines are very effective. Everyone should take them! This would be easy to do.  The Covid-19 team is doing a great job of protecting us. But they could do a much better job of selling themselves.

Brodbeck gave us another example:

“Instead of only reporting the 115 unvaccinated and 64 vaccinated COVID- 19 cases Thursday, public health officials could have added that 32 per 100,000 were unvaccinated and six per 100,000 were fully vaccinated. It would give the public a far more accurate picture of the effectiveness of vaccines.”

In other words, on a per capita basis unvaccinated people who caught Covid-19 on Thursday outnumbered fully vaccinated people who caught Covid-19 by more than 5 to 1!

Added to that, new Covid-19 cases are not the most important issue. Hospitalizations are much more important.  It does not matter so much if you get covid-19 but do not get seriously sick. That is really what vaccines are for. Most people who get seriously sick are unvaccinated and the number per 100,000 is much higher than for full-vaccinated people.

If the Covid-19 team could do a better job of communicating to us we would all benefit because more people would realize vaccines work.

 

Covid in the Age of Extremes

Epidemics/Pandemics, Extremism

 

In this day and age of extreme polarization and extremism, people who distrust authority, and there are surprisingly many of those, may be subjected to extreme abuse. For example, recently I heard about a case where a Republican politician who voted to impeach Trump, was told by someone that that the politician was going to hell and he could hardly wait to get to heaven to observe the politician fry.  Stop for a moment and think about what a monstrous god would provide such heinous entertainment for his faithful adherents.  Some people actually believe in such a God. I am sure some people have been met with similar abuse from people who don’t trust the medical authorities and think their God will inflict similar punishment on the perceived miscreants health care professionals.

Recently I read about a physician who had been abused as a Nazi in response to an opinion he gave online about vaccines. The physician also said he had been called a murderer and other “disgusting names” by Twitter trolls. These days people who step out into the limelight with their opinions often are greeted by such extreme views. We live in the age of extremes.

CBC journalist, Ian Hanomansing, has written a book about physicians who have stepped up to the plate to help and guide people in order to combat the lies, paranoia, fairy tales, and fake news that is out there. These physicians are helping individuals through these trying times as they face threats to their physical and mental health but are rewarded by bilious abuse. Yet these health care professionals heroically soldier on.

 

As Hanomansing said of these heroes,

“They (and other like them),  are our defence against the offensive and pin-brained voices of prejudice, pseudoscience, nonsensical advice, quackery, witchcraft and religious zealotry.  And they continue to inform and reassure us despite personal attacks on their character and well-being.”

When zealotry rules, everyone should run for cover.