Crosspost: Immunity Passports: A Debate Between Jay Bhattacharya and Alberto Giubilini
By Alberto Giubilini (University of Oxford) and
Jay Bhattacharya (Stanford University)
crosspost with Lockdown Sceptics
[Prof Jay Bhattacharya (Professor of Medicine, Stanford University) and I collaborate on Collateral Global, a new project that aims to evaluate the impact of lockdowns and other pandemic restrictions. We have the same view on lockdown and pandemic restrictions, but we do have our own internal, healthy disagreement. Most people who are skeptical and critical of lockdowns (as both Prof Bhattacharya and I are) are also against immunity passports (as he is), often for the same reasons. I disagree on this point and I think some form of immunity passport should be introduced. In this exchange published on Lockdown Sceptics, we try to explore exactly where our disagreement lies and try to identify possible areas of agreement on the matter. AG]
The Case For Immunity Passports
by Alberto Giubilini
Having read the excellent piece in the Wall St Journal by Prof. Bhattacharya and Prof. Kulldorff, I have the impression that they take many of the reasons against lockdowns to also be reasons against immunity passports. Among these, individual liberty is prominent.
I disagree.
What Is The Justification For Keeping Lockdown In Place? Two Questions For The UK Government
Written by Alberto Giubilini and Julian Savulescu
Oxford Uehiro Centre for Practical Ethics, University of Oxford
Given the success of the vaccine roll out in the UK and the higher than expected drop in COVID-19 deaths, it is legitimate to ask whether lockdown should continue to be the key strategy to contain the pandemic or whether the ‘roadmap’ announced by the UK Government should be adjusted. Because lockdown is a very exceptional measure, the burden of proof is on the Government to provide answers as to why the easing of lockdown is proceeding at the current pace and not faster. The impact of lockdown is devastating for the economy, mental health, and employment rates and the cost and benefits are in many cases very unevenly distributed. For instance, the young are at highest risk of redundancy, but benefit less from lockdown because COVID-19 pose a very low risk on them. There is a serious concern around the rise of referrals for mental health assistance for children and teenager over the past year. If the lockdown is justified at this stage, the Government has the burden of proof of providing a strong justification for this.
Such justification might need to be updated with respect to the one offered when the roadmap was announced on 22 February. That justification was centred on the target of “keeping infections rates under control” as determined by 4 tests: successful vaccine deployment program; vaccines being successful at reducing hospitalizations and deaths in the vaccinated; infection rates not putting unsustainable pressure on the NHS; and the risk assessment not being significantly altered by new variants.
Even assuming those criteria are fair, the justification now needs to take into account the “very very impressive” and “spectacular” results of vaccine rollout, to quote a lead researcher from Public Health Scotland. As we shall see below, there are reasons to think that the vaccines are producing better results than those expected by the Government and assumed by the modelling used to inform the roadmap. Plausibly also because of the vaccine roll out, the drop in COVID-19 deaths in the UK is now three weeks ahead of the estimates of the modelling that the Government has used to design its roadmap: while the modelling estimated that COVID-19 deaths would fall below 200 a day after mid-March, we reached that point on 25 February. The model suggested we would have as few as 150 deaths per day by 21 March, but we are at that point now.
In light of these data, the Government would need to justify using indiscriminate lockdowns to achieve something – protection of the vulnerable and the NHS – which data suggest is now achievable without overburdening the whole society (as lockdown is doing) and possibly even without burdening those who need protection the most (as selective shielding would do). Vaccines are offering a level of protection to the vulnerable (roughly 80-90% drops in hospitalizations and deaths) that, if it was achieved through measures like selective shielding, would plausibly justify considering selective shielding successful. But vaccines do this without the downsides of indiscriminate lockdown or of selective lockdown.
Guest Post: What Is The Case For Virtual Schooling?
Written by Thomas Moller-Nielsen
News that children in England were to switch to online schooling as part of the country’s third national lockdown in response to the Covid-19 global pandemic was met with widespread support in the British press. Doctors, public health specialists, and even teaching unions similarly applauded the decision. (Nurseries, which have remained open during the latest lockdown period, have also been put under heavy pressure to close.)
The justification for the suspension of in-person schooling during this pandemic, however, is far from obvious. Indeed, there are at least two prima facie plausible reasons for scepticism. Firstly, children are far less susceptible to serious infection or death from Covid-19 than adults are. (While the precise figures are open to dispute, the Medical Research Council Biostatistics Unit at the University of Cambridge has estimated that the infection-fatality rate for 5-14 year-olds in England is 0.0013% – which is roughly 24 times smaller than the infection fatality rate for 25-44 year-olds, and approximately 9000 times smaller than the infection-fatality rate for 75+ year-olds.) Secondly, virtual schooling – in addition to being a poor substitute for in-person schooling – is widely recognized to be a key contributing factor in students’ increased feelings of stress, depression, and anxiety during the pandemic, and has been similarly linked to many physical paediatric disorders such as juvenile hypertension and obesity.
In other words, it seems that: (i) children are not in serious danger of being (directly) harmed by Covid-19; and (ii) children are in very real danger of being harmed by online schooling. Why, then, should students be required to attend virtual school? Continue reading
Current Lockdown Is Ageist (Against The Young)
Written by Alberto Giubilini
Oxford Uehiro Centre for Practical Ethics and Wellcome Centre for Ethics and Humanities
University of Oxford
Former UK supreme court justice and historian Lord Jonathan Sumption recently made the following claim:
“I don’t accept that all lives are of equal value. My children’s and my grandchildren’s life is worth much more than mine because they’ve got a lot more of it ahead. The whole concept of quality life years ahead is absolutely fundamental if one’s going to look at the value of these things.”
This wasn’t very well received, to say the least. Experts were quickly recruited by the press to rebut his claims. Headlines were made to convey people’s outrage at the idea that we can put a value on human life, and what is worse, different values on different human lives (which, by the way, is precisely what the NHS regularly does whenever it decides whom to put on a ventilator when there are not enough ventilators for everyone, or when it decides not provide life-saving treatments that cost more than £ 30k per quality-adjusted-life-year). Continue reading
Pandemic Ethics: Utilitarianism and the Lockdown
by Roger Crisp
Utilitarianism is in the news. It was widely believed that the UK government’s so-called ‘herd immunity’ strategy, which involved sacrificing the important interests of a relative few for the sake of benefits for the many, was motivated by a commitment to utilitarianism. Now several commentators around the world have suggested that decisions to ease lockdowns so as to ‘open economies’ can also be seen for similar reasons as utilitarian. Continue reading
Contact-tracing apps and the future COVID-19 vaccination should be compulsory. Social, technological, and pharmacological immunisation
Written by Alberto Giubilini
Wellcome Centre for Ethics and Humanities – Oxford Uehiro Centre for Practical Ethics
University of Oxford
Main point:
Lockdown measures to contain the spread of COVID-19 have so far been compulsory in most countries. In the same way, use of contact tracing apps should be compulsory once lockdown measures are relaxed. And in the same way, vaccination should be compulsory once the COVID-19 vaccine is available.
We can think of the lockdown as a form of ‘social immunization’, of contact tracing apps as a form of ‘technological immunization’, and of course of vaccination as pharmacological immunization. The same reasons that justify compulsory lockdown also justify compulsion in the other two cases.
Pandemic Ethics: Why Lock Down of the Elderly is Not Ageist and Why Levelling Down Equality is Wrong
By Julian Savulescu and James Cameron
Cross-posted with the Journal of Medical Ethics Blog
Countries all around the world struggle to develop policies on how to exit the COVID-19 lockdown to restore liberty and prevent economic collapse, while also protecting public health from a resurgence of the pandemic. Hopefully, an effective vaccine or treatment will emerge, but in the meantime the strategy involves continued containment and management of limited resources.
One strategy is a staged relaxation of lockdown. This post explores whether a selective continuation of lockdown on certain groups, in this case the aged, represents unjust discrimination. The arguments extend to any group (co-morbidities, immunosuppressed, etc.) who have significantly increased risk of death.
Why You Should Not (Be Allowed To) Have That Picnic in the Park, Even if it Does Not Make a Difference
Written by Alberto Giubilini
(a slightly longer version of this blogpost will appear in the journal Think. Link will be provided as soon as available)
It’s a sunny Sunda
y afternoon, early spring. The kind of afternoon that seems to be inviting you out for a stroll by the river. Maybe have a picnic on the green grass, in that spot over there, away from everyone. Why not?
The simple answer is: because there is a pandemic and the Government is enforcing a lockdown. You should stay home. End of the story.
And there isn’t a complex answer. The simple answer really is the end of the story.
But why? You probably understand the reasons for the lockdown. But that is a matter of policy, a general rule for the population. What difference does it make if I just go over there, where there is no one, keeping at distance from everyone? I am not going to harm anyone.
You are (probably) right: it (likely) does not make a difference, and you are (likely) not harming anyone. However, that is not the only relevant question to ask when we ask what we morally ought to do, or what a Government may permissibly require of us.
Let us consider the ethically relevant aspects of this situation. Continue reading
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