Ethical Considerations For The Second Phase Of Vaccine Prioritisation
By Jonathan Pugh and Julian Savulescu
As the first phase of vaccine distribution continues to proceed, a heated debate has begun about the second phase of vaccine prioritisation, particularly with respect to the question of whether certain occupations, such as teachers and police officers amongst others, should be prioritised in the second phase. Indeed, the health secretary has stated that the government will look “very carefully” at prioritising shop workers – as well as teachers and police officers – for COVID vaccines. In this article, we will discuss moral and scientific reasons for and against different prioritisation strategies.
The first phase of the UK’s Joint Committee on Vaccination and Immunisation (JCVI)’s guidance on vaccine prioritisation outlined 9 priority groups. Together, these groups accommodated all individuals over the age of 50, frontline health and social care workers, care home residents and carers, clinically extremely vulnerable individuals, and individuals with pre-existing health conditions that put them at higher risk of disease and mortality. These individuals represent 99% of preventable mortality from COVID-19. Prioritising these groups for vaccination will mean that the distribution of vaccines in a period of scarcity will save the greatest number of lives possible.
In their initial guidance, the JCVI also suggested that a key focus for the second phase of vaccination could be on further preventing hospitalisation, and that this may require prioritising those in certain occupations. However, they also note that the occupations that should be prioritised for vaccination are considered an issue of policy, rather than an issue that the JCVI should advise on.
We shall suggest that the input of the JCVI is absolutely crucial to making an informed and balanced policy decision on this matter. But what policy should be pursued? Here, we outline some of the ethical considerations that bear on this policy decision.
Lessons for Philosophers and Scientists from Sherlock Holmes and Father Brown
By Charles Foster
Arthur Conan Doyle’s estate has issued proceedings, complaining that Enola Holmes, a recently released film about Sherlock Holmes’ sister, portrays the great detective as too emotional.
Sherlock Holmes was famously suspicious of emotions. 1 ‘ [L]ove is an emotional thing’, he icily observed, ‘and whatever is emotional is opposed to that true cold reason which I place above all things. ‘2 “I am a brain’, he told Watson. ‘The rest of me is a mere appendix’.3
I can imagine that many professional scientists and philosophers would feel affronted if they were accused of being emotional animals. Holmes is a model for them. He’s rigorous, empirical, and relies on induction.
But here’s the thing. He’s not actually very good. Mere brains might be good at anticipating the behaviour of mere brains, but they’re not good for much else. In particular Holmes is not a patch on his rival, Chesterton’s Father Brown, a Roman Catholic priest. Gramsci writes that Brown ‘totally defeats Sherlock Holmes, makes him look like a pretentious little boy, shows up his narrowness and pettiness.’ 4 Brown is faster, more efficient, and, for the criminal, deadlier. This is because, not despite, his use of his emotions. Continue reading
This Machine Kills Viruses
Written by Stephen Rainey
If we had a machine that could eradicate coronavirus at the press of a button, there would likely be a queue to do the honours. Rather than having such a device, we have a science-policy interface, and a general context of democratic legitimacy. This isn’t a push-button, but a complex of socio-political liberties and privations. We can’t push the button, but we can learn how to use the technology we do have – by collectively following policies like staying inside, wearing masks outside, and keeping distance from others.
Because of the coronavirus pandemic a novel form of this scientific research, technological application, and influence or control of nature (including humans) is emerging. In this case, the application is public policy, as based on multitudes of scientific advice. That over which control is sought is twofold: the virus, and people. Control of the virus is not really possible without some control over the people. Likewise, control of the people becomes harder where the virus is not controlled. Public trust in tough policies wanes if there is no end in sight, or no clear rationale in place. Continue reading
Even Though Mass Testing For COVID Isn’t Always Accurate, It Could Still Be Useful – Here’s Why
By Jonathan Pugh
This article was originally published here by the Conversation, on 22nd Dec 2020
The mass testing of asymptomatic people for COVID-19 in the UK was thrown into question by a recent study. In a pilot in Liverpool, over half the cases weren’t picked up, leading some to question whether using tests that perform poorly is the best use of resources.
The tests involved in this study were antigen tests. These see whether someone is infected with SARS-CoV-2 by identifying structures on the outside of the virus, known as antigens, using antibodies. If the coronavirus is present in a sample, the antibodies in the test bind with the virus’s antigens and highlight an infection.
Antigen tests are cheap and provide results quickly. However, they are not always accurate. But what do we mean when we say that a test is inaccurate? And is it really the case that “an unreliable test is worse than no test”? Continue reading
Selectively Saving Christmas?
Written by Ben Davies and Gabriel De Marco
The UK governments in Westminster and the devolved nations (Northern Ireland, Scotland and Wales) have made a recent about-turn regarding Christmas. Where there were previously plans to relax Covid-related restrictions for five days, they will now be relaxed for only Christmas itself, and not at all in some parts of the country.
The planned relaxations were extensive. And even following the recent changes, Christmas is being treated in a way that is considerably different to other major religious festivals: no relaxation of lockdown was seen for Sikh festival Vaisakhi, Muslim celebration Eid (where more extensive lockdowns were announced just the day before), Jewish Hanukkah, or Hindu Diwali.
Although it has not explicitly been posed as such, it seems reasonable to think that saving Christmas has been a long-term plan. The timing of the recent ‘second lockdown’ in England is also suggestive. In order to avoid many going into Christmas with infections, and many leaving with new infections, the thought may have been that we needed this “circuit-breaker”; indeed, when Johnson announced the lockdown at the end of October, one hope he expressed was that “taking action” at that point would make Christmas gatherings more likely. And even amid the recent reversal, communal worship can continue even in the new ‘Tier 4’ locations.
Legacies
By Stephen Rainey
Joe Biden won the recent US election. As yet, the normal concession speech from the losing candidate has not been forthcoming. Donald Trump’s actions since losing the presidency have been, well, Trumpian, prompting Biden to label them an ‘embarrassment.’ He also suggested that The Donald was endangering his legacy in not reacting more gracefully. But what use is talk of ‘legacy’? What matters most about it?
It would be easy to ‘Goldwater’ Trump, that is, diagnose some mental incapacity from afar. One could suggest he was ill-equipped to absorb his defeat. He has behaved in ways that could be seen as pathological. Maybe, we might continue, he really doesn’t believe this is the end. If that were the case, there would be no need to consider legacy. It would also be easy to have suspected that, far from sticking around, 45 would flounce out of the White House, his pride wounded. Legacy wouldn’t matter in that case, because the electorate, the people, would have shown themselves to be unworthy, having voted the wrong way. Sad. Continue reading
Antenatal Care During The COVID-19 Pandemic: Couples As Dyads
Written by Rebecca Brown
During the pandemic, many healthcare services have been reduced. One instance of this is the antenatal care of expectant mothers. Ordinarily, partners of pregnant women are permitted to attend appointments. This includes the 12 week scan: typically the first opportunity expectant parents get to see the developing foetus, to discover whether it has a heartbeat and is growing in the right place. This can be very exciting and, if there’s bad news, devastating. It also includes scans in mid pregnancy and (for first-time mothers) at 36 weeks, as well as the entirety of labour.
During the pandemic, many healthcare providers have restricted attendance at antenatal appointments as well as labour and postnatal care. Even when lockdown restrictions were eased, with pubs, zoos and swimming pools re-opening and diners in England being encouraged to Eat Out to Help Out, some hospitals continued to exclude partners from all antenatal appointments and all but the final stage of labour, requiring them to leave shortly after birth. This included cases where mother and newborn had to remain on wards for days following delivery. With covid cases rising, it seems likely that partners will once again be absent from much antenatal, labour, and postnatal care across the country. Continue reading
The Duty To Ignore Covid-19
By Charles Foster
This is a plea for a self-denying ordinance on the part of philosophers. Ignore Covid-19. It was important that you said what you have said about it, but the job is done. There is nothing more to say. And there are great dangers in continuing to comment. It gives the impression that there is only one issue in the world. But there are many others, and they need your attention. Just as cancer patients were left untreated because Covid closed hospitals, so important philosophical problems are left unaddressed, or viewed only through the distorting lens of Covid. Continue reading
Guest Post- Pandemic Ethics: Your Freedom Really Matters. So What?
Written by Farbod Akhlaghi (University of Oxford)
The coronavirus pandemic rages on. To the surprise of many, the enforcement of mask wearing, imposition of lockdowns, and other measures taken to try to halt the pandemic’s march have been met with some heavy and vocal resistance. Such resistance has materialised into protests in various countries against these measures taken by states, companies, and other organisations to prevent the spread of the novel coronavirus.
There are a range of reasons one might object to these measures. One reason that has repeatedly been voiced – sometimes shouted through angry un-masked mouths – is that these measures unjustly affect the freedom of those subject to them. The thought is that, for example, being forced to wear a mask, or denied entry into somewhere without a mask, is an unjust restriction of one’s freedom, presumably either to wear whatever they choose or to be free from the interference of others in going about one’s business.
Whatever good reasons there may be to object to these pandemic mitigating measures, I believe this one is simply a mistake. It is certainly true that our freedom, both to do things and from unjust interference, matter morally – they matter a lot too. But the moral significance of freedom, and the mere fact that measures like enforcing mask wearing, imposing lockdowns, and restricting movement do curtail such freedom, does not show that these measures unjustly restrict the freedom of those subject to them during this pandemic.
Failure to see this may be due to a failure to recognise the distinction, drawn by the moral philosopher Judith Jarvis Thomson, between the infringement and the violation of a right.
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