In bioethics, though, we’ve overcomplicated things. For instance, early in the pandemic, people were campaigning for “human challenge trials” into Covid vaccines. In normal vaccine trials, people are given the vaccine (or a placebo or other control), and then the researchers observe how many people get the disease naturally. If it’s significantly fewer in the vaccine group, then we say that the vaccine works.
But it can take months for enough people to catch the disease naturally. When I was on the AstraZeneca trial in summer 2020, prevalence was low – there was real concern that it would take many months to get enough data.
With human challenge trials, participants agree not only to be given the vaccine but also the disease. It lets you use far fewer participants, and get your results far quicker, than a traditional vaccine trial.
A promising vaccine candidate, the Moderna mRNA vaccine, was ready in a lab in January 2020. The hundred or so doses that would have been required to get very solid evidence of effectiveness could have been made at lab scale in a few days. We could have known by February, or March at the latest, whether the vaccines worked. Yes, we’d still have had to scale up production, and that would have taken months. But the whole process would have started earlier. Instead, Moderna’s vaccine was not given emergency use approval in the US until December.
As the philosopher Richard Yetter Chappell points out, there are obvious-seeming objections to human challenge trials. You have to give people a potentially dangerous disease: what if it kills one of them?
But one plausible estimate is that roughly 18 million people have died of Covid during the pandemic – that’s an average of about 28,000 a day. Bringing the end of the pandemic forward by even a single day could easily save thousands of lives. A small risk to a small number of young, healthy volunteers was hugely outweighed by a very likely large reduction in risk to many thousands of old, vulnerable people.
Philosophy fans might think that this is a classic utilitarianism problem: is it OK to sacrifice one to save many; can I torture the terrorist in order to find the bomb? But as Chappell notes, in fact it is not. There are willing volunteers offering a (small but real) sacrifice for the greater good. It is an act of altruism, or even heroism, not coercion. “In what other context would the default assumption be to ban heroic acts of immense social value?”, asks Chappell.
There have been other failures. Recently, the drug Paxlovid was shown to be highly effective against severe disease. So effective, in fact, that the trial was stopped midway, because it was deemed unethical to give half of the participants a placebo when it was clear the real drug worked.
But the drug is still not approved in the US. So as Zvi Mowshowitz points out, “It is illegal to give this drug to any patients, because it hasn’t been proven safe and effective,” but also, “It is illegal to continue a trial to study the drug, because it has been proven so safe and effective that it isn’t ethical to not give the drug to half the patients.”
This is not the only such case. A trial of a drug designed to protect against HIV was stopped last year, because the drug was so effective that it was unethical to give placebo. But the drug was not actually approved by the FDA until … Monday!
There are two important points to make, here. First, while I’m talking about “bioethics”, it’s not clear that it’s actually bioethicists who are the problem. For instance, Peter Singer of Princeton, probably the world’s most famous bioethicist, is on the board of 1DaySooner, the human challenge advocacy group, as is his fellow bioethicist Nir Eyal, of Harvard. Leah Pierson, a Harvard bioethicist who is writing a book about the failings of bioethics during the pandemic, stresses that when the CDC paused the use of the J&J vaccine, lots of the bioethicists she knows were appalled at the decision. But the practice of bioethics as actually carried out in major institutions, such as the FDA and CDC, often leads to these bad decisions. Matt Yglesias makes a good case here that public health agencies tend to follow somewhat rigid rules, rather than the best available science, leading to bad outcomes like a delay in approving fluvoxamine: perhaps I should complain about “institutionalised public health” rather than “bioethics” per se.
Second, as Pierson points out, “When these systems work well you probably don’t hear about it.” No doubt there are lots of drugs that get approved relatively smoothly, and trials which go ahead without much fuss. I don’t know how representative these problems are.
But the problems do exist, and they seem to be exacerbated by the pandemic. Chappell thinks that the main problem is one of status quo bias: that is, that changing things feels like the “risky” option, and keeping things the same feels “safer”. And, he admits, that may (or may not) be true in non-pandemic times. But in the pandemic, the status quo is visibly very dangerous. Throwing some low-but-not-zero-risk options into the mix, like early approval of vaccines or human challenge trials, are almost certainly lower-risk, in terms of the likeliest expected outcomes, than sticking with the status quo.
There is also an issue that humans instinctively think there’s a difference between bad outcomes caused by our actions, and bad outcomes caused by inaction. It’s hard to make a good philosophical case for this, and what the distinction between an “act” and an “omission” is (Jonathan Bennett had a go), but it’s how we feel. Killing one person by giving them a faulty vaccine feels worse, somehow, than letting a thousand die because we let the vaccines sit in a warehouse for another 24 hours.
And it’s easy to come up with reasons why we need to put more hoops in place for researchers and clinicians to jump through, because the one guy who dies in a botched human challenge trial is very obvious, whereas the thousands of people who would have died if the trial never took place are completely invisible.
But whatever the reason is that the hoops are in place, they are in place, and people have to jump through them to get things done. It took until December for the UK to decide to vaccinate the under-12s, despite it being well established that schoolchildren were driving the pandemic, because bioethicists could only take into account direct risk to the patient at the time – not the likelihood that prevalence would go up, or whether the children would rather not put their own relatives at risk. And it’s amazing, with hindsight, to read this approving piece from October last year about how a doctor prevented Donald Trump from forcing through early approval of a Covid vaccine.
It’s rare that academic philosophy can have such a direct impact on people’s lives. But how we apply bioethics really can save or kill thousands, just by changing the speed with which we approve drugs. In peacetime, perhaps, it’s OK to argue the toss and act with caution. But in a pandemic, perhaps we really ought to apply the standard of “Do the thing that kills fewer people”.
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SubscribeThere are so many factual inaccuracies and misconceptions in this article that frankly Chivers should stop writing about stuff he really knows nothing about. Frankly it is truly embarrassing that Chivers calls himself a science journalist, but at least its fun to correct him on almost a weekly basis. (1) It is absolutely not established that children are drivers of the pandemic – indeed transmission from infected children has been very very low indeed (as was evident from the Swedish data early on where they didn’t close the schools). (2) The vaccines have clearly been shown not to prevent either infection or transmission, so there is absolutely no logical or ethical reason to give vaccines to children who are at very very low risk of bad sequelae if infected, but are at sizable risk following vaccination (e.g. myocarditis in young boys and men). Indeed, it is nothing short of highly unethical.
Moreover, there is a very good reason why drugs are thoroughly vetted before going on the market. The current vaccines were never properly vetted. And any vaccine with the short-term risk profile of the current covid vaccines would have been withdrawn from the market a long long time ago (e.g. the swine flu vaccine). (And recall we have no idea what the mid-term or long-term adverse effects may be).
Likewise with the new Merck and Pfizer anti-covid drugs. The Merck drug’s safety profile has absolutely not been tested but it is known that it is mutagenic. It’s one thing using a drug like that as a drug of last resort to save somebody’s life, but quite another to administer it at the very start of symptoms which may not even develop into anything requiring hospitalization let alone admission into the ICU. Further, it’s even more inexcusable to administer the Merck drug given that it has been shown to be totally ineffective. As for the Pfizer protease inhibitor, it’s safety profile too has not been properly tested and nor has its long term efficacy. Giving a drug that acts against a single viral target (the viral protease) is only going to generate drug resistant mutations in short order. That’s precisely why AIDS treatment involves the use of multiple drugs against multiple targets.
In medicine it is always good to adhere to a very simple dictum: first do no harm. And that’s precisely why governments and public health authorities in the US and UK actively discouraging people from taking vitamin D, zinc and vitamin C, all of which are completely harmless, either prophylactically or at the very onset of symptoms is nothing short of medical negligence.
Chivers article is largely based on facts, whereas your response seems largely based on feelings.
It’s been well documented that the spike in cases when the schools reopened was largely due to infections amongst schoolchildren. Whether giving them the vaccine is the correct course of action however is up for debate, as the children themselves are largely unaffected by the virus. As the vaccines only seem to protect the person from the worst effects of the virus rather than stopping transmission I believe vaccinating children is an exercise in futility personally, but others would argue if it only slightly reduced transmission it would be worth it.
Also as Chivers pointed out in the article, he was talking about the ethics of fast tracking the vaccines, and asking the question about whether it can ever be justified. Some would argue that placing those in the trials at a greater risk is immoral and should never be done, whereas others would say the tiny increase in risk is worth it if it gets jabs in arms more quickly and prevents other vulnerable people dying in much greater numbers. On this I tend to agree that given the numbers who were dying with Covid at the time a slightly riskier trial process would probably have been ok, as long as those involved in the trials were aware of the risk they were taking.
You seem to have missed the entire point of the article, instead simply arguing that you don’t think the vaccines are safe.
Exactly, and his is a typical response of anti-vaxers – ignore everything posititive about vaccination because I don’t agree with it.
In fact, the article is very good. It is NOT saying that vaccination is good, it is making a general point using Covid as an example. Unfortunately Johann Strauss is typical of what makes UnHerd a waste of time.
Chris,
I think you may be confused.
Unherd , in there own words:
Now if i can give a criticism to us all, if we are on this comment thread then we’ve all fallen for it, its a Chivers piece on the most emotive topic around and we’ve all taken the bait, It’s nearly Christmas, its not worth this hostility, lets all have some mulled wine and too many chocolates instead, have a Merry Covidmas and may Greta bless you all.
Brilliant George
It has good articles, some very interesting comments, and unfortunately a minority of noisy extremists, obsessives and conspiracy theorists. Unfortunately that seems a similar profile to other sites.
Just like the rest of the population then. I do yearn for a rational and calm place to consider important issues questions and concerns.
Or, a minority of self-righteous, mandate pushing, lockdown totalitarian, pro vax sheep can’t come up with arguments in their position, so have to just call anyone differing:
“noisy extremists, obsessives and conspiracy theorists”
Which does cover my posting style pretty well – but still does not further your position.
you seemed to have misunderstood both Johan’s comment AND Billy Bob’s.
Reading two men b***h about another is so unpleasant. You’re not right, as an armchair scientist. Just stop.
I’m hear for the articles, not the grandstanding of some of the posters in the comments section. Who tend to be an unrepresentative clique. So UnHerd is absolutely not a waste of time.
In my humble opinion anyway!
I enjoy a good insult, but
‘Chivers should stop writing about stuff he really knows nothing about. Frankly it is truly embarrassing that Chivers calls himself a science journalist’
is kind of high school debating standard
School maybe but no high.
you have failed to point out what wasn’t a fact. Please elaborate because Johan’s comment is all true and confirmable.
‘spike in cases’ doesn’t really mean anything except a DESIRED outcome.
How is it a desired outcome? Looking at the UKs data there was clearly a spike in the number of infections when children finally went back to school, and it’s been well documented that a large number of these cases were children and their immediate families. As I’ve said whether this is cause enough to vaccinate the younger age groups is up for debate, I personally think it’s rather pointless vaccinating children as they’re rarely in danger from the virus itself. Others however may argue that even if by vaccinating youngsters you’re slightly reducing rates of transmission you’re protecting others they come into contact with so it’s worth it. Neither answer is 100% right or wrong, individuals will have different viewpoints largely based on their experiences with the virus, which was the premise of the whole article.
The original poster seems to have largely ignored the point the writer was making, instead going on a rant about the effectiveness of vaccines which while not wholly incorrect again raises other questions.
If the vaccines don’t prevent infection or transmission, which most of us will agree they don’t do, is it still worth the large scale inoculation programme just to prevent the more vulnerable coming down with more serious symptoms? Personally I’d argue it is worth it, even if it meant the original timeframe for clinical trials was reduced, however others may have a different view. The original reply made no attempts to answer these difficult questions at all
There is, in fact, given that we haven’t had time for the completion of the two year follow up trial, good reasons for not trusting the vaccine.
Billy Bob I have seen some green shoots lately, but you are regressing again. What part of the above post is emotional. Discussion of lives lost obviously segues into anti Covid meds.
“Chivers should stop writing about stuff he really knows nothing about. Frankly it is truly embarrassing that Chivers calls himself a science journalist“
Pathetic insults such as this add nothing to the debate. It automatically flags your reply as being motivated by hostility of vaccines rather than addressing the points raised in the article, which was about morality based on sheer numbers
“As the vaccines only seem to protect the person from the worst effects of the virus rather than stopping transmission…”
You can have no idea whether that statement is remotely true.
Is it not more likely that the virus has become less virulent over time as all viruses do. Bearing in mind the lies we have already been fed by those are charge, do not claims for the efficacy vaccine have about the same credibility as my claim that it is a all down to my prayers to the baby Jesus.
The point is what can you believe
Nobody knows if it’s 100% true, of course they don’t. However the fact the number hospitalisations and deaths were severely reduced as the vaccine rollout gained pace would imply to me that they do work in preventing the most serious symptoms. No doubt natural immunity also played a role but it would be a strange coincidence if the number of deaths reduced in each country as they began vaccinating
No it was my prays to the baby Jesus.
Or it could be the fact the fact that the virus had already taken its toll of the most vulnerable and was becoming less virulent as all viruses do, hence why us humans are still here.
Of course that plays a part, the omicron variant seems much less than delta for instance, though the delta seemed worse than the original one. Natural immunity would have built up over the last two years which no doubt offers people a degree of protection.
But if you’re seriously suggesting the tens of millions of jabs given played no part whatsoever in reducing patient and mortuary numbers then I see little point in carrying on a conversation with you, as you’ve clearly been blinded by your ideology.
Most people can see it’s a number of factors such as jabs, natural immunity and new variants that has seen numbers of deaths serious illnesses drop from their peak to what we’re now seeing
The thing that scares me is that beta was more virulent, and delta even more so. Omicron looks to be less virulent. The statement “the virus has become less virulent over time as all viruses do” has not been borne out for covid, unless you meant eventually
Totally disagree. Strauss’ comment is excellent and
(Sorry) certainly gives me the impression that Strauss knows more about ‘the science’ than Chivers.
Yes, first do no harm.
But that’s not the end of it. You also try to help. Help is sometimes risky – like moving an injured person. Difficult decisions.
How about you try helping by focussing on healthy life-styles, nutrition, exercise, fresh air, stress reduction etc etc instead of experimental medications given to people before they are even ill?
Presumably, in your world hardly anyone has died of or been seriously ill from covid? The two levels of risk should be taken together.
Isn’t it ironic that people minimising the pandemic so often then go onto enormously exaggerating the prevalence very rare negative outcomes from vaccines. Endlessly talking about ‘with’ rather than ‘from’ covid (which is a good point) but then somehow forgetting exactly this distinction with regards to vaccines!
I think those saying my response is not based on facts are in fact the emotional ones, and are not fully aware of the facts. Further I am certainly not anti-vaxx. Rather I’m looking at the real facts.
So here is the ethical question:
Do you give a vaccine to kids which is NOT sterilizing, does NOT prevent infection and does NOT prevent transmission. These vaccines are not the same in this regard as, for example, polio or measles vaccine in this regard. If they were the pandemic would already be long over.
That’s why a rush to judgement and fast tracking in those that really don’t require the vaccine is a massive ethical error and lapse of judgement.
The correct approach would have been to only distribute the vaccines to the population most at risk – i.e. the elderly and those with known co-morbidities. This would have represented a reasonable risk/benefit ratio, and further would not have produced conditions on the ground that facilitate the generation of variants that are vaccine resistant.
Further, it should be evident to all that the vaccines have failed to curb the pandemic. We do not have a pandemic of the unvaccinated at all, as shouted from the roof tops by the Biden administration. We actually have a pandemic of the vaccinated. Indeed, the likelihood of being infected by the new Omicron variant, according to the just published UK ONS statistics, is close to 4.5 times higher in the triply vaccinated and 2.3 times higher in the doubly vaccinated, relative to the unvaccinated. In other words, what this tells one is that the Omicron variant is evading the antibodies generated by the current vaccines.
I’ve never understood the “non sterilising” argument. If a vaccine is only 70% effective, is it useless?
Maybe it’s because, as you say, vaccines haven’t “curbed” the pandemic, and certainly could never end it without vaccinating the whole world to a high degree.
One thing that might eventually come out of this is a universal “sterilising” vaccine, that also wipes out some common colds
Another logical flaw. When it comes to death with or from COVID, one can clearly ascertain what the main cause of death was. For example, you have somebody with an end-stage lymphoma or leukemia or congestive cardiac failure, any infection can tip them over the edge. In the case of vaccines, however, there is a temporal relationship that has to be taken into account as well as the age and health of the vaccinees. i.e. if a 90 yr is vaccinated and subsequently dies, it may be difficult to ascertain whether death was due to the vaccine or simply old age (given that nobody lives forever). But when a healthy 15-20 yr old dies within a couple of weeks of vaccination, then you have to seriously look at what’s going on. When healthy 15-20 yr old males develop myocarditis at a much higher rate than expected, when rare clotting events (associated with low platelet counts) that most physicians are unlikely to ever see in their entire practicing lifetime appear in young healthy women, one has to take notice.
The truth of the matter is that if these vaccines were for anything other than COVID they would have been taken off the market a long time ago. Recall, the H1N1 swine flu vaccine in 2009: all it took was 35 deaths in children and the vaccine was removed from the market immediately.
Is that not the whole point of the artical. A vaccine could, rarely, kill a few “15-20 yr” olds, but save a larger number, therefore they should be encouraged to be vaccinated? Are you saying that vaccines kill more in this age group than they save? I would love to see the evidence for this
The accusation of ‘emotions’ rather than facts surprised me too. I think the emotion belongs to the recipient of the message who wants to believe the science is settled and doesn’t want to hear contrary voices, especially if they provide evidence.
I’m triple jabbed but have been accused of being an anti-vaxxer because I don’t agree with mandatory vaccination or vaccine passports. I have posted that I know numerous people who have had Covid after all jabs, and a young chef who has developed cardiac problems after his. I also know of a cardiologist who won’t let either of his teenage sons get jabbed. I was recently accused of being a liar for saying so…
“And that’s precisely why governments and public health authorities in the US and UK (were?) actively discouraging people from taking vitamin D, zinc and vitamin C” – I’m on your side on this one, but DID governments actively discourage? Seems to me more sin of omission than ‘don’t take Vitamin D!’.
I agree, however, GP or medical advice is still – after almost two years – ONLY “stay at home”; it is a disgrace.
Actually they refuse to give vitamins in hospital care. They must follow the NIH protocol.
Once in hospital, bit late to begin using vitamins. Vit. D takes some time to be useful in immunity boosting.
If you look at the “heat map” for cases in England on https://coronavirus.data.gov.uk/details/cases?areaType=nation&areaName=England you will see a band for school children and their parents. All my children living in the UK caught covid from their children. The same map shows the comparitively low cases in elderly people, partly because many have been cautious in who they meet and partly because of the vaccinations. The corresponding map for deaths in England shows that the mortality rate in elderly people has reduced but is still significant. Your arguement would be stronger if it focussed on keeping untested children away from the elderly as an alternative to vaccination. Then the analysis depends upon whether the child will inevitably be exposed to covid – which now seems very likely – and whether the child is safer with or without the vaccine. Not an easy calculation to make as you are comparing two very small chances. There are plenty of potential worries in protein interactions in a human but Tom is right to say that do nothing carries a risk that needs to be evaluated.
If the vaccines were sterilizing and therefore prevented infection and transmission, you would indeed be correct. The problem is that the vaccines are neither. So right now, the vaccines may only serve to prevent severe disease, or at least so it’s said but I’m not sure whether that has been actually shown. So vaccinating a child won’t prevent the child from being infected and transmitting to the parents. So how can one describe a call to vaccination for school aged children ethical. It has zero plus sides, and a lot of negative ones, both short and long term.
And incidentally, the adverse events are not incredibly rare. They are clearly very common, as is evident from the UK yellow book and the US VAERS database. A risk of 1 in 2000 to 1 in 5000 of developing myocarditis in young males, sufficient to require hospitalization, is not that rare, and the consequences are potentially very severe. Indeed, the consequences of sub-clinical myocarditis in young males 30-50 years down the road is also not insignificant.
What makes COVID difficult is that the spectrum of disease ranges from nothing (asymptomatic) to death. But fortunately, we now know exactly what segment of the population is most at risk and who need to be protected. That’s why the sensible approach all along would have been one of focussed protection as advocated by the Great Barrington declaration and effectively put into practice, independently, by Sweden.
And by the way, for those interested, they might like to look at the severe adverse effects, including deaths, that Pfizer found post-authorization: https://www.scribd.com/document/543857539/CUMULATIVE-ANALYSIS-OF-POST-AUTHORIZATION-ADVERSE-EVENT-REPORTS-OF-PF-07302048-BNT162B2-RECEIVED-THROUGH-28-FEB-2021#from_embed
This was as of Feb 2021, so very early on, and includes 42,000 case reports detailing 160,000 adverse reactions and over 1000 deaths. This is the data that Pfizer submitted to the FDA during the approval process, and has just been released pursuant to a FOIA request.
All I can say is that it’s none too pretty, and it’s probably time for Chivers, as well as others such as Chris, to open their eyes and see what the real situation is, rather than look at things through rose-tinted glasses. Of course, when the vaccines were first rolled out, most, including myself, thought that they would offer deliverance and an end to COVID – after all the 95% prevention of infection that was touted by Pfizer and Moderna was impressive. But this was for the original SARS-CoV2 virus and was also not far removed in time from the second shot of the series. The situation today has now changed dramatically. The vaccines are close to useless at preventing infection 6 months out (i.e. they’re protective effect doesn’t last long), and they are not at all effective against the newest Omicron variant. This is hardly surprising. The monoclonal antibody treatments, which were specifically directed against the original spike protein, are no longer effective against Omicron. So why one would expect the vaccines that make the original spike protein to be effective is beyond me. The target for neutralization is the ACE receptor binding site on the Spike protein, and this has mutated significantly.
I agree with your paragraph “What makes COVID difficult…” and the data was there early on, before the UK lockdown. Even now the Government is failing to focus on protecting the vulnerable. Pharmacies have run out of lateral flow tests that should be made available to all visitors to vulnerable people.
I do question whether vaccination in children has zero plus side. There should be a benefit from priming the immune system. This and the degree to which vaccination reduces transmissibility should be calculable. I despair at the failure internationally to systematically record data in a way that enables the calculations that are needed to be made. Now needed on Omicron.
Tom could have cited the advice for women who were pregnant not to get vaccinated now changed based on the problems they encountered when they caught covid. Though that is a particularly difficult calculation to make.
The issue regarding whether the vaccine primes the immune system appropriately or not is an interesting one. There is such a thing as “original antigenic sin”, and it is far from clear that the immune response in children is primed correctly following a vaccine targeted against a very specific component of the virus (i.e. the spike protein). i.e. the antibodies generated upon vaccination do not represent the broad set of antibodies produced upon natural infection with COVID which is why natural immunity post-infection is, according to many studies, something like 13x more effective than vaccination. So by priming the immune system against one specific component of the virus, and further one that is no longer in current circulation since it has mutated many times over, may actually be very deleterious when the immune system then has to react to a new variant.
I would just like to point out that the age range 30-50 is not “young” it is middle aged. A woman over 35 giving birth is classed as geriatric. Given rampant levels of obesity in all age groups in the west, perhaps heart problems in this 20 year age group have contributing factors besides the vaccine. Basically the whole subject is a minefield of unknowns and misleading data from both sides of the debate.
“the age range 30-50 is not “young” – It most certainly is if you’re on the other side of 70.
As for 35-year old pregnant women being classed as geriatric, you must be joking.
Yes. This is the great scam. When it became clear these were not sterilizing vaccines the propaganda changed to it prevents severe disease. There is no database of all the people who have been hospitalized, their vaccination status, and a column marked “disease severity”. There is no data to back up this claim. Actually we won’t even being allowed to see all the trial data until 2076! This is the level of transparency we are dealing with.
So right now, the vaccines may only serve to prevent severe disease, or at least so it’s said but I’m not sure whether that has been actually shown
Not the slightest proof your answer has any science-based validity. No reference whatsoever to any study to support your claims. Delirious assertions like “The vaccines have clearly been shown not to prevent either infection or transmission”. Instead of wasting your and our time writing such nonsenses, you could better use your spare time listening to the masterpieces of the great musician of whom you dare to use the name.
May I simply suggest you read the current ONS statistics rather than saying that my answer is not science-based. If you did your own research you would see that I was 100% correct. The issue is that those “Following the ScienceTM” are actually not following true science at all but manufactured science. And no I’m not going to give you a list of references or links. The comments section is not a place to write a scientific paper.
Without wishing to take sides in this reference-free debate, I have to say that I will be using ‘..If you did your own research you would see that I was 100% correct..’ as an argument-stopper quite a lot from now on. Thanks – ingenious.
The anti woke equivalent to “educate yourself”
Burst out laughing. Really.
I think JS said I may not be a first rate composer but I am a first class second rate composer
Children are not a main driver in this pandemic? Well, since the 1st of August 2021 the share of cases among those 17 and under (children) has risen from 10% to 15% of the total case numbers here in North Carolina. The total number of cases has risen as well as compared to last year. Sorry to ruin your article with facts.
Aren’t you confusing cases with actual disease. Number of cases is irrelevant. The more you test, the more cases you discover. But most of those cases are completely meaningless. The data from Sweden where the schools never closed is very clear cut: transmission from children is minimal.
As an interesting aside regarding cases vs deaths, it is interesting to compare the daily cases per capita and the daily deaths per capita from say Oct 2020 to June 2021 for the US and Germany: the curves for daily deaths per capita are close to identical within error, but the curve for daily deaths per capita in Germany during that period was about 1/3 that in the US (see http://www.covid.jerschow.com for a very nice graphical tool to display all this stuff for different countries and US states and overlay the results). Now, at face value that would imply that the case fatality rate in Germany was 3x higher over that period than in the US. However, German and US healthcare are really pretty comparable in terms of quality and technology so it’s unlikely that this observation can be attributed to poor German healthcare. Rather, it’s simply due to the fact that the US was testing a lot lot more and therefore found a lot more so-called cases. Never in medicine has anybody defined a respiratory infection by some test in the absence of any symptoms.
So you are making a big mistake: the only numbers that count are hospitalizations and deaths, not number of cases, the large majority of which are really non-cases from any meaningful clinical perspective.
A ‘case’ is defined as someone who has the actual disease. Either refute my stats or quit commenting.
How is 15% a majority?
There has been no accounting of the Vaers reporting on vaccine safety. Total and complete coverup. It has been completely ignored. It is a crime against humanity. These vaccines have resulted in thousands of deaths. We don’t know the amount because we as a society refuse to look at the data.
A strict policy of ‘do the thing that kills fewer people’, or rather ‘do the thing that results in fewer people being dead’ will inevitably destroy one’s trust in the public health authorities. There will be no counter to the suspicion that it is not in my interest to take the medicine or get the jab, if I believe the authorities have already decided that it is in the public interest to allow me to be damaged or killed because in their scheme of things, the total number of deaths matter, but the individuals do not. A system of ethics that sees people as means, and not ends is a system of ethics where every statement of “thou shalt not” and “thou shalt” is contingent on the outcome you want to get — and therefore written in pencil for easy erasure.
This isn’t what people want from the system of ethics they use to run their lives. And it isn’t what people want as a system of ethics for the people we trust in public office.
You are at least trying to comment on the article. Your view is reasoned unless your husband/daughter/mother is dying and then your reason will change in a moment. Yours is the reason of the bystander.
Empirically not so, in my case, though I agree the calculation looks different when the life you are trying to save, and the one that may be damaged is the same one — the one that will be taking the experimental medicine.
And for those whose close relatives are dying in the treatment queues for cancer treatment and cardiac surgery? Public health and total mortalities is not just about Covid. One of the few countries who have considered non-Covid public health in their measures is possibly Sweden. They didn’t manage to keep all routine hospital treatment on track but they tried to protect mental health of the youngest.
in 2021 Sweden had the lowest overall excess deaths in Europe. You aren’t supposed to know this.
I have banged on about Sweden’s excess mortality over and over. Gave up. The fear mongers won’t accept it.
Yes, probably true but there was a lot of prioritising Covid, shutting down normal wards and operating theatres when they figured the Nightingale hospitals (set up but never used) weren’t the best solution. Even the private clinics were having their staff requisitioned by the national health hospitals. I had a hernia op planned in May 2020 in a private clinic in Stockholm and it was touch and go whether the op would go ahead. They were operating maybe one day in 3 weeks at 3-4 days notice. I don’t think cancer patients on the national health would have been as fortunate as myself.
It also becomes difficult to see ‘reason’ in terms of how many die each way, when you or a family member are the ones seriously affected by a vaccine that you took in good faith, believing it to be safe, to avoid an illness that probably wouldn’t have harmed you seriously. Been there, done that, had the funeral.
That’s why I believe that the covid vaccines should have been given to those who were deemed or considered themselves vulnerable, rather than being effectively forced upon the young and healthy, for whom the risks of vaccine vs covid become more complicated, particularly for young males.
I am so sorry to hear this.
I am very sorry too. But, in the interests of information on vaccine-caused deaths, what did your relative die from?
You vaccine nazis are just evil
Wow, interesting, very thought-provoking. I guess the authorities would still be messaging ‘we’re doing what will save the most lives’. Would that work?
I am not sure what you mean by ‘work’. I do know that authorities who have decided that a large number of healthy individuals must be sacrificed in order to save a larger number of other lives cannot be trusted to not lie to you about how dangerous the treatment is. But once you cannot trust the authorities to tell the truth, pretty much anything goes. How do we know that they are doing this ‘to save more lives’ rather than ‘because I want to get re-elected next year’?
I haven’t trusted the authorities, the statistics they offer, the advice they give, the fear they peddle, or the demands they make since this thing began.
A couple of observations:
The thing that causes the most destruction and death is lockdowns – by some magnitude.
Then seeing as we now see the argument that during a pandemic corners might need to be cut, why is it that only applies to those medications and vaccines that make money for big pharma? Why when so many clinicians are having positive results with Ivermectin, is the drug banned in many countries because there has been no very large, expensive, double blind, randomised control trial conducted? This when the drug has one of the best safety records ever? It certainly passes the ‘do no harm’ test.
This article is nothing to do with whether I am pro-vax or anti-vax.
The reason why his logic does not work is that public decisions are not made by logic but by media reaction. As a digression, the death penalty in the UK was abolished by Harold Wilson because of media pressure on politicians. Day after day, the press would be focussing on the family of the man about to die with tears from his mother – “He was always a good little boy”.
Today the media focusses on celebs. Jordan Henderson, overpaid footballer, was quoted everywhere yesterday – he was worried that if football continued during Covid, we would not be focussing on the safety of the players. He did not offer to give up his super-inflated salary though.
So, if there was a drug trial and ONE person died, the media would focus completely on this one person. IMO this is a stupid reaction and shows how stupid we are today.
Suppose you have 5 people in a hospital waiting for various organ transplants, who will soon die without it.
The hospital then admits a critically injured patient who has been in a motorbike accident. He can be saved with some immediate medical attention, but otherwise will die.
The ‘do what saves the most lives’ principle would have us not treat him and let him die, so as his organs could be harvested to save the other 5 patients.
But I would challenge anyone to argue that would be the right thing to do.
Reality is more complex. There are moral principles at stake, as well as practical matters of trust in institutions, etc.
That’s where Utilitarianism is brutally exposed, in my opinion.
I like the example, more graphic than the runaway trolley. Is it a moral principle at stake or a human’s decision making capacity, humans cannot make dispassionate decisions.
Sitting at a table with three or four ICU consultants a decade or so ago, during a working conference in pandemic triage, as it happens, I was the only one surprised when one of them got out his IPhone and showed us the ‘throw a dice’ app, which he felt was generally the most effective (and customary) argument. But we all filled in the feedback form with something more philosophical.
Yes, a great example, and reality is more complex. The bike rider would be saved, possibly because it’s more immediate. That doesn’t necessarily mean it would be the right decision.
What are the criteria?
There is always the possibility that a way could be found to save the transplant patients, given enough time.
Time is everything. Some transplant patients might die of complications
Well watch out, don’t they own all your organs now unless you’ve opted out?
My ethics and instinct would be to save the biker. The others will have to wait/rely on their own bodies or even die. That is the reality, it is cruel, unforgiving. Those that are utterly dependent on the modern medicine machine for such invasive procedures like needing a new organ, need to come face to face with reality of death too.
Take this example- Why not just take a convict/ political prisoner and harvest his organs as they are doing in China?
Modern medicine machine is far out of its ethics limits. It’s NOT about saving as many lives as possible. It’s about seeing death as a reality & accepting it.
We are a humongous population of 7.7 b because of our lack of acceptance to let go. It’s going to keep getting worse because of our reliance on & expectation from quick fixes . Instant gratification from medicine is the cause our troubles in the first place.
The world is more complicated than just letting “kills fewer people” be the rule. Pure self-isolation with every person locked in their houses would ‘kill fewer people’ but turning people into prisoners is a terrible principle. Everything then is a balance and trade-off.
And the balance and trade-offs depend on risk and cost, and forecasts and predictions, and picking through unknowns and guesses – so a tight lockdown, might only make it more impossible to open up later. Or vaccination might itself be leading to mutation due to the principle of survival of the fittest – the vaccinated strain getting out competed by a strain not affected by vaccination.
Since this is all about judgement, balance, risk acceptance, but also broader principles about how we let individuals live their lives, views need to be weighed. Can we minimise pain and sacrifice but also retain maximum normality? There is no easy or simple pure boolean logical answer. What we choose will need to be done together, as a community, understanding pluses and minuses. Short term pain may end up to be more beneficial than being cowed long-term into rules and regulations that diminish our humanity.
And the options require imagination and innovation. For instance, if Omicron is mild, then it might be the variant we all need to catch to finally get to herd immunity. Or maybe we fund a dedicated Covid part of the NHS, to separate it from normal health services. Or perhaps we need different types of vaccinations. Or simply better treatments.
Completely correct
I appreciate the attempt to rationalize these decisions on a purely greatest good for the greatest number basis.
However, I think it’s legitimate to worry about the mass immunisation of children for a virus of minimal risk to them in order to – essentially – protect the elderly.
It normalises the idea that children are disease vectors and dehumanises them – it’s was notable (to me) that I saw an interview with Dame Esther Rantzen where she was talking about lockdowns (not the point of the article I know, but to make a point), I felt sure she would be opposed to the Covid mitigation measures as they have been unapologetically cruel to children and she received her knighthood for good work to protect children. Instead though, she was all for the restrictions.
I know the article is about vaccines not lockdowns, but I think the above illustrates how we are getting our priorities wrong in this pandemic and I think the article makes the same mistake from a different angle.
Children shouldn’t be used to protect the elderly – normalising the idea that they can has led to lockdowns putting hundreds of thousands of children around the world in extreme poverty in order to shield the affluent (first world) elderly. It is not a morally sustainable way to live. I would therefore disagree that the argument can be contextualised as a pure numbers game.
Finally (just as a thought) has anyone thought about what mass immunisation delivered on a repeated basis within such a short space of time will do to the ecosystem the virus propagates through and the impact of the selection pressures this puts on the virus? Isn’t the issue not the safety of the vaccines but the potential for selecting for worse variants by over medicating against previous ones? I don’t know – it’s an honest question, to the best of my knowledge we have never used vaccination in quite this way before.
im worried about the evolutionary pressure these vaccines are putting on the disease too, , this is a great video, its on bacteria rather than virus’s but i think the principal is applicable, its basically the story of how hospitals ended up with super resistant bacteria.
https://www.youtube.com/watch?v=w4sLAQvEH-M
surely if Covid is something which cannot be eradicated, then its something we should be learning to live with.
Thanks for this, it’s that parallel with the over use of anti biotics creating resistant bacteria which bothers me – I don’t see that the fundamental evolutionary principle is any different and no one seems to be addressing this.
Does the same apply to measles, tetanus, or human papilloma virus? Should we avoid vaccination and ‘learn to live with’ those diseases? And if not, what is the difference?
How many people have actually had the HPV vaccine? Tetanus is a bacteria not a virus and kills about 50,000 people globally a year and it has been this way for decades. It isn’t easy to catch. The MMR vaccine actually works. LOL. This article is from August 2019. The NIH better go back and have it rewritten because it doesn’t mesh well with the current propaganda stating there is no such thing as vaccine sterilizing immunity.
https://magazine.medlineplus.gov/article/from-virus-to-vaccine-studying-measles-immunity/
Sorry, but I do not understand which point you are trying to make.
Well first you need to know the fundamental difference between these agents (viral and bacterial) in terms of their ability to mutate. The vaccines for the measles virus and the tetanus bacterium are sterilizing. As for human papilloma virus, there have been quite a few deaths and Merck did a great job in marketing a vaccine which really isn’t required. HPV results in a nuisance superficial infection of no immediate consequence. It is true that HPV has been reported to have been shown as the main causative agent for cervical cancer, hence the justification for the the use of the HPV vaccine. However, I very much doubt whether the data are in yet as to whether the HPV vaccine actually prevents cervical cancer or how effective it actually is. Why? Because cervical cancer generally manifests itself in middle age onwards, whereas HPV is given to teenage girls. So there is a huge lag in years between administration of the vaccine and measurement of the desired effect. Further, routine annual Pap smears from the 20s upwards (although only currently recommended for some reason from 40s upwards) is more than sufficient to permit early diagnosis of cervical cancer and subsequent highly effective treatment/cure. So I would argue that whether to get the HPV vaccine is very much an individual choice and up in the air. It is certainly not a major public health problem.
I have a niece who suddenly became unwell and lost all her hair aged 15 and believes it was a reaction to the HPV vaccine. She won’t take the Covid jabs for this reason.
Good point, but I think herd immunity is often achieved in these cases
The argument about selecting for worse variants is pure speculation – which is probably why no one ever made those same arguments when discussing vaccinations against polio or smallpox.
It is certainly problematic to put children at (slight) risk and degrade their schooling in order to protect the elderly. It is, however, also problematic to deliberately let the elderly die in their thousands when you could have avoided it. I do not claim the answer is obvious. But one of my tests is that people who prefer protecting the children should admit openly, to themselves and to others, how many thousands of premature deaths their choice is likely to cause. After that we can discuss the trade-offs. If people prefer to deny the cost, or choose a set of ‘facts’ that means there is none, they are indulging in cake-ism. And that is not a basis for rational decisions.
No, the reason that people didn’t make those arguments when discussing vaccinations against Polio and Smallpox is that they are sterilising vaccines; they do not leak. (And when some people decided to vaccinate for Polio with leaky vaccines, the arguments _were_made.)
Yes, we would need to quickly vaccinate most of the 7 billion to avoid mutations. Maybe less effective vaccines only buy you time until a less virulent, but highly transmissible, variant comes along.
You’re all invited to my Omicron Christmas party 🙂
Yes, but again, small pox required one vaccination, administered in childhood, conferring life long protection against a slowly mutating pathogen. Influenza vaccines are offered once per year to a more limited subset of the population – and this is our closest analogue.
This is three vaccines and counting within six months to an increasing number of people with the prospect of more to come (fourth being considered in Israel and Germany).
There is also the precedent set for artificially promoting mitigation resistant strains of a pathogen with the aforementioned over use of anti biotics and bacteria. Unless there is some good reason why vaccines over come this basic principle of fitness in the face of environmental conditions, I think it should be acknowledged as more than idle speculation.
This is not a point about the safety or otherwise of any particular vaccine, hopefully they will develop a one shot annual vaccine soon enough and administer it in a more targeted fashion, and this argument will remain theoretical.
As for your other point, sacrificing the young for the elderly is morally bankrupt as a point of principle and at stake is what type of people we are. As it turns out, the years of life lost from doing that – for restrictions -are calculable and the most conservative estimate I’ve seen is that it outnumbers by four times so possibly more. The specific calculation for vaccines I don’t know.
@David Slade, George Glashan
I’d love to see the calculation of years lost from restrictions. My guess would be that while the calculation for the health effects of not vaccinating is imprecise, the calculation of the effects from lockdown would be pure guesswork, and so reflect mostly the preformed opinions of the person making the calculation, But I’d give it a try.
By the way, getting a flu vaccine every second year is looking like it is a better strategy than getting one every year, for the people who want the protection. The problem is that if the flu shots in successive years are sufficiently similar to each other, the one you get in the second year can make you less resistant to the strain of flu that is circulating. see: https://academic.oup.com/jid/article/215/7/1059/2979766
non-technical summary: https://www.cidrap.umn.edu/news-perspective/2017/02/studies-shed-light-effects-serial-flu-shots-current-vaccines-benefits
It is looking as if, most of the time, the current year’s flu shot is too close to last years, and will be too close to next years.
I’m not sure we said it was selecting for worse variants, vaccination give rise to variants which overcome the vaccine, the variants themselves could be better or worse than before, omnicron on early evidence appears to be less fatal but more transmissible , this transmissibility shows it is over coming the immunity of those already vaccinated. we are just highlighting that this vaccination programme all it does is keep us running on the same spot, create a vaccine to overcome the variant which overcome the last vaccine, repeat ad infinitum. We live with the flu, those that are at risk can volunteer for a vaccine, this flu vaccine does not eradicate the flu. Covid should be the same.
The premature death point works both ways, to what degree are the lockdowns shortening the lifespans of children, by being sedentary, reduced opportunity to exercise, less education leading to a lower overall economic activity over their lifespan. If we are looking at a vaccination programme that gives todays elderly an extra 2 years lifespan, but robs this generation children of 2 years at the end of theirs then what is the point of this?
Certainly the young have already lost nearly two good years of life— alive, yes, but not doing much living.
It’s very far from speculation. It’s exactly what is done in the lab by design. For example, if you want to select for antibiotic resistant bacteria, you grow the bacteria on plates containing the relevant antibiotic of interest. Similarly, in HIV, if you treat with a single anti-viral drug, whether an RNA polymerase inhibitor, an integrase inhibitor or a protease inhibitor, you rapidly generate escape mutations and consequent drug resistance in a given AIDS patient (and that’s exactly what happened at the beginning). That’s precisely why treatment of HIV involves the administration of multiple anti-HIV drugs, all with different modes of action. It actually helps, Rasmus, to know some biology.
As for children and COVID vaccines, given that the Public Health Authorities, including Fauci et al. have now explicitly stated that the vaccines prevent neither infection nor transmission, but only lower disease severity (an assertion for which they have presented no evidence), it would seem to me to be close to impossible to justify vaccinating children who are at no risk of developing severe disease from a COVID infection. Of course, if a child has significant co-morbidities (e.g. immunosuppressed, morbidly obese, etc….) that’s another issue. In other words, vaccinating the children does not prevent transmission from the children to their grandparents.
Yep, this is my biggest issue with these vaccines, which will I keep boring people with until I get an answer that I can believe
Not so much bioethics as a problem but the bureaucracy of bioethics. Politics and arse-covering.
Training in medical ethics in the late 70s consisted in learning, and applying the following principles.
1) Respect for autonomy. (Which would rule out coercion, bullying or sanction against anyone who declines a medical intervention, such as ‘anti-vaxers’.)
2) Beneficence. Ie: do good. This is where Chivers (detailed and subtly expressed) argument kicks in. But note that beneficence is subordinate to 1) above.
3) Non-maleficence. Ie: Do No Harm. Noting that this is ‘primum non nocere’ with the primum removed.
Chivers has pointed out in effect how these three principles are deeply in conflict under the challenge of a Covid pandemic. Yeah, but to some degree a respect for autonomy solves most of the problems – ‘let the people decide’. I appreciate that many relevant institutions have little or no respect for the judgement of ‘ordinary’ people, and that maybe that’s where much of Chivers conflict resides. Power issues have always bedevilled medical ethics decisions.
anyway, thank you for the article.
To answer the question the author poses we must look much more widely than pharmaceuticals and in a much longer term than the near future.
We need to look at the cost of lockdowns in the medium to long term in particular. Not just economic, but also the indirect implications for public health in other diseases and for child welfare and education.
I agree. It’s about blame and who in government, including the scientific advisors, are destined to carry the can when the public enquiry begins. No wonder the scientists are focusing on the ‘worst case scenarios’ in their modelling. Terrified of being help up as responsible for deaths from Covid and other diseases.
As we live in a world where journalists predigest news for us and decide what we are allowed to think and who we should blame, it’s no wonder sensible and ethical thought no longer holds sway.
Couldn’t agree more.
Unfortunately, comment sites like this also allow people to vent their emotions, making the blame cycle worse.
How can you write an article on bioethics and not focus the whole piece on Ivermectin and HCQ.
Extensive trials and on the ground experience have clearly shown that these well established drugs could have saved up to 80% of the lives lost. The reality is that Fauci et al were so determined to make their billions out of vaccines that they repressed the thousands of doctors who were getting stunning results from these two drugs.
Anyone who listened to how Joe Rogan got well so quickly will relate to this, and his interview with the amazing Dr Peter McCullough should be required listening for everyone who wants to see all sides of. Hat is going on.
And I now have first hand experience. I tested positive for Covid this last Monday and started on Ivermectin plus vit d, vit c, zinc and Quercetin and in two days I was up and about and today, apart from a few aches, I am back to normal. My wife who tested positive at the same time and recovered just as quickly.
I know 100% that Ivermectin works amazingly well, so why en’t they encouraging its use. After all, it is a far safer medicine than the vaccine, has a longer track record, and even though billions of doses have been given out over decades it has safety track record that the vaccine could only dream of.
After nearly two years of a pandemic you’d think Fauci, Whitty, Vallence and that amazing clinician Bill ‘Mr Vaccine’ Gates would have been able to come up wth some kind of home treatment protocol rsther than just saying “if you get covid stay at home, curl up in bed and pray”.
Not saving 80% of the lives lost due to a desire to force a vaccine on the world, and in the process make more money than you could dream of, is unforgiveable. The truth will eventually come out.
Now that is bioethics.
But Paul, there are now fabulous (super expensive, safety not assured) anti-virals to be taken as well! Whereabouts are you situated?
Love your sense of humour Lesley.
I understand your position, but unfortunately I am 95% sure you are wrong. Ivermectin might work, up to a point, but it is also quite likely that you would have had exactly the same result if you had taken a visit to Lourdes, powdered unicorn horn, or nothing at all. When facing a scary disease it is a great comfort to have a reliable cure to hand, and once you have got over the disease of course you trust your cure. The thing is that a lot of people get through COVID pretty lightly, a lot of people have a harder time but survive, and some die. Looking at just a few cases you cannot distinguish where you fit in. It is extraordinarily easy to jump to conclusions (when you really, really want to) and requires an enormous effort to exclude coincidence, bias, statistical errors, etc. and make sure that whatever you think you see is what actually happened.
I do not expect to convince you, but painstakingly careful analysis of evidence and trials is what has got modern medicine to be as good as it actually is. Abandon that in favour of anecdotes and quick conclusions, and you are back to homeopathy and bleeding.
I agree. I do think Ivermectin etc work (in fact I know they do in a multi-drug protocol and have shown strong antiviral effect against other viruses over the years) HOWEVER, in this (Paul’s) case it could be just coincidental. I got over Covid in one day with no change in any medication (except for the loss of taste for a couple of weeks)
If you listen to Dr. Peter McCullough who doubtless possesses higher competence than you on respiratorial infections you’d note that his suggested treatment plans involve a cocktail of immune supporting medicines and supplements: Ivermectin, vitamin D, C, Zinc, anti-bacterial nasal sprays and oral hygiene. I’ve managed to suppress colds and potential influensa for a few years now using Vitamin C and gargling anti-bacterial mouthwash. Unless you’re also at a level where you could be called to Congress to testify on these issues, you maybe should limit your devil’s advocate stance on throwing suspicion and doubt at everything you feel could be questionable?
E G-L tried listening. She found McCullogh unreliable, and I am happy to take her word. If McCullough has reliable evidence in favour of his claims, all he needs to do is publish that evidence, in writing, with references, data, statistical tests etc., so that his colleagues can evaluate his results. When he does that, I promise I shall read his paper, and the attempted refutations and try to form an opinion. Until then I am simply not interested. I would accept the authority of a general medical consensus unless I had some reasonable evidence to the contrary, but the general consensus is against McCullough. Otherwise I will filter people’s claims against whether they present proper arguments and data and make basic sense – which McCullough does not as long as he sticks to TV interviews. I am not going to take any cherry-picked individual on trust, no matter what his credentials, unless he is backed by convincing arguments and/or the majority of his colleagues. Otherwise scepticism is not only allowed, it is the correct scientific position.
Nice try, but the ‘concensus’ scientists are preventing Dr. McCullough and many others from publishing. Not because his research is flawed, but because his conclusions don’t support ‘the narrative’. And there is no appeal process when journals take a pass on research.
If McCullough really has solid data and analysis to back up his claims, he can write it up and put it on the interweb, or in some third-rate pay-for-publishing journal. He is way too notorious to ignore, so the ‘consensus’ scientists would then have to explain away a publicly visible and obviously correct argument. Some scientists would be convinced and try to confirm the McCullough claims – if nothing else in the hope of being part of a great discovery – and there would be more to explain away. In the long run the best arguments would win the field. That is how it works, but to start the process he has to have a solid argument and put it before his colleagues. If he chooses not to do that, the most obvious reason is that he does not have a convincing argument to present.
If you are a little cynical about this, think about the argument over the lab origin of the virus. For a long time that was effectively banished to the fringes – until someone put together a convincing argument and got it published in, of all places ‘The Bulletin of the Atomic Scientists’. That made it impossible to ignore, and the argument was good enough to show that the lab origin was a reasonable and plausible theory (even if we still do not know which alternative is correct).
Two things: (a) McCullough has written widely about all of this and spoken widely over it, as well as testifying in the US Congress; (b) anybody with half a brain and anybody who was in Wuhan back in January 2020 knew that the virus was a result of a leak from the Wuhan institute of virology. Indeed, one of my staff scientists was in Wuhan for the Chinese New Year in Jan 2020 and managed to get back to the US just before travel was shutdown, and he reported at that time that everybody there knew it came from the Wuhan lab. It’s just like if an outbreak started in the vicinity of Porton Down, the first suspect would be Porton Down; similarly if an outbreak originated in Fredrick Maryland, the first suspect would be USAMRIID at Fort Detrick. Same is true, for example, if a spouse is found murdered, the first suspect is always the other spouse.
So the Wuhan lab theory was only considered fringe because the powers that be (Fauci, Collins and others at the NIH, as well as Dazak) wanted to cover their asses, and suppressed any other points of view. And one can tell just how dirty these people are when Collins just before stepping down from the Directorship of the NIH last weekend, referred to the 3 epidemiologists who wrote the Great Barrington declaration as fringe – apart from being totally demeaning, since when are three very well recognized epidemiologists from Harvard (Kuhldorf), Oxford (Gupta) and Stanford (Battachrrya) fringe wackos. I don’t believe that those institutions are in the business of hiring and promoting fringe scientists.
There is a certain amount of truth to that. That, with supporting evidence, was one of the arguments that convinced me the Wuhan lab theory made sense after all (whatever the truth will turn out to be). Note, it takes arguments, with sources. MD PhD NN claiming that ‘anybody with half a brain’ knew it and citing hearsay from one of his assistants as proof is not going to make a difference.
It’s not a question of hearsay. It’s a question of what is the most likely explanation. An outbreak of some weird viral infection in Fredrick Maryland would immediately lead one to suggest that the culprit was at Fort Detrick, especially if it involved a virus that they were studying there. That’s exactly the situation that pertained in Wuhan with the institute of virology there. As I have pointed out to you, and perhaps you may think the police are completely stupid, but if a spouse is found murdered at home, the first suspect is always the other spouse. Nobody would consider that as a fringe hypothesis. It’s the first working hypothesis. And your first working hypothesis would not be that the murderer cam from a location a 1000 miles away. Put in those terms, don’t you see how things were manipulated regarding the Wuhan lab. Further, the wet market theory was completely silly because the wet market in Wuhan didn’t sell bats; the closest wet market that did was miles away.
Now I’m not saying that the Wuhan lab was definitively the source of SARS-CoV2, but it is certainly the most likely source given that they were working on SARS viruses and they had literally thousands of bats in the lab. A lab leak is not an uncommon occurrence, even at places like Fort Detrick, no matter how careful one might be, plus the Chinese tend not to be too careful.
After the latest data I put the probability of a lab leak at about 30%. If we could get reliable data from China we could adjust that – upwards or downwards depending on what we found. Regrettably the Chinese can be relied on to lie and obfuscate whatever the true answer is.
As for “the wet market theory was completely silly because the wet market in Wuhan didn’t sell bats” , other new infections came not directly from bats but via intermediate hosts, camels or civets, I believe. I am sorry and all, but as long as you continue to claim that anybody who disagrees with you has to be an idiot – while coming up with arguments that are as full of holes as a fishnet stocking – what you say just has no credibility.
Thanks for persevering on this subject, very informative.
Glad you’re prepared to accept the word of EG-L, a periodontist, over that of Peter McCullough, one of the most highly cited academic cardiologists in the world (and yes over 100,000 citations an an h-index of 120 or so – and that’s huge). Perhaps I’m missing something here, but it would seem to me that a physician probably knows a touch more about COVID than a dentist, no matter how good the dentist may be. i.e. As far as infectious diseases. EG-L is a well-educated layperson, but certainly not an authority or an expert., not that the so-called experts have exactly performed well during the course of the pandemic as so many have become overtly politicized.
I judge on what I see. EG-L points to convincing and solid papers that back her point of view. What she says makes sense. If McCullough did the same thing I would give him more weight than EG-L – but he does not. If a consensus of his colleagues backed him, I would believe them – but they do not. McCullough, as I see him, is a fringe scientist, a highly credentialled rogue, *because* he is in contradiction to the consensus of his colleagues, and refuses to do what it takes to try to convince them. Fringe is as fringe does. If you pick a single well-credentialled rebel as a source of gospel truth, and ignore the opposing consensus of colleagues who collectively have much more heft, you are no longer in the truth business.
Science, like GOd, is no respecter of persons.
There are thousands and thousands of doctors, nurse and scientists who support McCullough. He is far from alone. You just think he is Rasmus because you keep reading and believing the negative PR that big pharma pumps out daily to discredit anyone who isn’t walking the big pharma line.
They put up a page saying MCCullough is a quack. Nd you’re naively believing it.
What you are basically saying is that you never bothered listening to McCullough because in the Jo Rogan interview the number of papers he cited was quite extraordinary.
Now, you don’t have to agree with McCullough after you’ve actually listened to what he has to say, and nor does EG-L, but EG-L is not a medical expert. She’s a dentist. She’s informed for sure and entitled to her perspective which very much mirrors the “Thesis” so to speak. But she has a tendency to nit-pick and not see the forest from the trees, which is perhaps not surprising for somebody whose research track record is rather limited. Further, she tends to exhibit an awful lot of confirmation bias. e.g. she requires an extraordinary amount of proof regarding ivermectin, but nothing close to the same standard regarding Covid vaccine boosters which have been initiated not based on any randomized controlled study but by seat of the pants gut feelings which may or may not be right.
It’s also worth noting that much of the current COVID literature is garbage whether it has been so-called peer-reviewed or not.
It is not hard. If McCullough knows for sure that vaccines are useless/dangerous and that his vitamin cocktails have a large effect, then there will be data to back that opinion. Thorough, well-analysed data, published in writing for his colleagues to check through. I just want to see those data. If there are no such data, McCullough has no way of knowing, and nothing he says can be relied on.
For the boosters, there have been millions and millions of vaccinations studied. They the a large, positive effect. Do you deny it? So vaccinations are known to work, but the antibodies decline over time. The intrinsic probability that a top-up vaccination will help is pretty high, so you need less extra evidence to try it. The intrinsic probability that a random antiparasite drug willl help is a lot lower, which is why you need more data before you back itt.
As I understand it, a lot of his experience comes from treating patients, knowledge of factors influencing respiratory infections and not through reading trial results. Well, there aren’t many on Ivermectin and other immune supporting substances. Why is this? Then there’s the “concensus scientists” aspect. Sounds reasonable but then you have to ask how many of these are in the pockets of Big Pharma? I suspect those who are are fairly high up the ladder of professional recognition and reputation, possibly aided in their career by cooperation or association with some of Big Pharma’s component parts. Then there are all the other scientists and experts in respiratorial infections who are maybe too afraid to speak out or have relationships with their peers which they don’t want to jeopardise in terms of the future career and standing.
I’m just a layman trying to apply my common sense judgement to what I’m taking in. I have never considered myself to be a follower of conspiracy theories but I’ve been perplexed by the facts and suppositions which Dr. David Martin has uncovered in the last 12 months, particularly his recent exposure of the covert organisations and companies behind the supposed propaganda and mass manipulation of government and societies in Big Pharma’s interests.
You’re fairly selective of your sources and are prepared to believe and trust these as long as there are papers to reference but where is your perspective and curiosity in exploring other lines of interest irrespective of there being peer reviewed papers to lean back on or not?
Part of science in general is that the reliable theories are those that a majority of core, knowledgeable people in the field agree on. They are sometimes wrong, but as long as people are genuinely trying to find the truth, they will get there over time. And an absolute core principle is that you need strict protocols and book-keeping. It is jsut too easy to fool yourself for anything else to be relied on. On COVID you have people in health departments, hospitals and universities all over the world looking at the COVID data as they come in and trying to figure out what is happening. And publishing their data and analyses for their coleagues to criticise. I would assume that at least a large fraction of those people are honest, competent, and trying to get it right. And if so the better arguments really ought to win through, eventually. If you assume that all the competent, involved people are either bought or cowed, and the available data are too manipulated to rely on, you have nothing left that allows you to judge, and ‘we are all doomed’. If I was a medical researcher I might use my perspective and curiosity to produce some data that could prove some new and unconventional ideas. As a mere reader I limit myself to listening to the people who have evidence, and avoid spending my time on those who have none to present. Anyway, did you notice that there was a big set of trials of repurposing existing, safe, cheap drugs, right from the start of the epidemic? Several drugs were found to work and are used in ICUs as we speak. Why would people perversely decide to ignore Ivermectin, if there was sufficient evidence it worked?
As for Dr. David Martin, he said this ““Weaponized ‘COVID’ Injections Have Seriously Harmed And Killed Many — While Bought-And-Paid-For Public Officials Continue To Lie And Terrorize The Public”“. Cranks speak thus. So, show me some reliable numbers, if you want me to take him seriously.
The big question with McCullough (or anybody making claims) is: ‘How do they know’? Now I would not deny that you can get important knowledge from long day-to-day experience of treating patients without randomised controls or statistics. Provided, that is, that we are talking about things where differences are immediate and visible (even if small) so you get a clear feedback. But with COVID on one has had time to build up that kind of experience, multidrug treatments do not give clear and immediate feed-back, and anyway McCullough has not spent his days in the COVID wards. Whatever he knows, he knows from research
If you look at his publication record, he has 1216 (!) entries on Google Scholar. Assuming he is a good and conscientious worker he will at least have read, understood, and contributed to all of them. Even if up to half of those are double countings (newspaper articles citing him etc.) that is still something like a paper every two weeks for thirty years. Quite obviously he cannot have spent most of his time on patients, and he cannot have done the bulk of the work on all those papers. Nothing wrong with that, but it means he is in practice a research group leader. Then you see that the vast majority of those papers are on heart, kidney and vascular system, with a certain number clinical trials etc. Surely he is immensely knowledeable in those areas, but *not* in viral disease or the respirtory system,wahere most of the COVID action is.
In short, his authority is *not* from experience of relevant patients, nor from expertise in respiratory diseases, but as a senior researcher. From research. For that to be worth respecting, he needs to stay within the rules and behaviours of research, such as publishing reliable evidence to back up his conclusions, and dealing convincingly with critism by his colleagues. Since he is not doing so, he has lost any claim to authority.
McCullogh unreliable? Are you being serious. Check out the guys resume for crying out loud. If he is unreliable then there’s no hope for us.
This is not a matter of a personal opinion or gut feeling. It is a matter of doing research and weighing evidence. No matter how good a cardiologist the man is, his opinion by itself does not prove anything. The size of his following does not prove anything either, unless they got there by evaluating the evidence. If he had the evidence, he would publish it, and possibly win the argument. As long as he sticks to unproven opinion, he has chosen to put himself outside science. He is not the only one. At least two Nobel prize winners have chosen to back their hunches (in an area where they are not specialists) and use their personal prestige to announce unsupported conclusions. They, too, have put themselves outside the process, however great scientists they have been in other areas and times.
EG-L may not be able to revolutionise science or do great investigations – or treat heart attacks. But she is capable of reading the literature, evaluating what looks like making sense, and making a considered judgement about what is currently known – or not. I have seen her posts. That makes her a much more reliable source than much better credentialled people who neither produce nor quote any evidence and choose to shoot their mouth off regardless.
PS. EG-L – my apologies for giving your person such prominence. I do not want to embarrass you, and I am not mistaking you for a reincarnation of Marie Curie. It just so happens that you are a good example, on this forum, of how one ought to navigate the controversial literature in a case like this.
To navigate the literature one really has to be able to look at it critically, rather than just accept what one believes while dissing alternative points of view. It’s easy to nit-pick and say that the requisite RCTs have not been conducted with ivermectin etc… but it is extremely difficult to conduct the correct RCT during the course of a pandemic when all these drug cocktails have to be administered at the very onset of symptoms, not 5 days later. Currently there is an ivermectin trial on-going at Oxford, but I will guarantee it will probably fail or not be conclusive because they are recruiting people up to 2 weeks after onset of symptoms. Since COVID is a multi-phasic disease involving first the virus itself followed by an inappropriate overly active immune response (which is the thing that kills), the design of the trial is such that good results from early treatment (at the onset of symptoms) will be severely diluted by poor results from late treatment.
If you do some basic research into the extensive studies about Ivermectin throughout the world you’ll realise that you have fallen, hook line and sinker, for what big pharma wanted you to believe. Not only that, but you have then gone on to spread these blatent lies to others who will do the same. In doing this, people like yourself have unwittingly cost lives.
I don’t blame you Rasmus, as big pharma are truly evil and have a history of discredting drugs they can’t make billions out of, but please don’t keep on spreading this misinformation as people are dying who needn’t.
And where has that careful analysis of evidence and trials been carried out for the vaccines, and especially including the addition of boosters. The end point of the vaccine trials was not hospitalization or deaths but cases. Indeed, in the Pfizer trial comprising around 40,000 people, there were only 3 deaths, 2 in the vaccine arm and one in the unvaccinated arm (or vice versa, can’t remember which, but either way it’s not a significant difference).
With regard to ivermectin and HCQ, these may or may not be helpful. But recall the placebo effect, especially when it comes to the immune system, is really important. So taking some meds, some of which are OCT, others on prescription that have a 50 yr + extraordinary safety record, together with the knowledge that many physicians have treated literally thousands of patients each with excellent results, is a no lose proposition. After all, it sure can’t be any worse than curling up in bed and praying to the good Lord for deliverance!
If I get you right, you are saying that it is fine to recommend anything that has a good safety record, even if you have no idea if it works. As long as you believe it works the placebo effect will take care of the rest. The homeopathy option, basically. All I can say is that I strongly disagree with you. Once you start on that road, you will never get to anything that actually does work.
“I know 100%”
Not true. You assume it.
The invermectin may have had no effect, you could well have got better by doing nothing.
Coincidence is not correlation.
Correlation is not causation.
Anecdote is (generally) not evidence.
We’ll probably never know. There is little evidence and any attempts and trials to provide more evidence has undoubtedly been suppressed in the interest of $$$$.
Actually anecdote in medicine is evidence. That’s how good medicine used to be done. And that’s why one talks about the art of medicine and what makes the difference between a robot and a truly outstanding physician.You make an observation and you build upon it. And eventually you move on to a RCT which is expensive to do and difficult to design properly.
In the context of things like ivermectin, it’s not just a single anecdote but many many anecdotes. If a doctor has treated a 1000 patients for Covid with ivermectin, for example, and not had a single one (or only a couple) require hospitalization, and this has been repeated many times over with different physicians, it is very likely indeed that ivermectin has had the desired effect, especially when one considers and compares to the results of doing nothing.
That is how good medicine used to be done – back in the 1800’s. You make an observation and you build upon it, and then you move on to an RCT – which is quite likely to show that you were wrong inthe first place. That is why we insist on doing them.
There is definitely a profit/control motive behind the mad vax push but I also listened to McCullagh and was disappointed. Surely the point of vax is to stop people getting sick in the first place, rather than treating them when they get it. So it should be a cheaper and more effective measure in the long run. Problem is the current vax don’t even seem to reduce symptoms enough to justify its cost I’ve seen numerous vaxed people say they got Covid and were sick and symptomatic. These are healthy young people so without vax the nature and duration of their symptoms would have been the more or less the same. But it is the same with ivermecton, you may have recovered just as quickly without it
Tom Chivers arguments sound compelling, as always, but I am a bit dubious in this case. “Do the thing that kills fewer people” raises the question ‘How do you know that it will’? And what happens if we apply this rule widely? The evidence behind drug approvals is fiendishly complicated, unexpected consequences are always a risk, and there are always strong reasons to have your pet project approved – or any cure, if you need one. And people are fantastic at biasing themselves to believe that the evidence favours them. If it is the norm that promising treatments go through on the nod, how many ineffective remedies will we get for e.g. cancer? And how will we convince people to choose the sometimes harsh drugs that do work, if there are nice, gentle drugs that have been approved already (but may not actually work)? How do we convince people to get vaccinated if they know – and have official approval – that Ivermectin and vitamin D is all you are going to need? If Trump can approve a vaccine for purely political reasons and get medical approval, Thabo Mbeki can approve beet juice as an anti-AIDS drug – and who can say he is wrong? How many disasters will it take before people stop trusting the drug approval process altogether? And how many adverse vaccine reactions would it take before people who hate and fear Trump refuse to take a vaccine that was approved by him personally in order to win an election?
The slow approval process definitely has costs, but it also serves to put a necessary brake on the tendency to further your own interests, take shortcuts, and disregard the risks, particularly risks to someone else. Any changes had better make sure not to lose this objective.
I seem to remember us disagreeing before, but on this, I am 100% with you.
There is another problem with “Do the thing that kills fewer people”, which is “over what time scale”. Covid is not such a good example here, since it will (may have already have) mutate down to something that is no great problem.
But consider a virus that does not mutate and which remains endemic. Repeated mass vaccination may reduce the mortality rate to zero, but will, like all medical treatments, have lifelong negative effects (up to and including death) in at least some people. Over the years those numbers mount up.
On the other had, focusing on treatments for those who are badly affected by the virus should, over time, reduce their numbers, to a point below the corresponding negative consequences of the vaccine.
The numbers and time scales are open to debate, but there is a downside to the quick fix that becomes the permanent fix. Plus, once some level of collateral damage is considered acceptable, there is always the temptation that a bit more is also acceptable.
Giving people the choice about whether to have a potentially risky vaccine or not in a pandemic might be acceptable. Forcing them to have it when, based on their age, state of health and prior infections, the risks outweigh the benefits for them, is not.
Each life is the only one that person has. Each mother or father is the only one their children have. It is not a statistical exercise.
Just a small clarification, regarding self-driving cars. I need to refine the sources but for the past few years the test have shown them to be less safe than human controls, there are lots of challenges ahead before this might be achieved no longer looks inevitable.
With the current level of technology you’re probably correct, however there will come a day when automated cars are much safer than human driven ones, which is what the theoretical in the essay is referring to
That kind of argument could be used to justify anything, unfortunately. How do you know? It may be that true communism gives the highest possible happiness to humanity once it has time to develop. You can certainly not prove the contrary. But I still prefer not to embark on multiple generations of harsh dictatorship in the expectation that the ultimate goal will make the exercise worth it.
I’ve no idea how you got communism from self driving cars to be honest. I was merely stating that I believe that as technology progresses there will come a day that statistically self driving cars will be safer than human controlled ones. Whether people will be ready to put their lives in the hands of a computer controlled car is another matter entirely
I mean that in either case you are deciding based on your belief that in the long run a completely new and different system will be much better than the one we have now. And in either case you have no way of proving you are right – and you are very vulnerable to wishful thinking. Which I think is not a good basis for embarking on what is essentially an irreversible transition.
I never said it would be better for society, however seeing as technology has increased the safety of almost every other industry with which it has become prevalent we can assume quite confidently that there will come a point when a self driving car is statistically less likely to crash than one driven by a person with the risk of human error.
How we manage that situation when the technology arrives will be the cause of many debates about how to integrate it into society
You mean true communism like in N Korea ?
How about the ethics of making choices and taking personal responsibility? The driving analogy is a good one and taken to its logical conclusion the only “choice” of cars will be the colour of the self-drive one. This attitude is currently permeating throughout society and nowhere is it more apparent than in the coercion, soon to be a mandate in some countries, to have the vaccine, even though it has been clearly established that immunity in those who have recovered from Covid is higher, and longer-lasting than that conferred by the vaccine. The science behind the effectiveness of wearing masks is threadbare at best, several behavioural scientists have acknowledged that it is nothing more than a comfort blanket and an obedience training aid. Obedience to diktats is all.
Within a very few generations the ability to think logically and critically, to make decisions and to take responsibility for one’s actions will be bred out of the human race. With the possible exception of a tiny, selected “élite” the world will be full of zombies. Is that what we want?
Maybe I could agree with Tom Chivers (I am an MD, not a philosopher) if there were no alternatives to the vaccine, but there are. Many! Se covid19criticalcare.com and others.
Second I cannot agree to vaccine kids with an experimental vaccine in order to protect adults.
There are no philosophers agreeing with Tom Chivers. The philosophers are the ones who are watching in horror as ‘the science’ claims to know what it does not know and censors any who question them.
Ivermectin? It is certainly an alternative, but so far only a minority believes that it actually works.
I am not inclined to self experiment when I read “Ivermectin works by binding to invertebrate muscle and nerve cells of parasites, causing paralysis and death of parasites”. We give it to the horses albeit reluctantly.
You do realize that ivermectin is a drug for humans and has completely eliminated river blindness. That’s what the Nobel Prize in Medicine was awarded for, not because of its use as a horse de-wormer. And by the way, we also give ibuprofen to horses, an OTC NSAID that I’m sure you’ve had the pleasure to consume. But, of course, if you were to taker a horse dose, you would probably die in short order from a massive GI bleed.
There’s a little bit more to it, at least in the US. One of the problems is that physicians in many states have been prevented from prescribing it without risk of loosing their license. For example, in Maryland no physician will now prescribe ivermectin, even for scabies (where it is regularly used), for fear of losing their license. In Florida, on the other hand, one can still get an ivermectin prescription quite easily.
In other words, there are many forces at work, and it is quite easy for the authorities, through the medical boards, to quash a particular treatment strategy involving any prescription medication. No doubt exactly the same is true in the UK with the NHS and General Medical Council.
“A small risk to a small number of young, healthy volunteers was hugely outweighed by a very likely large reduction in risk to many thousands of old, vulnerable people.”
This is an interesting extract and perhaps demonstrates why we have made the choice we have. Those most at risk here are those we can least afford to lose while those who’d benefit most are the ones circling the drain.
Care on value here. Just because I am circling the drain it does not I do not value my short remaining life more than that of a younger person. If you then change the value frame of reference from what I think about the value of my life to what 3rd parties consider as the value of my life (vs the younger person), well who are you to say which life is the more valuable? Would you wish to live in a country that had laws that attributed a differential value to citizens lives
Isn’t that exactly how public health already works? If I needed a transplant, and so did someone twice my age and only one donor was available, I’d get it (all things being equal). Similarly if it was between me and someone half my age, it would not be me receiving said donor.
In the UK, we actually place a value on remaining quality of life years, which is then used to determine how much we’d spend on medical interventions.
These may be imperfect systems, but the general principle seems reasonable enough.
Exactly.
The most unethical thing throughout the entire mass vaccination campaign has been to tell only one side of the story – “vaccines are safe and effective” – without properly informing the public about the risks (no matter how minor these might be). The second most unethical thing (borderline criminal) has been the monomaniacal insistence on vaccines, almost to the complete exclusion of all the tools we have in our arsenal to prevent and treat infection. In other words, it is extremely unethical to approach a trolley problem while failing to mention that it is actually a trolley problem, just as it is extremely unethical for governments and pharmaceuticals to unilaterally decide what risk is appropriate for their citizens without telling them.
Probably too late now for anyone to read this but all should know that Japan’s health admin put up a warning notice that the vax did have side affects and that there are always risks. These have to be weighed up by the individual and considered against the possible risk of the natural infection.
For anyone who has actually studied philosophy and ethics, this piece reminds you of the science major who abruptly walks out of class halfway through the first lecture in disgust. They just don’t get it, and hence they spend the rest of their lives looking down on philosophy and ethics as nonsense created by people who are too dumb to study science. Kurt Vonnegut wrote extensively of this type of person – the one completely unable to see the limitations of their own knowledge, or fully imagine the consequences of being wrong when you ‘play god’. This was Robert Oppenheimer until he realized, too late, what he had done. Undoubtedly, his invention saved far more people than it killed, in the short term. By this author’s standard, that’s the beginning, middle and end of the discussion. But then come the unintended consequences – one of which may be the eradication of all life on the planet. Do we really know the long term impact of our recent public health interventions, and do we really know the harms that they cause? Or do we simply run a 3 month trial and decide that if nothing bad happens in 3 months, we can extrapolate that ‘knowledge’ in all directions? Certainly there are times we must act on incomplete information, and calculated risks must be taken. But is this really one of those times? And is that justification to stop imagining what could go wrong?
I do not know about bioethics and if they played any role in COVID response but “do the thing that kills fewer people” has not been a guiding principle. If it was hundreds of thousands of people who tested for COVID would not be sent to their homes for 14 days without any treatment.
Such a treatment was available, although it could not be said that was 100% effective. Some doctors prescribed existing, proven safe, off label medication is early stages of COVID and the results were very positive. There are studies proving that from India etc..
But those doctors were actively prosecuted in some jurisdictions.
By the way, not killing people does not seem to be such high priority for governments. The only fully approved vaccine in Canada now is Johnson&Johnson. But it is not really available, only few thousands doses in the province of Ontario. Pfizer and Moderna, both emergency approval is being pushed on everybody. Nothing to see here, Just another conspiracy theory.
A fine essay by Tom Chivers. It’s interesting, at least to me, to see how a trained philosopher thinks about these problems. And it’s hard to argue with most of his conclusions: a fully rational approach to, for example, assessment of potential risk posed by the Astrazeneca vaccine would not have resulted in its withdrawal from the market in many countries.
It’s worth bearing in mind, though, that the development and approval process for all these vaccines and covid medications has, by industry standards, been phenomenally fast. Even allowing for a cautious regulatory bureaucracy, hundreds of thousands of lives have been saved by the fast-tracking of vaccine and covid drug review by the FDA and equivalent agencies.
As I’m sure the author understands, though, these decisions are not made in a vacuum by a panel of academic philosophers and statisticians. The grubby business of politics intervenes. Look how much doubt has been cast on the safety of these vaccines based on the speed with which they were tested and approved compared to historical standards. The politicians always knew they couldn’t cut too many corners, or adopt too many unconventional testing or approval pathways, lest they further alienate a large part of the population.
I pin my hopes on antiviral drugs as much as vaccines. The drugs recently approved are all repurposed. They were originally developed to treat other viral infections and were not tailored to the SARS-cov-2 virus, yet some are still highly effective. There are other drugs in the pipeline that were designed against SARS-cov-2 and they should be even better especially when used in combination.
Merry Christmas to the author. He sometimes gets quite a lot of flak in the comments section, and I don’t always agree with him, but I appreciate his quantitative approach to issues such as covid.
Don’t underestimate the importance of legal immunity to the process. It’s amazing how artificially eliminating negative consequences can tip the scales.
I’d put it more like this. Ethics as a form of rational calculation sounds great in the classroom but, stress-tested in a pandemic, is found wanting. We need to become more conversant with the types of good that cannot be worked out on the back of an envelop because they are more to do with character than calculus, vision than utility – a sense of what life is for beyond statistics of survival.
Short termist selective parochial bean counting without nuance – need I say more ?
It’s truly unfortunate that the author does not even mention the ethical principal that he’s actually fighting against: “First, do no harm”. Is there a reason that doctors swear that oath, and not the one Chivers proposes? In fact there are many reasons – none of which even get mentioned here! Chief among them, some times scientists are absolutely sure of themselves and yet get it catastrophically wrong. Like a teenager discovering music for the first time, Chivers wades into medical ethics. He just heard “Mary had a little lamb” and he thinks it’s better than Mozart.
Tom, my wife and I got the JNJ jab cause a doctor friend rec’d it. She reported queasiness, dizzy, blood pressure fluctuations and blood in the stool, yet Jansen told her it had nothing to do with the vaccine. JNJ went on to confess 7 days later while holding their cards close the vest. Therefore, ultimately, we cannot arrive at any metanalytical conclusion because everyone’s cards aren’t on the table
If the objective is to reduce unnecessary deaths, then we should be concentrating on the biggest cause, and it is not Covid. Poverty and all that goes with it is the biggest cause of deaths. We can aim to vaccinate the world but not feed the starving, provide clean water, and provide basic health care for many.
All this depends on your point of view and distance from the outcomes.
E.g. it’s probably true that so-called “smart” motorways save lives overall, by avoiding fatal accidents in the faster-running lanes, but that’s not much consolation if someone you love is killed on the nearside lane of a motorway with no hard shoulder. Save the most (hypothetical) lives v. save one known life
Ethics. Who needs them?
Not much to add, by way of comment, other than to note that I agree with my son-in-law, Richard Yetter Chappell, who happened to be visiting me in Kansas with my daugther and grandson and sitting across the breakfast table from me when I read the article. He clicked the link to see which of his papers was being cited.
Typical Chivers. Bioethics are there for a reason and you being scared of contracting covid is not good enough to stop having there.
A bit of a flaw in the argument is that the trials of the vaccines have not shown a reduction in all-cause mortality (the mRNA vacc trials combines show a trend of increased mortality). This is reflected in some country data in younger age groups. The article seems to only put value on people not dying of COVID-19, whereas a normal ethical approach would include other deaths in that equation, as they end up causing a similar impact on the person concerned..
“Do the thing that kills fewer people”
As an ethical model the above is no good whatso ever.
Say if you were a doctor and you had 1000 patients. Would you use the model or would you choose to save the young and allow those on their death bed to expire?
OK to disregard the risk of maiming or death if you or your family have not suffered.
Also as the risk of dying from Covid 19 and its variants is so small in the UK (less than 1% of the population) the risk of dying from other untreated diseases could be higher. This is never taken into account.
This is a very silly article.
The point is that the people dying and suffering from bad vax effects – heart problems etc are at minimal effects from Covid itself.
Why should healthy people put themselves at risk to save lazy disgusting obese fatsos who refuse to take care of themselves.
“In peacetime” hahahaha
I’ve never heard anything so ridiculous in all my life. PMC urban middle class liberals genuinely think they are in a war. I’d love to live inside the head of a PMC for a day, the level of narcissistic delusion is quite off the charts….
”Do the thing that kills fewer people” = change medicine into a practice that improves people’s resilience and health rather that fixes them. This ‘medicine’ also includes making sure people have decent lifestyles (housing, education, non-industrialised food), where people can feely decide on what medicine is best for them and then there is no need for articles like this where, depending on your views, the data you believe (or not) turn things around in circles about these type of new medicines being ‘good’ or not.
Note: these vaccines are not really vaccines ,they are new medicines: we are learning about them and will not know for a long time whether they are good or not… nobody knows for now.
https://ijvtpr.com/index.php/IJVTPR/article/view/23
And: put all data in context of public health (overall health) and stand back: look into tendencies over many years etc etc: Do proper public health not just ‘covid health’. Those who use absolute numbers must be cheating or have no clue.
Sorry Mr chivers: Even though you made a good effort of being thorough this is still very superficial journalism because you took the very narrow ‘fear of covid, covid is the only thing in town’ narrative as an example to make your analysis.
…oh and this WHO message: https://www.youtube.com/watch?v=OSLYI8cw5sc&list=PLeRQg2pVwzrtmpzNH4Gc5FpxNtBXhLgto&index=1
One of the things that convinced me that Covid wasn’t a dire threat to mankind is exactly the response detailed about re covid and HIV vaccines/prophylactics. The actions taken are precisely the type taken by those who are no longer worried from an existential point of view, but, rather, worried from a political point of view. Now, compare that to the Bomb. Now, my great uncle worked on the math end of that, not worrying in the slightest about the future repercussions, as the threat at the time was so great. And, yes, he was a lifelong pacifist.
I suspect it has as much to do with heuristics. An individual can be completely aware of Covid and the worldwide impact it is having but until it has a direct impact on their life, they could chose ignore it. Having a new vaccine with an associated risk factor (no matter how low) injected into them, their perception changes.
Testing allays peoples fears, in the end people need to be encouraged to take the vaccine, coercion only raises peoples suspicion.
Frequency of CVST is between 2 and 5 cases per million per year. So in 6.8M individuals vaccinated we can expect something between 13 and 34 cases over the course of a year. Unfortunately we do not know the duration of the trial so it’s difficult to comment further but at first sight six cases does not look particularly alarming.
WHY CHIVERS IS WRONG ABOUT BIOETHICS
Because he is posing the wrong question.
Ethics is not about calculation. Bioethics must be part of a larger morality, and, of course subordinate to the general one. Chivers finds it ethically inappropriate that a vaccine is not offered to elderly people, of whom 1000 were “killed” by the virus, just because there are some indications that a much smaller number might be hit, and possibly killed, by the vaccine instead. He holds bioethical consideration responsible for the death of a much higher number of people.
On my part I say “thank God” that those bioethical considerations are still regarded as important. As a society we would be responsible for a small number of deaths caused by the vaccine, but we are not responsible for the mortality of humans. This is the distinction which is important.
Calculation is for one-dimensional questions. Life and ethics are, however, not one-dimensional. If we reduce ethical questions with more than one dimension to calculation, it is a sign of moral poverty.
This is also why it in my opinion is wrong, or at best insufficient, to criticise lockdowns for being the wrong trade-off (which is not even made). Saying that e. g. the loss of education is not worth the claimed reduction of excessive death may lead to the right conclusion, but it is not the right reason.
The right reason would be that we care about the education of the youth and we accept natural death. Understanding and protecting human life starts with accepting death. Only in light of our mortality are we able to appreciate and protect life in the right way.
Or you could put it the other way round: If you appreciate and protect life in the right way, you also accept natural death. Actually, I suspect this to be the better way of explaining the world’s Corona response. We have lost so much of our natural sense of life that there is little but the mere length of it to protect.
However, wearing a mask also helps 😀
Thanks for another thought-provoking argument, Tom. I appreciate the thrust here, although might quibble about some particulars.
Another realm I would like to see this dictum (“do the thing that kills fewer people”) applied is energy production. Nuclear kills far fewer than coal and natural gas, but here in the US we have been steadily moving away from nuclear to the other two…
https://ourworldindata.org/grapher/death-rates-from-energy-production-per-twh