0. Don't lie to the public. Even though you may think it is helpful in the short run, it is devastating in the long run.
All the rest is commentary.
The Ethical Principles of Public Health
11–20 of 67 posts
Re: The Ethical Principles of Public Health
#12I'm missing the arguments for why any of these guidelines are supposedly ethical. The implication of these are that a handful of individual's rights to refuse e.g. vaccines is appropriately balanced against a potentially huge loss of life and societal disruption. I guess it depends on what system of ethics one goes by. If one believes that you should NEVER force someone to do something against their will and accept t…
A major assumption in the 'principle of least harm' on forcing people to get vaccines is that the vaccines are well-characterized in terms of efficacy and side-effects. In the case of the smallpox vaccine, it was a sterilizing vaccine (i.e. there were zero breakthrough cases post-vaccination as far as I know, so it could be used to effectively eliminate the virus from human populations), and the side-effects, though quite severe in some cases (far more than anything reported with Covid vaccines as far as I know), were well-characterized. For example:
Inoculation with vaccinia virus is highly effective for the prevention of smallpox infection, but it is associated with several known side effects that range from mild and self-limited to severe and life-threatening.
(2003) "Smallpox Vaccine: The Good, the Bad, and the Ugly"
http://www.clinmedres.org/content/1/2/87.short
The Covid vaccines are uniformly non-sterilizing, i.e. breakthrough cases are common, even apparently the norm (this may be due to rapid evolution of new virus strains relative to older clinical trials) and the side effects seem to be relatively poorly characterized (heart issues with young adults? fact or fiction?). Hence, glowing stories like this Nov 2020 report on the Moderna vaccine might need some reconsideration:
https://www.science.org/content/article/absolutely-remarkabl...
One could argue, at this point, that a Covid vaccination is really only net beneficial to the elderly, obese and immunocompromised (comparable arguments have been made for the influenza vaccine). One could also argue that for-profit pharmaceutical corporations (who have refused to release patent rights to other manufacturers, which would drive down costs) have large conflicts of interest relative to their desire to maximize profits by pushing vaccination on those for whom it serves no beneficial purpose.
Re: The Ethical Principles of Public Health
#13Coronavirus hit New Zealand in 2020, and by May 2nd twenty people had died. New Zealand implemented lockdowns and ordered vaccines, although they took a while to come. By the end of October 2021, 28 people had died of Covid in New Zealand. They had massively attended sporting events at the height of the world pandemic as coronavirus was undetectable in the country. Once pretty much any one who wanted to be vaccinated got vaccinated, they loosened the rules.
Whereas in the US you have immediate resistance from these Christian fundamentalists (Hillsdale is Christian fundamentalist). Over one million Americans are dead of Covid, lots of people have long Covid, and anecdotally hospitals were full and all hospital patients saw delays in care, so I am sure people who could not get cancer treatments died due to these nuts.
Re: The Ethical Principles of Public Health
#14I'm missing the arguments for why any of these guidelines are supposedly ethical. The implication of these are that a handful of individual's rights to refuse e.g. vaccines is appropriately balanced against a potentially huge loss of life and societal disruption. I guess it depends on what system of ethics one goes by. If one believes that you should NEVER force someone to do something against their will and accept t…
A major assumption in the 'principle of least harm' on forcing people to get vaccines is that the vaccines are well-characterized in terms of efficacy and side-effects. In the case of the smallpox vaccine, it was a sterilizing vaccine (i.e. there were zero breakthrough cases post-vaccination as far as I know, so it could be used to effectively eliminate the virus from human populations), and the side-effects, though…
These guidelines aren't specific to COVID though, and they are not conditioned upon any projected efficacy or disease severity.
They are laid out as a matter of principle, valid even assuming, say a 90% fatal disease and a 90% effective vaccine with only minor side-effects.
Re: The Ethical Principles of Public Health
#15Reasonable principles.
I think by now most of us know that in the most recent pandemic, the public has been repeatedly deceived if not straightup lied to regarding efficacy and side-effects of the vaccines as well as the origin of the virus, and public individuals shamed and silenced for stating things that half a year later became mainstream news, over and over again.
Re: The Ethical Principles of Public Health
#16In the spirit of 8. Public health scientists and practitioners should avoid conflicts-of-interest, and any unavoidable conflicts-of-interest must be clearly stated. "Hillsdale [College] is a conservative Christian institution with ties to the Trump administration. And the scholars behind the academy — Scott Atlas, Jay Bhattacharya, and Martin Kulldorff — are connected to right-wing dark money attacking public health…
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Re: The Ethical Principles of Public Health
#170. Don't lie to the public. Even though you may think it is helpful in the short run, it is devastating in the long run. All the rest is commentary.
> 0. Don't lie
I think this is also good advice for engineering teams, companies, humans.
Re: The Ethical Principles of Public Health
#18I'm missing the arguments for why any of these guidelines are supposedly ethical. The implication of these are that a handful of individual's rights to refuse e.g. vaccines is appropriately balanced against a potentially huge loss of life and societal disruption. I guess it depends on what system of ethics one goes by. If one believes that you should NEVER force someone to do something against their will and accept t…
> forcing people to get vaccines
Does it not depend on the vaccine?
What if instead we had a therapeutic which shortened an individuals infectious period, would you also feel comfortable forcing that?
What if the disease in question disproportionately affected group A but not group B, would you also feel comfortable forcing that vaccine upon group B?
Re: The Ethical Principles of Public Health
#19In the spirit of 8. Public health scientists and practitioners should avoid conflicts-of-interest, and any unavoidable conflicts-of-interest must be clearly stated. "Hillsdale [College] is a conservative Christian institution with ties to the Trump administration. And the scholars behind the academy — Scott Atlas, Jay Bhattacharya, and Martin Kulldorff — are connected to right-wing dark money attacking public health…
Yes and...
This latest agitprop is a rehash of anti-mask The Great Barrington Declaration:
https://en.wikipedia.org/wiki/Great_Barrington_Declaration
https://en.wikipedia.org/wiki/Hillsdale_College#Academy_for_...
Salon's Matthew Rozsa's recap of that debacle:
https://www.salon.com/2020/11/19/this-doctor-is-popular-amon...
I just spot checked some of the signatories of these Ethical Principles. Rough. Here's two representative samples:
https://en.wikipedia.org/wiki/Jay_Bhattacharya#COVID-19_pand...
https://en.wikipedia.org/wiki/Robert_W._Malone
> ...are connected to right-wing dark money attacking public health measures
Including The Heritage Foundation, The Federalist Society.
https://en.wikipedia.org/wiki/Hillsdale_College#Allan_P._Kir...
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I think it's fine to do retrospectives. What I used to call "The Good, The Bad, and The Ugly". What works, what didn't, what would you change. A pandemic is a crisis. Of course mistakes will be made. Learn and do better next time.
Attachment to notions like "herd immunity" wrt to this coronavirus is just nutty. I'm just a noob, but my impression is that this coronavirus mutates so fast that herd immunity isn't likely.
I'm okay with comparing prevalence of mask wearing with outcomes. There are always tradeoffs. Learning from this experience will helps us better model public health responses for future pandemics.
Lastly, with today's charged discourse, I utterly dismiss any missive that does not encourage vaccination as partisan concern trolling, or worse.
Re: The Ethical Principles of Public Health
#20I'm missing the arguments for why any of these guidelines are supposedly ethical. The implication of these are that a handful of individual's rights to refuse e.g. vaccines is appropriately balanced against a potentially huge loss of life and societal disruption. I guess it depends on what system of ethics one goes by. If one believes that you should NEVER force someone to do something against their will and accept t…
A major assumption in the 'principle of least harm' on forcing people to get vaccines is that the vaccines are well-characterized in terms of efficacy and side-effects. In the case of the smallpox vaccine, it was a sterilizing vaccine (i.e. there were zero breakthrough cases post-vaccination as far as I know, so it could be used to effectively eliminate the virus from human populations), and the side-effects, though…
>One could argue, at this point, that a Covid vaccination is really only net beneficial to the elderly, obese and immunocompromised
Maybe, maybe not
"The Incidence and Effect of Adverse Events Due to COVID-19 Vaccines on Breakthrough Infections: Decentralized Observational Study With Underrepresented Groups"