Is it ethical to aim at ‘herd immunity’ to the coronavirus?
by Michael Cook | 21 Mar 2020 |
_640_399_c1_c_c.jpg)
British Prime Minister Boris Johnson garbled his government’s coronavirus strategy. The media reported that the UK (and the Netherlands) were adopting a “herd immunity” approach to combatting the disease.
The chief scientific adviser to the government, Patrick Vallance, suggested that the UK would allow millions of Britons to be infected, boosting eventual herd immunity. “Our aim is to try and reduce the peak (of the infections), broaden the peak, not suppress it completely,” Sir Patrick told the BBC. “Also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission.”
Dubbed the “Keep Calm and Carry On” approach – which sustained Britons during the Blitz – it was immediately criticised by epidemiologists as unworkable and unethical.
Not long after, the government backed down on its rhetoric and the term “herd immunity” was no longer mentioned.
The idea of herd immunity is founded on the idea – as yet unproven for coronavirus – that people who have been infected are immune to future infections. If enough people in the population become immune, the diseases stop spreading. For a highly contagious disease like measles, 95% of the population has to be immune to achieve “herd immunity” for the other 5%. For coronavirus, only about 60% (theoretically) need be immune for the disease to stop spreading.
In practice, this means that the government would take a relaxed approach to social distancing, quarantines and lockdowns. The more robust, healthy people who become infected the better. Public health authorities would focus on protecting vulnerable people, particularly the elderly, while the virus spreads slowly through the population. The ultimate goal is not to overload the hospital system with seriously ill people.
Is this notion – as expressed in the media – ethical? Some big questions hover over it. For one, coronavirus immunity is not like measles immunity. The former is achieved by being randomly exposed to the virus in the wild; the latter through the orderly administration of a vaccine. That means that the herd immunity can’t be controlled and the elderly remain at risk.
Furthermore, the coronavirus arithmetic is brutal. “One expert analysis found that creating herd immunity in the UK would require more than 47 million people to be infected,” says one epidemiologist. “With a 2.3% fatality rate and a 19% rate of severe disease, this could result in more than a million people dying and a further eight million needing critical care.”
Michael Cook is editor of BioEdge
One of the guidelines of the UK’s Nuffield Council on Bioethics about the coronavirus pandemic (see below) is that “Liberty-infringing measures to control disease, such as quarantine and isolation, can be justified if the risk of harm to others can be significantly reduced.”
I agree, but I am still surprised at how few questions have been raised about the draconian restrictions on civil liberties prompted by the crisis. These are sure to lead to recession, soaring unemployment, bankruptcies, and social dislocation. They are the harshest that I have ever experienced in my lifetime – and, with few exceptions, there’s been nary a peep of opposition. In fact, my impression is that op-ed pages segued smoothly from anger at government overreach to anger at government underreach in a month.
How long can lockdowns be sustained? As the Wall Street Journal points out, “no society can safeguard public health for long at the cost of its overall economic health.” I don't think that it is utilitarian to observe that deferring or suppressing discussion of the costs, financial and social, of our response to the coronavirus could backfire. Human dignity is paramount; acting ethically is essential. But good ethics is based on a knowledge of all the facts -- and not just the facts about hand-washing.
I agree, but I am still surprised at how few questions have been raised about the draconian restrictions on civil liberties prompted by the crisis. These are sure to lead to recession, soaring unemployment, bankruptcies, and social dislocation. They are the harshest that I have ever experienced in my lifetime – and, with few exceptions, there’s been nary a peep of opposition. In fact, my impression is that op-ed pages segued smoothly from anger at government overreach to anger at government underreach in a month.
How long can lockdowns be sustained? As the Wall Street Journal points out, “no society can safeguard public health for long at the cost of its overall economic health.” I don't think that it is utilitarian to observe that deferring or suppressing discussion of the costs, financial and social, of our response to the coronavirus could backfire. Human dignity is paramount; acting ethically is essential. But good ethics is based on a knowledge of all the facts -- and not just the facts about hand-washing.
 Michael Cook Editor BioEdge |  |  |  |
NEWS THIS WEEK
by Xavier Symons | Mar 21, 2020
Prison populations are at great risk from the outbreak.by Carolyn Moynihan | Mar 21, 2020
Permits abortion of the disabled and abortion for sex selectionby Michael Cook | Mar 21, 2020
It’s an ill wind that blows nobody goodby Michael Cook | Mar 21, 2020
More elderly might dieby Michael Cook | Mar 21, 2020
A very useful document for policy-makersby Michael Cook | Mar 21, 2020
Euthanasia care is not a top priority in health careby Xavier Symons | Mar 21, 2020
Staying at home can be ethically complicated.by Michael Cook | Mar 21, 2020
“The incarnation of gender violence in its most painful form,” says a judgeby Michael Cook | Mar 18, 2020
Inspired by the adventures of a South Korean spy BioEdge
Level 1, 488 Botany Road, Alexandria NSW 2015 Australia
Phone: +61 2 8005 8605
Mobile: 0422-691-615
.png)
No hay comentarios:
Publicar un comentario