Sigurd Bergmann Posted Wed 14 Oct 2020, 10:41am Updated Wed 14 Oct 2020, 10:41am Source: ABC New Australia Featured Photo Source: Unsplash, CDC
We speak of “herd immunity,” in the context of a life-threatening pandemic, as a way of providing protection for an entire population. It is a state that can be achieved either artificially, through a vaccine, or naturally, by a sufficiently large number of people (around 60-85 per cent) contracting the virus.
The leaders of Sweden’s Public Health Agency (Folkhälsomyndigheten) have repeatedly insisted that they are not actively pursuing “natural” herd immunity in response to the COVID-19 pandemic. And yet, they have repeatedly promised that “herd immunity” would soon become manifest, and have called it a beneficial by-product of their overall strategy.
After months of confusion, however, Johan Giesecke — the architect of the Swedish strategy and mentor of the Agency’s “chief epidemiologist” Anders Tegnell — has publicly promoted “Sweden’s herd immunity approach,” which entails a “controlled spread” of the virus “among the under-60s” and a “tolerable spread” of the virus “among the over-60s.” A number of leaked documents and public statements corroborate the widespread suspicion that this has long been the Agency’s strategy.
Demonstrably, Sweden’s incautious approach — which has been interpreted in other countries as a Sonderweg, “separate path” — was driven by pursuit of natural herd immunity in the population. Such an approach, which is the polar opposite of New Zealand’s elimination strategy, has recently attracted attention in the United States, where the death toll from COVID-19 has passed 220,000. President Donald Trump’s latest pandemic advisor, Scott Atlas, has caused considerable controversy by advocating the same method as Sweden — which was amusingly mischaracterised by Trump himself as “herd mentality.” This comes in the face of a warning given by some Swedish scientists in May, who warned the United States “not to do what we did.”
The question I would like to broach here is: Is natural herd immunity ethically responsible and politically acceptable?
But before diving into the ethical dimensions of this question, it is worth reminding ourselves of legal dimensions. In August, a campaign was initiated to scrutinise the British government’s initial decision to allow the virus to spread unchecked, and to investigate whether the state has acted criminally in its pursuit of herd immunity, in breach of Article 2 of the European Convention on Human Rights. A similar investigation — which is already underway in France — will probably also take place in Sweden sooner or later, and we can expect a large number of cases to come before the European Court of Human Rights next year.
Here, I want to lay out some of the reasons why the strategy of pursuing natural herd immunity is unethical, irresponsible, and morally unacceptable in democratic societies which have an obligation to uphold the equal value of all citizens. Such is the unanimous assessment in all other European countries — although three of them were tempted and considered pursing this strategy for a few short days, before abandoning it altogether.
Utilitarianism’s malfunction
The method of allowing a viral infection to spread — either freely or at a “reasonable rate” — is profoundly unethical because it exposes large groups of citizens to life-threatening risks. Senior citizens, those with severe illness, and those who due to low income, scant education, and limited job opportunities, are exposed to a significantly greater risk of mortality than rich, younger, healthy citizens. The method discriminates against the elderly, the sick, and the poor, and diminishes human dignity and equal rights of citizens. It thus violates fundamental principles in the Swedish democratic constitution.
Pursuing natural herd immunity fits well into the schema of ethical utilitarianism, where one is obliged to maximise happiness (or some cognate value) for the largest possible number of people by calculating and optimising the consequences of actions to achieve the desired goal — in our case, “public health.” In the context of a pandemic, the public health of a society is sought by quickly attaining a state where many healthy, young, highly productive citizens with immunity can keep the economic gears of society turning.
Some, however, necessarily must pay the “price” for this happiness when ethically weighing the short- and long-term consequences against each other. Selection, de-prioritisation, and palliative (instead of hospital) care are side-effects for the elderly. Medical staff in Sweden have reported many such situations of ethical stress, even as the authorities have assured that healthcare was not overburdened, despite the fact that it was being stretched to the breaking point and beyond. Herd immunity thus entails various forms of medical violence and, to some degree, even euthanasia — a question examined by the Christian Ecumenical Council. In addition, the lack of a rapid reduction of the infections (through an early lockdown) has led to a “medical care debt” (due to unexecuted treatments), taking the health system years to compensate. Applied utilitarianism in the context of a pandemic reveals its fatal malfunction.
Even so-called duty ethics obviously has its shortcomings, but given the traditional Western image of humanity it is not unreasonable that principles such as “Thou shalt not kill,” “All people have equal value,” and “Human rights apply equally to all citizens” should be applied without compromise. Herd immunity without doubt ignores these constitutionally protected rights and the associated understanding of what it means to be a human being; ultimately, it violates the commandment not to kill. Aptly, therefore, virologist Sandra Cieseck has remarked, “First and foremost this path [of natural herd immunity] is undesirable as the virus is causing so much damage that many people would die.”
What are your thoughts on herd immunity? What are your thoughts on a vaccine? Why?
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