Is striving for herd immunity, regardless of the human “culling” that may be required, ethical?
One of the things that Singaporean public health authorities have been talking about recently is that they have discovered that the COVID-19 virus is smart and relentless. It keeps trying to find its way into vulnerable populations. And it will never give up! In their case, the virus was able to enter their vulnerable migrant worker population living in crowded dormitories. And it exploded.
Looking at Sweden, some have suggested that this difference in death rate is inconsequential because these are people who would have died anyway. They have proposed that the death rate in these Nordic countries will eventually even out because death rates will inevitably rise once the lockdowns in Sweden’s neighbors are slowly relaxed. A second or third or fourth pandemic wave will wash out those elderly and vulnerable who were saved during the first wave. Why not get it over with now?
This retort assumes that flattening the curve simply delays inevitable deaths so that the health care system will not be devastated. This is one reason. The other reason is that flattening the curve delays deaths in the hopes that some therapy or vaccine will be discovered to prevent them altogether.
As a past hospital chaplain, I know that many advanced cases of metastatic cancer are inevitably terminal. However, we work to delay death for two reasons. For a medical breakthrough. And for more time, which for most people, even dying people, is sweet and precious. We are doing the same for the elderly and vulnerable in this time of pandemic.
In the end, I cannot endorse a “burn through” strategy because it inevitably increases the number of deaths, especially of poor and vulnerable people, who may be spared when a therapy or vaccine arrives. Moreover, short of a lockdown, no government has discovered a way to adequately protect the elderly and those who are at risk from viral community spread.
For someone who is pro-life and who values the intrinsic dignity of the human person and the preferential option to protect the poor and vulnerable, this strategy of allowing the virus to spread through a population to achieve herd immunity would not be an ethical option.
Rather I believe that we should continue to mitigate community spread with social distancing practices that attempt to preserve the economy while minimizing death. And we especially cannot forget the poor!
But what about the large number of deaths that we can expect from an economic crash or depression? Should these deaths not also be considered here?
I did not count these deaths because these deaths are not there to be counted!
Though it is counter-intuitive, there is a lot of data that shows that death rates actually decrease during economic downturns. I am not an economist so I will rely on a write-up in the journal, Nature, which is one of the world’s foremost scientific publications. The article is titled, “How the Next Recession Could Save Lives” [Nature 565 (2019): 412-415].
In the report, the author makes several important points that I will highlight here for the purposes of this essay.
First, economic data from US history reveals that more people – babies included – died when the economy prospered. Death rates go down during economic downturns. Second, the gross death rate in the USA reached its lowest point in the historical record kept until that time, during the Great Depression.
Third, death rates in Europe dropped faster during the Great Recession in the late 2000s than before the crisis. Fourth, death rates dropped dramatically in Spain during the Great Recession where unemployment reached 20%.
In fact, because of this data, José Tapia Granados, a health economist at Drexel University calls the link between recessions and lowered death rates “almost as strong as the evidence that cigarette smoking is bad for health.”
The article acknowledges that it is not clear why recessions and depressions lower death rates. Nonetheless the contrary claim that economic downturns necessarily lead to higher death rates is not supported by the evidence from history.
In sum, it is clear that economic downturns lead to much suffering, both psychological and physiological, especially among the poor and marginalized. However, they do not trigger an increase in the number of deaths in society.
Therefore, if they do occur because of the social distancing measures in place in a community, they are an invitation to endure the difficulty and pain as a sacrifice needed to save the lives of the elderly and the vulnerable in time of pandemic.
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