Those who have the capacity to understand the science must also accept the political situation in the US today. Many will simply reject a moral argument for worldwide vaccination. To use the jargon, targeted advertising appealing to the tribal instincts we are witnessing will be the only means of persuading many in our population.
Will most people know if it's a strong argument? I suspect that we're discussing how to present things to an audience that will not know if it is a strong argument.
It's a bit the same as the "we should have told people that masks protect them instead of others" argument... do I wish people were more serious about wearing masks and properly at that? Yep! Do I think we should lie to them because a non-trivial amount of them are selfish pricks? Nope...
I also think the straightforward moral argument may have a bigger constituency than a convoluted one that people may not even believe given how well vaccines and boosters may well work. Just like masks. Lot of people were really roaring to do their part last year. You saw it in polls and in behavior.
I've been wondering if there are lessons from times of war (not all times of war, just times of war that people rightly or wrongly feel patriotic about) that could have been used all along to build a sense of solidarity and "we're in this together, do it for the good of your country" kind of thinking. It's hard to forget how powerful that rhetoric was in the early 2000s, and how unpatriotic you were viewed as if you didn't support the invasions. Not saying it's a *good* lesson, just that it might be effectively implemented for a better reason.
Antonia, do you mean specifically nationalist sentiment, or wartime solidarity in general? It's a lot tougher to mobilize patriotism against a virus that doesn't have a nationality and is ravaging most other countries besides our own (although the "Chinese virus" people tried). But I think wartime sentiment and rhetoric *was* there in the beginning, as much as it possibly could be for something so amorphous and decentered. Basically overnight my community began scrupulously social distancing (I remember a friend in Brooklyn posting about the empty streets feeling like a silent act of love, as everyone stayed home to protect their neighbors), and masks were a badge of honor by May. That's a remarkable transformation when you think about it! Every time I went online I was bombarded by messages of solidarity, inspiring memes, "we're all intimately connected," "we must support one another," countless articles proclaiming the end of individualism, mutual aid and so on (some of which carried into Black Lives Matter). And then most of this slowly drained away amid the tedium and contempt of habit and familiarity, and relentless backlash.
One observation that really stays with me from this past year (possibly different from yours) is that the straightforward moral argument is powerful and compelling, always there as a resource -- and all things equal it prevails over the selfish argument - but it's also uniquely fragile and must be continually nourished and fought for. It speaks for itself, but can't always fend for itself.
Wartime solidarity in general, though I want to be very clear this is just a foggy, amorphous idea.
I mean, given your example it does sound like it's effective. I live in northwest Montana, in a smaller liberal-leaning town in an extremely conservative county so our messaging was both mixed and messy. Our city council and mayor did a great job with "we're all in this together," a *really* good job, but the larger county population's resistance often drowned out that sense of solidarity and made it all so exhausting. There's layers and layers of this (awful county commissioners, great county health department, etc.) but it seemed clear that if Trump had been a different person and actually used some of that rhetoric our situation might have been completely different. That's obviously always going to be hypothetical. But in any case I don't think any kind of straightforward moral argument would have worked. The messaging about masks protecting *other* people was very clear from the hospital and health department but all the resistance turned it into "it's my choice whether to put myself at risk."
That's interesting about your liberal community sandwiched within a conservative county nestled within the enigma that is Montana! I recently viewed a roundtable where a few experts were talking about vaccine hesitancy, and one of the speakers who lives in northern Montana was using anti-mask sentiment there as a case study to shed light on the related issue of vaccine skepticism (I don't remember which county - I think it was more eastward).
Part of my point was that even in my own hometown of New Haven, CT which is pretty darn progressive, the wartime attitude worked for awhile but soon enough it petered out, as everyone got accustomed to the situation and a mixture of indifference and habit set in. Of course, you could argue that habits at their best serve as the crystallized manifestation of that original solidarity. But somehow it doesn't feel this way.
I'd be interested in hearing that roundtable! It does seem like vaccine hesitancy is intertwined with anti-masking in strange ways that involve the kind of "pure body" attitude (aversion to putting anything in the body that feels "foreign" along with an insistence that masks degrade the quality of air being drawn in, which I notice nobody said anything about during wildfire season).
That's a great point about the wartime attitude. I suppose that's the same anywhere, and for any situation. No society can keep that going indefinitely. Makes me think of the rationing in post-war Britain, too -- stiff upper lip and patriotism can only get you so far. This feels like a possible topic for another Zeynep article!
I’m not sure this argument actually means much—unlike the mask issue, this is not a matter that will be determined by ordinary citizens. In fact, there doesn’t really seem to be a question of whether people in the developing world will be vaccinated—the question is how soon, whether it requires waiving patents and whether/when the US will release its surplus vaccines, as noted in your NY Times column. But the audience for the argument are world leaders, not regular folks or even academia, and we should consider that maybe those folks are less susceptible to “hippy dippy” arguments than the average human (who still have a high tolerance for basic-human-rights violations happening far away). I actually think the argument in the Times column—that the US and Europe should maybe use this as a golden opportunity for some “soft power” diplomacy to get ahead of the Chinese and Russians (who have their own, possibly less effective, vaccines) is the most persuasive argument for the people actually in a position to decide.
There's a popular karmic narrative that will often surface when people discuss this topic, whereby anyone who ignores the developing world will find the virus coming back to haunt them for their hubris and selfishness. But as you point out, the arc of viruses doesn't automatically bend toward justice. Sometimes viruses.....just. The world (even or especially as revealed by science) can be a really unfair, unpredictable place. Maybe it's enough to simply make the moral argument for its own sake as you suggest, and if people want to assign karma they can do so without relying on epidemio-logic.
I totally agree that we shouldn't lead with the "selfish & practical" argument, but my sense is Stroehlein was invoking this more as a Plan B for those who are unreachable otherwise, a kind of rhetorical last-ditch appeal. "Hippy dippy wishful thinking" isn't his own characterization of the moral argument, more like an interpretation of the other person's dismissal.
I've been thinking about how we had this play out with HIV/AIDS, too. Wealthy countries had the triple cocktail, and there were attempts to move things along the "but it will mutate" arguments. In the end, activists ended up pushing very hard and that's (a big part of) what got the rest of the world access. The idea that virus will punish the immoral is attractive and very human, but morality is what we (choose to or not) impose on the world rather than that just comes out of karma as you put it.
I wonder how the dynamics differ between this kind of differential access for effective treatments (as in HIV), and unequal access for effective prevention (vaccines). I would think it's even more challenging to properly distribute a preventative measure because timing is that much more critical, and you have to set up the necessary infrastructure, as opposed to just having the drugs on hand to give patients once they fall ill. And you have to contend with vaccine skepticism as well (whereas I doubt most AIDS patients were rejecting antivirals right and left, if they were available). So activists have to overcome all this as well.
My friend was just back in his home country of Morocco for a few weeks, and he tells me that over there they are much more strict about enforcing vaccine administration for all eligible parties: if you don't take the vaccine, you lose your job. On the other hand, things are way more opened up there and essentially zero restrictions on crowds, masks etc.. So there are interesting interactions between vaccine access and local cultures of enforcement (both vaccines and NPIs).
Speaking of selection pressures, would the usage of the viral vector vaccines or the mRNA ones which target the spike protein lead to newer resistant variants? It looks like these vaccines are less effective against variants where the spike protein mutates. Is there a parallel here with the remdesivir chain of events leading to the creation of the UK variant?
Hi Zeynep! Your post has two facets to it -- is the selfish claim true, and is it effective. To avoid muddying things up, I'll just reply to the latter point.
Would you agree that, if you had a Magic 8-Ball that could accurately tell you which message was more effective, that you would use the effective message even if you considered it morally inferior? If not then we don't need to debate effectiveness. 8-)
There are very large numbers of people whose job it is to predict what messaging will be most effective, such as advertising execs and political consultants. I'm leery of our year-long history of trying to guess at what messages will work. Is there not a more rigorous way to decide? Or maybe just do targeted advertising? Your posts are so often about data and facts, but this facet is of necessity handwavey.
We had people who tried to outguess people by telling them not to wear masks, lest they engage in unsafe conduct. Even Saint Fauci originally said that only about 60% of Americans would need to take the vaccine in order to contain the virus, but later admitted that he was lying because he thought the real number would be too intimidating. Individuals untrained in marketing are making marketing decisions.
There's also been a lot of conversation about whether to give people enough info to decide for themselves how to stay safe, versus giving people clear and terse tweet-sized summaries.
I wish we had an area-expert to turn to so that the most highly educated elite people on the planet are not trying to guess the psychology of the mainstream of humanity.
You said: "Plus, even if there were some completely rational but coldly calculating individuals who might be suspect to such reasoning..." Libertarians and xenophobes -- both of which the USA has in abundance -- would prefer the selfish argument. Perhaps not completely rational, but none of us are if we're honest with ourselves.
I don't have the Magic 8-Ball but my sense is that we exaggerate how well selfish arguments will work (they don't work well really and may even backfire) and underestimate that the plain moral case actually has widespread appeal.
Selection pressure is certainly important in the formation of new variants, but so is absolute number of viral replications. There are many sub-clades of virus found via viral genome sequencing that are unlinked to immunocompromised hosts. These are also "variants" and, by chance, may end up being more or less lethal/transmissible.
I think it is difficult to determine causality in the formation of new variants; though, of course, selection pressure via (non-efficacious) plasma and pharmaceutical interventions won't help. Similar to antibiotic resistance, that one.
But I think the selfish argument of "we don't want more variants circulating so let's vaccinate everyone" is very well plausible to be a good strategy to prevent immune evasion.
On the other side of the coin, of course, is the idea that the mutational landscape of SARS-CoV-2 (or any virus, for that matter) is limited due to the necessity of ACE-2 binding by the RBD. This leads many to believe that new SARS-CoV-2 variants will be limited in their ability to become a "superbug" a la B117. With evolution, though, who knows but God?
Anyways, we agree: world-wide vaccination is a priority. I believe in this firstly due to basic human morality. Secondly, and perhaps more convincingly to the Kissinger-types, we must help the world to keep us from a potential future disaster.
I don't disagree at all that ending the pandemic is good for everyone, including for limiting future evolution, but I also think the selfish argument may be weaker than people think because there is a potential way out for the selfish crowd as we imagine them. They can get vaccinated and get their boosters and live their lives and not care.
I’m not sure this argument actually means much—unlike the mask issue, this is not a matter that will be determined by ordinary citizens. In fact, there doesn’t really seem to be a question of whether people in the developing world will be vaccinated—the question is how soon, whether it requires waiving patents and whether/when the US will release its surplus vaccines, as noted in your NY Times column. But the audience for the argument are world leaders, not regular folks or even academia, and we should consider that maybe those folks are less susceptible to “hippy dippy” arguments than the average human (who still have a high tolerance for basic-human-rights violations happening far away). I actually think the argument in the Times column—that the US and Europe should maybe use this as a golden opportunity for some “soft power” diplomacy to get ahead of the Chinese and Russians (who have their own, possibly less effective, vaccines) is the most persuasive argument for the people actually in a position to decide.
While this is an engaging argument, - I don't think it is of much practical importance. The premise gives too agency to "us" and not enough to "them". We are no longer the movers and shakers of the world, if ever we were. Most large countries have the technology to make a decent vaccine and those that don't can purchase them in the quantities they need. For example, Mali may need our help but Nigeria won't. And Mali will get the vaccine from countries with the variety of motives states are known to have.
Am I wrong that by the time the booster shots make it into my arm, they will likely be a full year out-of-date with respect to new strains? This wouldn't make me (or others) feel safe from variants.
Well, that's what part of this messaging is but.. I don't think that's necessarily completely true. The existing vaccine plus annual variant may well be protective enough--not that variants aren't a threat of any kind, but they probably aren't the kind of threat that will move the selfish and immoral to move to vaccinate the world.
The NYTimes reported last week that in large parts of Africa and Asia the virus does not seem to have spread. A follow-up report based on input from researchers suggests that the correlation of susceptibility to the virus correlates inversely with obesity within the population at large.
Assuming there is some accuracy to these claims, how would they modify your position? Would you still aim to vaccinate people in countries where the virus has not taken hold simply on a humanitarian basis? Or would you focus on regions where it has taken a hold?
I suspect that in many poorer / totalitarian countries around the world, we don't honestly know how many people have had the virus. Even in the USA we don't think we know how many have had it, in part because of limited testing availability. Would you trust the numbers of cases as reported by the governments of Venezuela or the Congo? Heck, Brazil, given their politics?
There's also another theory going round that the recency of the MMR shot is a key aspect. e.g. many adults in Asia were only vaccinated 20 years ago as part of mass campaigns, so even the adults there were vaccinated relatively recently. There is a correlation between places with low vaccination rates and high Covid infection rates. But it's not well proven yet.
Venezuela and Congo are not necessarily representative, and are to my mind a red herring.
Japan, Thailand, and Vietnam are among the low-rate countries. Brazil is listed as a high-rate country.
Accuracy of data clearly is an issue in understanding and testing the veracity of any correlation.
Still, if you assume for the sake of argument that it’s accurate enough, what’s the correct approach to vaccinating people who seem not to be susceptible?
Yes, it's true, those two countries were extreme examples. But I even called out the USA and our poor testing. I guess I'm just skeptical of directly comparing reported case loads, but I'm open to an argument that Japan and Ukraine can be directly compared, for example.
The year-over-year change in total deaths seems like a more reliable metric, since I believe that most countries (except the poorest) accurately count the number of dead each year. The NYT for a while tried to collect those stats; I don't know if they still are.
But assuming that it's accurate enough, I would think that countries with low spread of the virus should be the lowest priority to become vaccinated, but that everyone should eventually be vaccinated to prevent new variants. Similar to how people who can work from home are deprioritized to be vaccinated, yet essential workers can be prioritized. But I suspect that vaccinations will follow monetary and geopolitical incentives rather than moral and medical reasoning.
One problem is that we don't totally have a handle on the causal mechanisms in the low-spread countries outside the ones that acted early/decisively. I have my theories, for sure, but I think there is a puzzle there that is as of yet unanswered, and a more transmissible (or longer contagious) variant may well tip over whatever came together to suppress transmission in, say, India. Plus, the unvaccinated countries that kept things out via strict controls are uniquely vulnerable to a wave. It's a very thorny time, epistemologically, too. I am not completely confident in my own explanations (heh!) of a good number of countries though I think we have a better idea for others.
Those who have the capacity to understand the science must also accept the political situation in the US today. Many will simply reject a moral argument for worldwide vaccination. To use the jargon, targeted advertising appealing to the tribal instincts we are witnessing will be the only means of persuading many in our population.
But would those people respond to a purely selfish one? Especially given that it's not as strong an argument as it may appear...
Will most people know if it's a strong argument? I suspect that we're discussing how to present things to an audience that will not know if it is a strong argument.
Let me see if I can spin this: "Do unto others as you would have them do unto you."
As expected, you have once again provided great reporting, analysis, and values.
It's a bit the same as the "we should have told people that masks protect them instead of others" argument... do I wish people were more serious about wearing masks and properly at that? Yep! Do I think we should lie to them because a non-trivial amount of them are selfish pricks? Nope...
I also think the straightforward moral argument may have a bigger constituency than a convoluted one that people may not even believe given how well vaccines and boosters may well work. Just like masks. Lot of people were really roaring to do their part last year. You saw it in polls and in behavior.
I've been wondering if there are lessons from times of war (not all times of war, just times of war that people rightly or wrongly feel patriotic about) that could have been used all along to build a sense of solidarity and "we're in this together, do it for the good of your country" kind of thinking. It's hard to forget how powerful that rhetoric was in the early 2000s, and how unpatriotic you were viewed as if you didn't support the invasions. Not saying it's a *good* lesson, just that it might be effectively implemented for a better reason.
Antonia, do you mean specifically nationalist sentiment, or wartime solidarity in general? It's a lot tougher to mobilize patriotism against a virus that doesn't have a nationality and is ravaging most other countries besides our own (although the "Chinese virus" people tried). But I think wartime sentiment and rhetoric *was* there in the beginning, as much as it possibly could be for something so amorphous and decentered. Basically overnight my community began scrupulously social distancing (I remember a friend in Brooklyn posting about the empty streets feeling like a silent act of love, as everyone stayed home to protect their neighbors), and masks were a badge of honor by May. That's a remarkable transformation when you think about it! Every time I went online I was bombarded by messages of solidarity, inspiring memes, "we're all intimately connected," "we must support one another," countless articles proclaiming the end of individualism, mutual aid and so on (some of which carried into Black Lives Matter). And then most of this slowly drained away amid the tedium and contempt of habit and familiarity, and relentless backlash.
One observation that really stays with me from this past year (possibly different from yours) is that the straightforward moral argument is powerful and compelling, always there as a resource -- and all things equal it prevails over the selfish argument - but it's also uniquely fragile and must be continually nourished and fought for. It speaks for itself, but can't always fend for itself.
Wartime solidarity in general, though I want to be very clear this is just a foggy, amorphous idea.
I mean, given your example it does sound like it's effective. I live in northwest Montana, in a smaller liberal-leaning town in an extremely conservative county so our messaging was both mixed and messy. Our city council and mayor did a great job with "we're all in this together," a *really* good job, but the larger county population's resistance often drowned out that sense of solidarity and made it all so exhausting. There's layers and layers of this (awful county commissioners, great county health department, etc.) but it seemed clear that if Trump had been a different person and actually used some of that rhetoric our situation might have been completely different. That's obviously always going to be hypothetical. But in any case I don't think any kind of straightforward moral argument would have worked. The messaging about masks protecting *other* people was very clear from the hospital and health department but all the resistance turned it into "it's my choice whether to put myself at risk."
That's interesting about your liberal community sandwiched within a conservative county nestled within the enigma that is Montana! I recently viewed a roundtable where a few experts were talking about vaccine hesitancy, and one of the speakers who lives in northern Montana was using anti-mask sentiment there as a case study to shed light on the related issue of vaccine skepticism (I don't remember which county - I think it was more eastward).
Part of my point was that even in my own hometown of New Haven, CT which is pretty darn progressive, the wartime attitude worked for awhile but soon enough it petered out, as everyone got accustomed to the situation and a mixture of indifference and habit set in. Of course, you could argue that habits at their best serve as the crystallized manifestation of that original solidarity. But somehow it doesn't feel this way.
I'd be interested in hearing that roundtable! It does seem like vaccine hesitancy is intertwined with anti-masking in strange ways that involve the kind of "pure body" attitude (aversion to putting anything in the body that feels "foreign" along with an insistence that masks degrade the quality of air being drawn in, which I notice nobody said anything about during wildfire season).
That's a great point about the wartime attitude. I suppose that's the same anywhere, and for any situation. No society can keep that going indefinitely. Makes me think of the rationing in post-war Britain, too -- stiff upper lip and patriotism can only get you so far. This feels like a possible topic for another Zeynep article!
Yeah, my county is beautiful and exhausting.
Yup- And as you pointed out above, selfish people will find a way out one way or the other...
I’m not sure this argument actually means much—unlike the mask issue, this is not a matter that will be determined by ordinary citizens. In fact, there doesn’t really seem to be a question of whether people in the developing world will be vaccinated—the question is how soon, whether it requires waiving patents and whether/when the US will release its surplus vaccines, as noted in your NY Times column. But the audience for the argument are world leaders, not regular folks or even academia, and we should consider that maybe those folks are less susceptible to “hippy dippy” arguments than the average human (who still have a high tolerance for basic-human-rights violations happening far away). I actually think the argument in the Times column—that the US and Europe should maybe use this as a golden opportunity for some “soft power” diplomacy to get ahead of the Chinese and Russians (who have their own, possibly less effective, vaccines) is the most persuasive argument for the people actually in a position to decide.
absolutely right on. There is no need to try and find the best moral reason to convince nation states to do what is in their own best interest.
There's a popular karmic narrative that will often surface when people discuss this topic, whereby anyone who ignores the developing world will find the virus coming back to haunt them for their hubris and selfishness. But as you point out, the arc of viruses doesn't automatically bend toward justice. Sometimes viruses.....just. The world (even or especially as revealed by science) can be a really unfair, unpredictable place. Maybe it's enough to simply make the moral argument for its own sake as you suggest, and if people want to assign karma they can do so without relying on epidemio-logic.
I totally agree that we shouldn't lead with the "selfish & practical" argument, but my sense is Stroehlein was invoking this more as a Plan B for those who are unreachable otherwise, a kind of rhetorical last-ditch appeal. "Hippy dippy wishful thinking" isn't his own characterization of the moral argument, more like an interpretation of the other person's dismissal.
I've been thinking about how we had this play out with HIV/AIDS, too. Wealthy countries had the triple cocktail, and there were attempts to move things along the "but it will mutate" arguments. In the end, activists ended up pushing very hard and that's (a big part of) what got the rest of the world access. The idea that virus will punish the immoral is attractive and very human, but morality is what we (choose to or not) impose on the world rather than that just comes out of karma as you put it.
I wonder how the dynamics differ between this kind of differential access for effective treatments (as in HIV), and unequal access for effective prevention (vaccines). I would think it's even more challenging to properly distribute a preventative measure because timing is that much more critical, and you have to set up the necessary infrastructure, as opposed to just having the drugs on hand to give patients once they fall ill. And you have to contend with vaccine skepticism as well (whereas I doubt most AIDS patients were rejecting antivirals right and left, if they were available). So activists have to overcome all this as well.
My friend was just back in his home country of Morocco for a few weeks, and he tells me that over there they are much more strict about enforcing vaccine administration for all eligible parties: if you don't take the vaccine, you lose your job. On the other hand, things are way more opened up there and essentially zero restrictions on crowds, masks etc.. So there are interesting interactions between vaccine access and local cultures of enforcement (both vaccines and NPIs).
Speaking of selection pressures, would the usage of the viral vector vaccines or the mRNA ones which target the spike protein lead to newer resistant variants? It looks like these vaccines are less effective against variants where the spike protein mutates. Is there a parallel here with the remdesivir chain of events leading to the creation of the UK variant?
Hi Zeynep! Your post has two facets to it -- is the selfish claim true, and is it effective. To avoid muddying things up, I'll just reply to the latter point.
Would you agree that, if you had a Magic 8-Ball that could accurately tell you which message was more effective, that you would use the effective message even if you considered it morally inferior? If not then we don't need to debate effectiveness. 8-)
There are very large numbers of people whose job it is to predict what messaging will be most effective, such as advertising execs and political consultants. I'm leery of our year-long history of trying to guess at what messages will work. Is there not a more rigorous way to decide? Or maybe just do targeted advertising? Your posts are so often about data and facts, but this facet is of necessity handwavey.
We had people who tried to outguess people by telling them not to wear masks, lest they engage in unsafe conduct. Even Saint Fauci originally said that only about 60% of Americans would need to take the vaccine in order to contain the virus, but later admitted that he was lying because he thought the real number would be too intimidating. Individuals untrained in marketing are making marketing decisions.
There's also been a lot of conversation about whether to give people enough info to decide for themselves how to stay safe, versus giving people clear and terse tweet-sized summaries.
I wish we had an area-expert to turn to so that the most highly educated elite people on the planet are not trying to guess the psychology of the mainstream of humanity.
You said: "Plus, even if there were some completely rational but coldly calculating individuals who might be suspect to such reasoning..." Libertarians and xenophobes -- both of which the USA has in abundance -- would prefer the selfish argument. Perhaps not completely rational, but none of us are if we're honest with ourselves.
I don't have the Magic 8-Ball but my sense is that we exaggerate how well selfish arguments will work (they don't work well really and may even backfire) and underestimate that the plain moral case actually has widespread appeal.
Selection pressure is certainly important in the formation of new variants, but so is absolute number of viral replications. There are many sub-clades of virus found via viral genome sequencing that are unlinked to immunocompromised hosts. These are also "variants" and, by chance, may end up being more or less lethal/transmissible.
I think it is difficult to determine causality in the formation of new variants; though, of course, selection pressure via (non-efficacious) plasma and pharmaceutical interventions won't help. Similar to antibiotic resistance, that one.
But I think the selfish argument of "we don't want more variants circulating so let's vaccinate everyone" is very well plausible to be a good strategy to prevent immune evasion.
On the other side of the coin, of course, is the idea that the mutational landscape of SARS-CoV-2 (or any virus, for that matter) is limited due to the necessity of ACE-2 binding by the RBD. This leads many to believe that new SARS-CoV-2 variants will be limited in their ability to become a "superbug" a la B117. With evolution, though, who knows but God?
Anyways, we agree: world-wide vaccination is a priority. I believe in this firstly due to basic human morality. Secondly, and perhaps more convincingly to the Kissinger-types, we must help the world to keep us from a potential future disaster.
I don't disagree at all that ending the pandemic is good for everyone, including for limiting future evolution, but I also think the selfish argument may be weaker than people think because there is a potential way out for the selfish crowd as we imagine them. They can get vaccinated and get their boosters and live their lives and not care.
Let's keep it simple. WHO distributes Kf94 masks to everyone world wide while they are waiting for vaccinations. Good value for the money.
I’m not sure this argument actually means much—unlike the mask issue, this is not a matter that will be determined by ordinary citizens. In fact, there doesn’t really seem to be a question of whether people in the developing world will be vaccinated—the question is how soon, whether it requires waiving patents and whether/when the US will release its surplus vaccines, as noted in your NY Times column. But the audience for the argument are world leaders, not regular folks or even academia, and we should consider that maybe those folks are less susceptible to “hippy dippy” arguments than the average human (who still have a high tolerance for basic-human-rights violations happening far away). I actually think the argument in the Times column—that the US and Europe should maybe use this as a golden opportunity for some “soft power” diplomacy to get ahead of the Chinese and Russians (who have their own, possibly less effective, vaccines) is the most persuasive argument for the people actually in a position to decide.
While this is an engaging argument, - I don't think it is of much practical importance. The premise gives too agency to "us" and not enough to "them". We are no longer the movers and shakers of the world, if ever we were. Most large countries have the technology to make a decent vaccine and those that don't can purchase them in the quantities they need. For example, Mali may need our help but Nigeria won't. And Mali will get the vaccine from countries with the variety of motives states are known to have.
Australia watching PNG where transmission of COVID19 is well ahead of vaccinations.
Am I wrong that by the time the booster shots make it into my arm, they will likely be a full year out-of-date with respect to new strains? This wouldn't make me (or others) feel safe from variants.
Well, that's what part of this messaging is but.. I don't think that's necessarily completely true. The existing vaccine plus annual variant may well be protective enough--not that variants aren't a threat of any kind, but they probably aren't the kind of threat that will move the selfish and immoral to move to vaccinate the world.
It'd be fascinating to conduct a few focus groups. Anyone have a spare $50K? 8-)
The NYTimes reported last week that in large parts of Africa and Asia the virus does not seem to have spread. A follow-up report based on input from researchers suggests that the correlation of susceptibility to the virus correlates inversely with obesity within the population at large.
Assuming there is some accuracy to these claims, how would they modify your position? Would you still aim to vaccinate people in countries where the virus has not taken hold simply on a humanitarian basis? Or would you focus on regions where it has taken a hold?
I suspect that in many poorer / totalitarian countries around the world, we don't honestly know how many people have had the virus. Even in the USA we don't think we know how many have had it, in part because of limited testing availability. Would you trust the numbers of cases as reported by the governments of Venezuela or the Congo? Heck, Brazil, given their politics?
There's also another theory going round that the recency of the MMR shot is a key aspect. e.g. many adults in Asia were only vaccinated 20 years ago as part of mass campaigns, so even the adults there were vaccinated relatively recently. There is a correlation between places with low vaccination rates and high Covid infection rates. But it's not well proven yet.
Venezuela and Congo are not necessarily representative, and are to my mind a red herring.
Japan, Thailand, and Vietnam are among the low-rate countries. Brazil is listed as a high-rate country.
Accuracy of data clearly is an issue in understanding and testing the veracity of any correlation.
Still, if you assume for the sake of argument that it’s accurate enough, what’s the correct approach to vaccinating people who seem not to be susceptible?
Yes, it's true, those two countries were extreme examples. But I even called out the USA and our poor testing. I guess I'm just skeptical of directly comparing reported case loads, but I'm open to an argument that Japan and Ukraine can be directly compared, for example.
The year-over-year change in total deaths seems like a more reliable metric, since I believe that most countries (except the poorest) accurately count the number of dead each year. The NYT for a while tried to collect those stats; I don't know if they still are.
But assuming that it's accurate enough, I would think that countries with low spread of the virus should be the lowest priority to become vaccinated, but that everyone should eventually be vaccinated to prevent new variants. Similar to how people who can work from home are deprioritized to be vaccinated, yet essential workers can be prioritized. But I suspect that vaccinations will follow monetary and geopolitical incentives rather than moral and medical reasoning.
One problem is that we don't totally have a handle on the causal mechanisms in the low-spread countries outside the ones that acted early/decisively. I have my theories, for sure, but I think there is a puzzle there that is as of yet unanswered, and a more transmissible (or longer contagious) variant may well tip over whatever came together to suppress transmission in, say, India. Plus, the unvaccinated countries that kept things out via strict controls are uniquely vulnerable to a wave. It's a very thorny time, epistemologically, too. I am not completely confident in my own explanations (heh!) of a good number of countries though I think we have a better idea for others.
Why choose? Each message can work, depending on who hears it. They integrate well under the "We're all in this together" umbrella.
Because the "don't be selfish" one may well backfire? That's what I fear.