CharonY

Yes that is true, but the issue is that, it would have been insufficient to lockdown China alone. Once it was clear that it was a bigger outbreak virtually all countries had to lock down to ensure spread. If the next pandemic also has pre-symptomatic spread and/or diffuse symptoms, it would be the same issue. Detection would be after spread already happening. If it was less contagious and/or otherwise more visible, then actual contact tracing could work, as SARS and MERS have shown. That being said if all affected countries had adopted zero-COVID measures it might have stopped.

That would not have been feasible. When the first pneumonia clusters appeared, it was not clear that it was a new disease. Until it was identified and a test was developed, it was already spreading outside of China (based on a range of ancillary data including social media analyses of pneumonia cases, wastewater and blood bank analyses). The only way it would have worked if one was able to almost immediately identify a new virus, which would required population-wide genomic surveillance of almost all pneumonia cases. Alternatively one would need to lock down before diagnoses. That would basically mean repeated lockdowns throughout flu season, for example. In other words, the key element here would be better surveillance. Fundamentally I think yes. This is mostly based on a number of parameters, including direct health burden, but also strain on healthcare system and associated risk to health (as folks cannot get care for other conditions due to COVID-19), but also mental health burden especially for health care workers. Colleagues working in the health care system have been burned out for quite a while and how frustrated it is for them to see spike after speak leading to increased hospitalizations like clockwork. Adding on top that the longer we drag it out, the less compliance we are going to get (and further shifting the risk calculus). So overall I do think that public health is indeed hitting a breaking point or at least that we are very, very close to it. That being said, I would be more in favour of a gradual shift. I.e. starting with exclusion of unvaccinated folks, as we have seen that after such measures there is almost always an uptick in vaccinations. Surveys have found that there are a quite a number of especially younger folks who do not have specific body autonomy issues or anti-vaccinations sentiments. They just don't get vaccinated because they consider it not necessary for them and also an inconvenience. Creating inconvenience for being unvaccinated therefore changes their behaviour.

Unless I misunderstand you, but it seems to me that you argue the balance should be dependent on the political environment, whereas my argument would be dependent on the actual medical and public health situation. E.g. if hospitals are overwhelmed in a way that cannot be fixed, then the balance shifts towards a higher need for the public good (as the health burden is no increased). Unless you mean to focus on the political reality of the matter, i.e. that public health decisions in reality are actually dependent on politics (regardless whether they should or not) in which I agree. As mentioned above, the tipping point is the balance of activities vs public health burden. I.e. if 'mostly' still results in breakdowns of critical care or increased health burden (hospitalizations, long-term issues, death etc.), it is not enough anymore.

So that is an interesting argument. The aspect of body autonomy is, in many ways, complex. Fundamentally having control over your body is arguably a fundamental right and history has shown us terrible things when these rights were violated without consideration. Moreover, there are also aspects in which fierce arguments are made to limit those, such as in case of pregnancies. The situation specifically with vaccines is complicated as fundamentally we are balancing body autonomy with public health requirements. Ethics cuts both ways here. There are many thoughts around the issue ranging from how far we should be allowed to go to increase compliance. Reading through literature, it rather quickly is clear that there are no clear answers to the ethical question. One way to balance these issues is to find an equilibrium which balances of the right for autonomy with the severity of the public health measure. I think that for those living in a society there should be a tipping point where the common good takes precedence of the individual will. The tricky bit is mapping out where this point should be. It is not a perfect framework, but would at least take the public threat level into consideration rather than being an absolute. The best way, of course would be to inform and educate, but I am pretty sure we are talking about the bits where this approach does not work.

I would be careful about that. We do not have good age-stratified data on unvaccinated severe cases yet (there is another report from SA which I should spend more time on, but from skimming it seems not to be conclusive yet, either). Current data suggests that it is not worse and there is at best a careful perhaps on whether it could be milder on average. Each individual might still face severe consequences, especially in the older age segment. Moreover, from a public health perspective, if the virus is less virulent, but spreads faster, it can still have a similar or higher net burden than the more virulent variant. In fact, spread is the more critical value here, since if it manages to spread through the population in a way delta still couldn't, we could actually face much higher net hospitalizations. This is exactly the scenario public health officials are very afraid of. There can be rather complicated situations pertaining to it. For example, folks can be co-infected with different variants (in areas with extremely high prevalence of infections), but only one manages to fully settle in its host. But for the most part the assumption is that infected persons regardless of the variant are less likely to immediately catch a related infection again. This is related to the amount of neutralizing antibodies, which are not highly specific and therefore should protect against most variations out there.

I think the basis for the approach is the concept or proportionality. Public health groups have to carefully evaluate the various scenarios and look at the health burden in relationship to the necessary measures to alleviate them. Fundamentally the question is how many deaths are we alright with relative to measures to be taken. The burden of the measures themselves must also be taken into account as they themselves may pose public health risks. The issue here is that all we can do is follow best scientific estimates as we will only know in the aftermath how badly it has become. For this particular disease, it was pretty clear (at least among health professionals) that, if unchecked, it would in short order disrupt health care systems. In hindsight that has become true and is clearly one of the deadliest pandemic in modern times. So at least the properties of the disease would have warranted more rigorous measures compared to, say SARS or perhaps even Ebola, not because of mere death rates (both have higher case fatality rates) but were also easier to detect, which allowed other containment measures to be sufficient. But I guess we really can't have absolute certainty when it comes to these measures as at some point a judgment has to be made and clearly we cannot shut everything down each time we find a new virus. Conversely, it also means we need a more robust pipeline to make these evaluations and judgements and not hope that things politically align, as ultimately the biology determines the timeline in which we have to act.

I think the bigger point here is not whether measures are allowed. They certainly are. Likewise, policies are in place to encourage certain behaviour and discourage others. This is no different in a pandemic. But perhaps rather what potential limits are under the overall framework of human rights. In another thread there were comments indicating that it should be possible to essentially suspend human rights. In contrast, I think that effective measures are not only feasible but should in fact not be at odds with human rights in order to ensure public health and safety. Rather, the right for health is tightly interconnected to other human rights and therefore effective policies should fulfil these standards. In other words, it not a yes/no situation with regard to pandemic measure, but one should rather ask whether the measures are: improving public health (i.e. following science); deployed fairly and equitably; has enough measures in place to ease hardships and promote compliance. Enforcing safe vaccines against a deadly disease in public spaces would fall under that mandate, for example.

I don't think anyone here right now is arguing against it.

I think you are mentioning two issues here. One, is that of liability, which can lead to criminal or civil persecution, the other is one regarding the ability of the government to impose restrictions within (not beyond) the limits of human rights. In that regard we are in agreement that mask and vaccination mandates are something that can be implemented (similarly to laws against drunk driving or for seat belt mandates). The other part is more about potential persecution of violating these orders. They are a bit outside of the humans rights discussion at hand, as once laws or ordinances are in place, punishments can be meted out for their violation. But again, it means that these restrictions should be implemented within certain limitations. For example, it should not be possible for the government to arbitrarily quarantine certain folks but let others do as they wish, without scientific justification. Likewise the length of these measures should not be at will but be aligned with public health requirements. It should not be possible to isolate folks, and at the same time deprive them of food and water and other necessities. It should be impossible for the government to euthanize people just because folks are afraid that they might be infected (as in the US some lawmakers proposed during one of the Ebola outbreaks). If we as a society say that we can grant as well as remove rights just because we hit a rough spot, than these rights are worthless. Instead, we need to use them as guiding principles in which to implement public health measures. That is one of the basic arguments for vaccinations as a public health mandate and why the main argument that in itself it is not a violation of the human right of self determination.

There is a big difference in these scenario as shooting folks is obviously a crime and there are laws that deal with it. In case of infections, if you do it willingly, there is likely a ground for prosecution, but again, it would be after the fact. In a public health scenario you apply rules for everyone and as such must be carefully calibrated. It is, for example reasonable and lawful to request negative tests and mandate masks and vaccinations in long-term care facilities. Stay-at-home orders or isolation mandates are also largely in line with human rights consideration with certain provisions (i.e. one must be allowed to have access to food water and necessary medication). I also prefer to think of humans rights not as something granted, but something that is inherent, but with certain limitations within a society. The difference here is that in the latter it means that reduction of freedoms have to be justified, whereas there is no stipulation in the former model.

In this thread I would like to explore the legal and ethical basis of pandemic (or public health in general) related restrictions of human rights. I will focus on human rights as outlined by the universal declaration of human rights https://www.un.org/en/about-us/universal-declaration-of-human-rights as well as the International Covenant on Economic, Social and Cultural rights https://www.ohchr.org/en/professionalinterest/pages/cescr.aspx. Specifically Article 12 of the covenant is important here: In a specific comment the office of the high commissioner for human rights outlined that: In other words, they see a close connection between these rights. Yet certain health measures might curb rights. The basic framework to realize health within a human rights framework is therefore that any restrictions need to be implemented in a way that maximizes the outcome but must also be lawful, proportionate, necessary and applied fairly. These limitations have been outlined in the Siracusa Principles https://www.icj.org/wp-content/uploads/1984/07/Siracusa-principles-ICCPR-legal-submission-1985-eng.pdf So independent of the actual implementation in the last years, there are guiding principles for the lawful implementation of public health measures. As such implementing public health measures, including isolation or other mandates are not necessary at odds with human rights principles. In fact, I would argue it is dangerous to frame it that way as it would necessarily decrease compliance and delegitimize the measures themselves. That being said, it can be argued that many implementations might have been insufficient in following these guidelines. Fore example, self-isolation can result in the loss of job. While many countries have provided some worker benefits, that may be insufficient. Likewise, it can be argued that many of these measures are not applied equally. Low-income folks have a harder time following many measures as they are strapped for means, while higher income folks or folks with jobs that allow remote work are barely affected. This is not only exclusively a human rights argument, but also one of public health, as folks with economic constraints are often less likely to get tested in the first place, in fear of losing their jobs. We can explore the intersection of each of these rights with a view on public health and discuss their implementation (and potential violation) of a given right. For example: Quarantines and lockdowns are obviously a limitation of the the freedom of movement. In order to ensure lawful implementation several aspects must be safeguarded. These include: - only implement mandatory restrictions when scientifically warranted and only when individual health and safety can be safeguarded. This includes ensuring that folks can continue to secure their livelihood, have access to necessities and have access to other necessary services (e.g. support for disabled). Fundamentally speaking, mostly voluntary measures in conjunction with education, widespread screening and contact tracing are in fact likely to work better in most areas as it will increase cooperation. Erosion of public trust on the other hand is likely to result in more folks trying to evade these measures.

I think the topic is worth exploring, but should probably be in a different thread. If it is alright with everyone, I am going to sketch out a very rough OP and post it in the Ethics section. Edit: Done, not very well thought out (as usual) but contains some reading material to set a baseline.

My point is that e.g. fining them or mandating vaccines in public spaces is not a violation of human rights, or at least within the confines of the social contract. Suicide on the other hand is the opposite, it is about fulfilling individual desires vs social norms. The issue here is safeguarding the individual against themselves with regulating under which conditions suicide should be allowe.

I should add that my comment really only makes sense if there are virtually no or a massive reduction of hospitalizations associated with omicron. If it spreads to many more folks, even a milder on average outcome might still cause a net increase in hospitalizations.

In the current pandemic travel restrictions would likely only had a small impact. Basically once the virus was identified, it was already too late. I.e. detection was severely lagging spread.

I think it is a bit of a false dichotomy to pit quarantine measures vs human rights. There are a couple of good discussions out there and I can link some once I am bit less tired. But fundamentally the argument is that in order to prevent serious harm (and millions of deaths clearly qualify), such measures can be justified, as long as certain limitations are in place (e.g. scientifically justified, time limited, non-discriminatory application, etc.)

Well, there is quite some truth to it, though the issue is that the politicians themselves are in many parts of the world propagating the issue. Moreover, there is political efforts to actively diminishing public health measures, as we have seen in the US for example. Well, they obviously do not see it that way. Many corporations are rather short-sighted when it comes to profits. Or perhaps they actually did the calculation and the current strategy is turning up a bigger profit. Who knows, but clearly public health is not at the forefront of these considerations. I think in the US the CDC is collecting data. The issue here is that each state has a different ways to count and report (and there is some evidence of suppression) so whatever ends up at the CDC can be hard to compare. This ranges from seemingly simple issues as dates, for example. Different dates could be used for regional reports, such as when the patient sample was taken, or when it was actually tested or when it was reported. Then we have different testing rules. In some areas everyone can get tested, others only test symptomatic folks. Some collect vaccination status of patients, others don't. I am not actually sure whether the NHS has similar challenges (did not think to ask that, though there are different data streams. I.e. for example the data set for clinical tests and the one for surveillance with volunteers. I do not think that they can be cross-referenced as participants and patients are anonymized. Canada has similar challenges with the different provincial health systems.

Except of course sometimes the morons are those in power and if they are allowed to throw democracy out of the window they can effectively neuter health responses. That is a fair point and I think that again goes toward the idea of centralized efforts rather than local or even business-led efforts.

Despite some struggles, there are some aspects where UK has deployed good ideas, especially in the surveillance area. Large-scale sequencing of patient samples as well as efforts to detect otherwise unidentified infections are some of the examples, which provides us with much better data than elsewhere. Also thanks for putting in the effort. We had a meeting with folks working on that end with the NHS and they were telling us that folks sometimes do not keep it up because the reporting system (especially in the beginning) was quite annoying to handle.

To summarize (and re-iterate) some general thoughts on this topic: - Surveillance and reporting has to be improved. We need a more pro-active and less reactive approach. This takes money, ongoing commitment and the development of and maintenance of expertise. Some measures, such as travel restrictions are really only helpful if surveillance can keep up. Otherwise measures will happen too late. - Health response and messaging must not be political. It has to follow the best available science. It should be communicated to the public (repeatedly, it seems) that recommendations are bound to change. However, more information sessions should be provided within smaller groups to explain some of the intricacies of the recommendations. More often than not, folks that are properly briefed have a better chance of reaching others in their sphere of influence who are misinformed. - Responses have to the funds for emergency measures, including beefing up ICUs, create isolation wards, beefing up staff etc. This is connected to the general health system which should be tested and improved for these situations. - If disaster hits, make it clear to the public that sacrifices are necessary to ensure safety. Engage and discuss reasons with the public as needed. - Create centralized response systems, which allows coordination on a national, ideally international level. - Assess weaknesses in supply chains and develop strategies to keep it moving if things have to be shut down. - Don't treat infectious diseases which have high potential of spread as a local challenge. Once a pandemic becomes likely, nations have to coordinate. This includes development and distribution of vaccines as well as expertise to localize and isolate infections. - We have to take the threat seriously before it happens. Successful containment responses (such as SARS) were often ridiculed as overblown. Folks have to learn that there is no such thing. Either it is successful, then it looks overblown, or it isn't, which leads to what we have now.

The issue is that nowadays there is big pressure on faculty to pass students to keep retainment high. If I applied the same criteria I did even a decade ago more than half the class would fail and that would create a lot of headaches. In the olden days when I was a student we typically had only about 20% of a given glass getting the degree (the rest would drop out or change their degree; in Germany there is a teaching track, for example). This would not be possible in the North American system. However, there are reasons for that. A big one is that feds and provincial/states have slashed support for universities. Thus, they are creating an environment where universities are supposed to run more like companies rather than educational institutes. This creates an incentive to basically have as many students as possible in their respective bracket. Failing students means losing money, so there is a conflict between faculty and administration over the balance between graduation rate and student quality. If you teach introductory classes most remains rather static. And while you can switch it up topic-wise in the 300 and upper classes, the pace in which you can introduce new stuff is mostly limited by the ability of students to absorb the info. I can almost guarantee that one of the most common questions in class nowadays is "is it going to be part of the exam". Especially during the online switch I found teaching more challenging than ever before. I think teaching can be intellectually rewarding, but I found it often not to be the case. There is a lot I could talk about student interactions, but I think the nature of it has changed over the years and I suppose we are not that well aligned anymore. With regard to work-life balance, in natural sciences you have the added workload of running a lab (or equivalent). Which means you are basically running a mini-company, where you have to have a steady influx of funding in order to pay for experiments, graduate students, postdocs and technicians. This is not only highly competitive, but also takes a lot of time. This is on top of the teaching and administrative (committee) work that you also have to do. During semesters with teaching (depending on the load) there is rarely any time to do "proper" research or grant writing, so time is very squeezed. It may be different in liberal arts disciplines where grad students often are not paid and therefore research funding is less of a constraint. Again, depends on the university (teaching colleges pay substantially less than 100k, for example, but then you could some of the courses with a MSc only). Research has a lot of what you would call procedural aspects to it. Especially as a prof you do not get to do the fun bits, your role is more coordinating and directing (and getting money in, and selling the research). I also think you are selling company work a bit short. It depends a lot on the role you have, the vast majority of the folks I started off doing a PhD ended up in companies and most have relatively diverse jobs to fulfil. It can be sales and directing new products, others develop new formulations for medication or vaccines, prototyping new products and so on. In all cases post-PhD level jobs tend to be more about coordination and management of projects and people, networking and doing the right pitches to the right people. Single-minded repetitive work is rather rare. Even folks that work in highly regulated jobs, such as quality control or product management tend to have more managerial duties. I.e. supervising the team that does the actual work. The only exception I can think of a industrial postdocs, which, for the most part (from what I have heard) are not a good place to be in. That all being said, there is a big variation of jobs out there and I suggest that you read up on experiences and reports regarding jobs of the various fields. From the OP it appears to me that you mostly have drawn your view about these jobs from a handful of individuals but the jobs in related fields are quite diverse and reading about these different experiences is likely to give you a more three-dimensional view regarding how the day-to-day actually looks like.

A pre-print from the UK https://khub.net/documents/135939561/430986542/Effectiveness+of+COVID-19+vaccines+against+Omicron+variant+of+concern.pdf/f423c9f4-91cb-0274-c8c5-70e8fad50074 suggests that the effectiveness of vaccines against symptomatic disease caused by omicron is further lowered compared to delta. For the AstraZeneca vaccine there was no protection after 15 weeks and for two-dose BioNTech vaccine the effectiveness to around 34-37% after 15 weeks. After booster the effectiveness increased to 75.5%. However, the case numbers were fairly low and they could not ascertain protection against severe disease outcomes.

I beg to differ. Or at least often it does not appear that way, especially with administration trying to pass everyone with a pulse. Other than that only in teaching universities, community colleges and similar institutions you do majority teaching (and often a ton of administrative work). Typically, the salary in these institutions is lower. In other universities in order to obtain tenure you have develop and maintain a successful research program, which basically means you need to be successful in getting external funding. These positions also require a PhD and more often than not also requires you to severely restrict your private life (i.e. having family time or getting enough sleep) at least until you get tenure. By then you are so screwed up, you just continue like that. Making a million a year is not possible by salary alone, most that are at least in striking range of that that level of income either run a successful business (e.g. consulting, medical practice, company) on the side. Salaries around 100k are realistic, but for instructors or community college teachers it is significantly lower. Teaching has also become decidedly less fun as especially during financially demanding times there is often a huge pressure on grades. And it is not a lot of fun if students are not interested in the topic, but are laser-focused on selecting courses that gives them the best grades with the least effort.

Or don't drink and drive. Too many still frame public health as personal risk mitigation and do not consider their impact on others.

As Swansont mentioned, there already mechanisms in place that restrict certain liberties (e.g. freedom of movement) in place. It is just that the local and/or federal governments are unwilling to implement them.