Human Rights in a pandemic

[zapatos]

41 minutes ago, CharonY said:

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.

Exactly. And in the case of the current pandemic my view is that we have not reached that point. In the US at least, if we cannot even get the states to quit fighting things like mask mandates then trying to mandate vaccines will be like tilting at windmills. We are so far from that point that even discussing it on a national level will likely lead to chaos.

For places where 'the public good' is more of a priority the conversation could at least take place, but if people are 'mostly' getting vaccinated and following mask and distance mandates I don't see where the government can claim to have reached that tipping point.

[CharonY]

1 hour ago, zapatos said:

Exactly. And in the case of the current pandemic my view is that we have not reached that point. In the US at least, if we cannot even get the states to quit fighting things like mask mandates then trying to mandate vaccines will be like tilting at windmills. We are so far from that point that even discussing it on a national level will likely lead to chaos.

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.

1 hour ago, zapatos said:

For places where 'the public good' is more of a priority the conversation could at least take place, but if people are 'mostly' getting vaccinated and following mask and distance mandates I don't see where the government can claim to have reached that tipping point.

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.

 

[zapatos]

8 hours ago, CharonY said:

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.

I think the starting point is always the science and the medical situation. Our goal should then be to achieve as much of that as possible. That being said, there will always be competing goals, and public health recommendations will tend to impact those other goals. One cannot simply ignore the other goals. Back in my early days of IT we were tasked with improving the efficiency of our mainframe response times. Our first suggestion, not actually made to anyone outside our group, was to kick off all the users from the system thus ensuring no wait times for data retrieval. My point being that all public health recommendations will interfere to some extent with other worthy goals.

8 hours ago, CharonY said:

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.

Do you feel we've reached that tipping point? That the situation is so dire that stronger measures, such as 'vaccine or forced confinement' are needed?

[mistermack]

When I originally posted about human rights, I was talking about right at the beginning of the NEXT pandemic, what have we learned, and what should we do differently. 

Experience is now teaching us that a contagious virus will evolve to me more contagious, as the pandemic progresses. So that what seems to be a manageable situation at the start, can get worse and worse. 

The best chance of stopping it is right at the beginning, before it mutates, and before it spreads more widely. If the Chinese had descended on every outbreak in numbers, enforcing a strict lockdown for 3 weeks wherever an outbreak happened, the virus would now be extinct. There is no doubt about that whatsoever. Locking down worked very well, at the beginning. 

In the UK, we got infection numbers down from 5,000 a day to 400, before they eased off the lockdown. And that was a pretty mild lockdown, no locking people in or stretching human rights. So it's an absoulte fact that if a truly rigorous lockdown routine had been followed when the virus had firs been detected, it would no longer exist, and the cost would just have been a bit of inconvenience to a few thousand people, for a few weeks. 

It's really a no-brainer. You kill it at the outset, and argue about the ethics later. A stitch in time saves millions. 

[dimreepr]

24 minutes ago, zapatos said:

Do you feel we've reached that tipping point? That the situation is so dire that stronger measures, such as 'vaccine or forced confinement' are needed?

We can never know when we cross the event horizon, but we can wear a seat belt.

With such strong push-back against sensible measures, such as mask wearing and vaccination, I think the tipping point is in our rear view mirror.

Fundamentally, human rights in a pandemic is no different to any other time; we're not allowed to kill, through action or inaction.

If that requires a stick, then so be it; even if we'd all prefer a carrot.

 

 

17 minutes ago, mistermack said:

It's really a no-brainer. You kill it at the outset, and argue about the ethics later. A stitch in time saves millions.

Evolution won't let you do that...

 

[zapatos]

24 minutes ago, mistermack said:

So it's an absoulte fact that if a truly rigorous lockdown routine had been followed when the virus had firs been detected, it would no longer exist, and the cost would just have been a bit of inconvenience to a few thousand people, for a few weeks. 

Huh. I didn't know that was an absolute fact. Good to know.

23 minutes ago, dimreepr said:

If that requires a stick, then so be it; even if we'd all prefer a carrot.

 

So what specifically are you suggesting?

[dimreepr]

17 minutes ago, zapatos said:

So what specifically are you suggesting?

We look for a benevolent dictator as suggested by Socrates, failing that we hope for the best and try not too kill anyone.

[zapatos]

50 minutes ago, dimreepr said:

We look for a benevolent dictator as suggested by Socrates, failing that we hope for the best and try not too kill anyone.

Thanks for being specific.

[CharonY]

2 hours ago, mistermack said:

If the Chinese had descended on every outbreak in numbers, enforcing a strict lockdown for 3 weeks wherever an outbreak happened, the virus would now be extinct. There is no doubt about that whatsoever. Locking down worked very well, at the beginning. 

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.

3 hours ago, zapatos said:

Do you feel we've reached that tipping point? That the situation is so dire that stronger measures, such as 'vaccine or forced confinement' are needed

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. 

 

[TheVat]

17 hours ago, zapatos said:

Or not. People make the decision every day to do things that are not good for their health.

Are you again purposely misunderstanding to make a point? Body autonomy does NOT "require the cooperation of others".

Full disclosure:  have not read the posts following this one, so sorry if any redundancy.

I understand body autonomy.  My point (perhaps clumsily expressed) was that you are missing a full definition of that self-determination if you do not include the free choice to avoid situations that may infect you with a dangerous virus.  Those with great wealth, or telecommuters, or retirees, can do that.  But those who MUST work and who may face firing if they don't show up (and other potential consequences like eviction), cannot make the free choice to avoid the virus if their job forces them into contact with mask scoffers, anti-vaxxers, et al.   For whatever their reasons, they feel they must assume the risk, and they are given no choice as to who may violate their personal space with contagion.  And many of those front-liners (surprise!) also started out with greater health vulnerabilities to begin with.  

From what I witnessed the past almost two years, it seemed to me that society placed a differential value on the bodies of the poor and the bodies of the affluent, insofar as the covid virus was concerned (and, for sure, in other respects too for a long time).   So, yes, body autonomy (in terms of how one chooses healthy environments) proved to be something of a luxury item.  I'm not saying some of them possibly didn't freely make bad choices of diet, smoking, whatever, but they were forced into a situation of no real choice as regards the covid virus.   I hope this clarifies a bit.  I don't expect agreement, but I do like to be intelligible to others.  🙂

 

[mistermack]

I believe that the horse has already bolted, with covid-19, because it is now so incredibly contagious. But it wasn't originally. Lock downs had a dramatic effect originally, but they didn't persist with them, they just locked down till cases dropped, and then they took the foot off the brake. That's no longer an option with omicron. Your average lock down will hardly affect it. 

But for the NEXT pandemic, given what we now know, it should be easy to nip it in the bud. Unless it is immediately very highly contagious, right from the word go, which is possible but not very likely.

The thing with human rights is that they don't actually exist, unless we make them. They only exist in our heads, and as such, they can be anything we decide, as a society. 

I'm in favour of keeping them high, but certainly, they don't come before lives and health. They are a compromise, just like all other laws. 

[CharonY]

1 hour ago, mistermack said:

I believe that the horse has already bolted, with covid-19, because it is now so incredibly contagious. But it wasn't originally. Lock downs had a dramatic effect originally, but they didn't persist with them, they just locked down till cases dropped, and then they took the foot off the brake. That's no longer an option with omicron. Your average lock down will hardly affect it. 

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.

[mistermack]

1 hour ago, CharonY said:

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.

I can remember quite clearly when it was starting to spread in China, it was known just how serious it was. ( Remember that at the start, the death rate was over five percent of cases, so it was really regarded as a real threat ). Very shortly after that, it popped up in Korea, and Italy. But at the time, lockdown was really effective, even though the lockdowns were very sloppy. 

China cleared the virus, and was just getting about five to ten cases a day from returning travellers. If Korea and Italy, and any other countries that got cases locked down the affected area, as soon as a case was notified, they could easily have eradicated it in each new outbreak. 

Time after time, countries have underestimated the threat, and overestimated the negative effects of lockdown. After all, if they HAD eradicated it, with drastic lockdowns, the world would be far better off now. We are all paying the price of a failure to bite the bullet.

[CharonY]

18 minutes ago, mistermack said:

I can remember quite clearly when it was starting to spread in China, it was known just how serious it was. ( Remember that at the start, the death rate was over five percent of cases, so it was really regarded as a real threat ). Very shortly after that, it popped up in Korea, and Italy. But at the time, lockdown was really effective, even though the lockdowns were very sloppy. 

The timeline is a bit inaccurate- it was detected later on in Korea and Italy, but retrospective studies (i.e. looking back in time to check for evidence of infections) indicate that it was circulating already before the first cases were detected. In fact, the high fatality rate is likely associated with significant underestimate of ongoing cases (i.e. many positive cases were simply not detected, especially in the early months of the pandemic).

You are correct that if other countries had followed a zero-COVID strategy going forward (as e.g. New Zealand), it might have burned out, or at least kept levels low enough that vaccines might have eradicated it. My point was that single-point lockdown at least for this pandemic, would not have worked. It would needed to be a more global effort.

And if the a next major outbreak has similar characteristics (i.e. positive cases are not easily spotted before transmission happens) it is unlikely, regardless of country in which it happens, that we are able to detect it in time to lock down before it gets out of the country.

In other words, we also need better surveillance measures to make public health measures to be effective.

[mistermack]

1 minute ago, CharonY said:

My point that single-point lockdown at least for this pandemic, would not have worked. It would needed to be a more global effort.

Only because the lockdowns were not real lockdowns. It worked in China, and that's one fifth of the globe right there. And even in China, the lockdowns were a bit leaky, but as I said earlier, they eradicated it apart from returns. What China couldn't control was it's borders, they really needed some kind of wall. 

[CharonY]

12 minutes ago, mistermack said:

Only because the lockdowns were not real lockdowns. It worked in China, and that's one fifth of the globe right there. And even in China, the lockdowns were a bit leaky, but as I said earlier, they eradicated it apart from returns. What China couldn't control was it's borders, they really needed some kind of wall. 

No, you are misunderstand what I am referring to. With single-point lockdown I meant China in your original assertion:

6 hours ago, mistermack said:

The best chance of stopping it is right at the beginning, before it mutates, and before it spreads more widely. If the Chinese had descended on every outbreak in numbers, enforcing a strict lockdown for 3 weeks wherever an outbreak happened, the virus would now be extinct.

While it would be true that an early lockdown could have worked, it is often not feasible to react in time. For new diseases it takes time to realize that a) it is a new disease (China extended the timeline here because of suppression) and b) identify the agent (that was done rather quick though) and c) develop methods to diagnose them.

Once we are at step c) in the modern world the disease likely has already crossed borders. The only ways would be either a better method for new disease detection or to lockdown at even the suspicion of an outbreak. The latter would unlikely to be practical.

Perhaps to add a timeline to it, antibody tests have indicated that individual cases might have been in Italy as early as September 2019 (See Apolone et al. https://doi.org/10.1177%2F0300891620974755). 

SARS-CoV-2 was only identified Jan 2020 and the very first indication of clusters in China which were suppressed where also around September. Based on what we know about the original variant, it is likely that it was circulating earlier than that, before it created these clusters, but basically invisibly. While China had a reporting system, it was designed for SARS, so when folks tested negative, it stayed invisible. And again, I think the identification part is where we need to spend a lot of effort on. Otherwise, even if we close the doors really firmly, it will always be after some cows have already escaped the barn.

[Doogles31731]

I can make a case to show that ‘freedom’ in a democracy is “the right to have an equal say with everyone else about the rules, at Local, State (County?) or National levels, that govern your behaviour in your culture.”  

Obviously we can’t have a referendum on every minor issue, but we all get one vote to elect a representative who will have a say on our behalf on the framing of the laws and Acts that govern what we can or cannot do at every level of our lives.

These bylaws and Acts of Parliament come into force if the majority of our reps vote for them, and by definition in a democracy, we accept the will of the majority whether we like it at individual level or not.

Now every State (in the generic sense) has Health Acts which empower Health Departments to establish Regulations on all health matters. And there are penalties mentioned in these Acts if people flaunt the Regulations. We all know that a percentage of our kind tend to flaunt many Laws and Regulations, so we naturally have to have Law Enforcement Bodies. Prosecutions in such cases are justified to my mind.

A corollary of ‘one person, one vote’ in democracies is that we also have ‘free speech’, so we can always resort to eloquence of argument if we believe some Laws can be changed or improved and we can always vote for different reps at the next election.

On the matter of quarantine preventing the poor from working, Australia and a couple of other Nations provided a ‘Job Keeper’ allowance for people so affected. That seemed sensible to me and it worked very well here.

[MSC]

So I saw a few comments I wanted to address; @dimreepr regarding the "benevolent" dictator, is there a specific historical example that you can think of that was definitely benevolent when they became dictator, and stayed that way? 

Conflicts between rights, like the right to good health and the right to freedom of movement have often been settled by the fact that all of our claims to rights, rely on the right to life and good health. There are moral grounds for medical professionals to subject people to medical treatments against their will. Conservatorship and stewarding for the mentally ill. I imagine there are probably many refusing vaccines who could be suffering from an environmentally caused form of panic disorder. If you are unconscious with a life threatening injury and next of kin cannot be found, chances are they will treat you up to and including life saving surgery. Without asking your permission, but assuming it. Only reason they would not, is if you had an official DNR order. 

I'm a little surprised the precedent for human rights in a pandemic has not been brought up. During the Spanish flu (H1N1 type a) of 1918, refusing to wear a mask in public, straight up got you arrested, in the USA at least. Can you imagine what they would have done with people refusing a vaccine for that, if they had one at the time?

As it stands, 50,000,000+ worldwide died during the Spanish Flu. 5,000,000+ have currently died of covid, vs 50,000,000 whom have contracted it. 

The death toll of the Spanish flu in the USA, is around 200k lower than the current covid death toll. Now, the population of the USA has grown around 3 times as much, so by rate, the spanish flu killed a higher percentage of the population, yet the population at the time also lacked the potential to reach the sort of numbers we could see soon with the right mutations of the coronavirus with a far higher population. 

For me, it ultimately comes down to this, I can self isolate, get a vaccine, wear a mask, and can temporarily give up my freedom for the common good of all, a number of times in my life, but I can only die once. With death, the only thing I have close to rights then, is last rites. It's the end of freedom, health, marriage, owning a business and watching my daughter grow up. So people nutting up, vaxxing up and shutting up would be great. Or maybe we can just declare all the antivaxers mentally ill and just give them the vaccine whether they want it or not. Hey, it amounts to self harm if we just let them go out and get covid, plus biological assault of others. I think in some places, even pre-pandemic, you could get charged with assault for sneezing on someone. Especially if it is maliciously done, like spitting on someone. 

It's weird, even though nobody is eating each other, this stuff feels like a zombie apocalypse, the antivax crowd are pretty brainless. 

 

[Meganthompson8]

I believe that sometimes the authorities need to be tough with society. and society needs to reconcile, be patient and understand the whole situation. If you don't want to obey the rules, why would you choose authority?

[zapatos]

1 minute ago, Meganthompson8 said:

If you don't want to obey the rules, why would you choose authority?

Sorry, I'm not clear what you mean by this. Can you elaborate please?

[Meganthompson8]

3 minutes ago, zapatos said:

Извините, я не понимаю, что вы хотите сказать. Можете ли вы уточнить, пожалуйста?

I believe that there are situations where you need to silently obey the rules. especially during a pandemic.

Edited February 23, 2022 by Meganthompson8

[zapatos]

30 minutes ago, Meganthompson8 said:

I believe that there are situations where you need to silently obey the rules. especially during a pandemic.

Even if you believe the rules to be wrong? Certainly we have enough examples of governments imposing rules that were not good for the people the rules applied to.

[Phi for All]

26 minutes ago, Meganthompson8 said:

I believe that there are situations where you need to silently obey the rules. especially during a pandemic.

Or celebrate them loudly with a smile because you're doing your part to keep your society safe. Aren't we all glad there are laws that prevent people from urinating in the streets? Aren't there situations where the government "being tough with society" is exactly why we have government in the first place?

I think the mistake is in thinking mandatory masking or isolating is the government being "tough". In this case, enforcement of laws should be considered a neutral or null state. If the police give you a ticket for going over the speed limit, are they being "tough on society"?