The Tribune

“Be a patriot, protect other people.”

US President Joe Biden

A recent article in The Atlantic observed: “When the polio vaccine was declared safe and effective, the news was met with jubilant celebration… ‘Polio routed!’ newspaper headlines exclaimed. ‘An historic victory,’ ‘monumental,’ ‘sensational,’ newscasters declared...

“One might have expected the initial approval of the coronavirus vaccines to spark similar jubilation – especially after a brutal pandemic year. But that didn’t happen. Instead, the steady drumbeat of good news about the vaccines has been met with a chorus of relentless pessimism.”

We are living in a different age. Among other factors, back then more people experienced and saw the ravages of polio firsthand. Today, there is relentless negativity by some, including those drunk with anger and personal grievances.

Social media and at times poor reportage has either spread or insufficiently addressed fabrications, conspiracies, disinformation and misinformation, which has often spread at the same rate of COVID-19, including all manner of reckless and specious commentary.

Reasonable and judicious questions concerning the virus and vaccines are critical. But there is also a widespread global and domestic dissemination of anti-intellectual, anti-scientific and superstitious memes impervious to treatment or vaccines.

Responding to anti-vaxxers and the 49 percent of men in the United States who identify as Republicans and who say they do not plan to take a COVID-19 vaccination, President Joe Biden responded with a clear and passionate moral call: “Be a patriot, protect other people!”

In a letter to Roman Catholics, Archbishop Patrick Pinder lent his moral voice in the promotion of COVID-19 vaccinations: “This is to protect the health of the recipient, the health of all those with whom the recipient comes into contact and especially to protect the most vulnerable for whom infection with this virus could mean serious illness, hospitalisation or worse.

“In this regard, receiving the vaccine promotes the common good by protecting an individual’s health, promoting public health and saving lives.”

Gambling

Pope Francis has referred to a vaccination as “an ethical action, because you are gambling with your health, you are gambling with your life, but you are also gambling with the lives of others”. Francis understands that taking a vaccine is a civic duty and the morally best thing to do.

Bishop Neil Ellis has also lent his powerful public voice in the call for Bahamians to receive the life-saving vaccine. Experts are assessing the degree to which various vaccines slow transmission to others. Being vaccinated is a form of enlightened patriotism.

A vaccination is not mandatory. In the end it is a personal choice. But the choice not to take a vaccine can affect others. Not taking a vaccine is a moral choice. We are human beings, not unfeeling automatons who should be indifferent to the needs of others.

The story of Mary Mallon is instructive. Nicknamed “Typhoid Mary” a century ago by the press of the day, Mallon was an asymptomatic typhoid carrier who infected between 51 to 122 people while working as a cook. Medical professionals advised Mallon to remove her gallbladder, which was the infection centre in her body.

Mallon could not understand how her gallbladder could be a danger to her or anyone else as she herself was asymptomatic and not visibly ill. She refused the surgery and spent the next 23 years of her life on North Brother Island, New York, where she was quarantined. By refusing the surgery she was a health risk to others.

A diagnosis of cancer and the decision to forgo various treatments is a very personal choice. But to refuse a vaccine or to wear a mask during a raging pandemic is a different sort of moral choice. In a public health emergency, our individual choices affect others.

One medical expert posed the emergency in this fashion. If a country was being invaded, some people coming out to fight the enemy with their individual guns is not the same as a country mounting a collective response with all of the armaments at its disposal designed to save and to protect the collective good.

During the pandemic the majority of Bahamians have followed the public health measures. It is quite likely the majority will also take a vaccine. But for herd immunity we need as many people as possible to be vaccinated.

The COVID-19 pandemic has posed a series of ethical choices for individuals, societies and governments.

The virus can neither be fought successfully by individuals nor countries in isolation. COVID-19 greedily and malevolently exploits selfishness and self-absorption on the part of individuals, countries and blocs, which refuse to cooperate.

The virus is not intimidated by nationalism and isolationism by countries, including those who may now be hoarding vaccines as variants jump borders causing more death and suffering.

Alarming

The vaccine battles in Europe, pitting the European Union against the United Kingdom, including the availability and safety of various vaccines, is alarming. The battles appear more political than medical.

Even as the United Kingdom is successfully rolling out the Oxford-AstraZeneca vaccine, some EU Member States, including France, Germany, Italy and Spain have been slow to vaccinate, appear to be undermining the UK-designed vaccine and are headed back to quite restrictive lockdowns because of variants.

Meanwhile, both Europe and the United States appear to be hoarding vaccines. According to the UK Guardian: “The American government has now bought enough doses of vaccines from Moderna, Pfizer and Johnson & Johnson to vaccinate 500 million people – nearly the entire eligible population twice over.”

Even as there is a glut of vaccines in the developed world, many developing countries, including The Bahamas, are still struggling to get vaccines to reduce illness, suffering and death, including in much of Africa, where many countries are having extraordinary difficulties acquiring vaccines.

Post-pandemic, the African Union should collaborate with India and China to set up biomedical and vaccine manufacturing facilities for the continent, so that Africa no longer has to rely on Europe or the US in such emergencies.

Ethically, many developed countries have proved selfish in sharing vaccines, even as China and India, both with populations of over a billion, are selling and sharing vaccines with developing countries.

In a current interview on BBC, Cyrus Poonawalla, Chairman and Managing Director of the Serum Institute of India, noted that the Institute intended to manufacture one billion COVID-19 vaccines by the end of the year.

He indicated that while India was quickly ramping up domestic vaccinations, the subcontinent had an ethical duty to simultaneously assist other countries. He also declared that it is in India’s self-interest to help other countries, with whom it wants to resume economic activity and trade as quickly as possible.

Self-Absorbed

China and India are gaining friends by sharing vaccines, while the European Union and the United States are looking isolated, self-absorbed and inequitable. An international common good includes caring for one’s own while also being concerned about the needs of other countries, including out of enlightened self-interest.

With pending approval of emergency authorization of the AstraZeneca and Novavax vaccines in the US - which are in addition to the already approved Pfizer, Moderna and Johnson & Johnson vaccines - America will have many hundreds of millions of vaccines, beyond what the country can deploy domestically.

The world continues to be a Petri dish or bowl for the virus. The pandemic only ends when it ends for the world. In places where the virus is out of control variants will continue to emerge, posing a threat to the entire global commons.

Just as there are ethical dimensions for state actors, our personal decisions have moral dimensions.

While one is free to smoke cigarettes and drink and eat to excess, such personal choices affect public health systems, which is why countries often impose so-called sin taxes on cigarettes, alcohol and sugar in order to pay for the cost of these behaviours to public health.

In medical and bioethics, autonomy is an important principle. “Autonomy is Latin for ‘self-rule’. We have an obligation to respect the autonomy of other[s], which is to respect the decisions made by other people concerning their own lives.”

But there is a constellation of principles when making choices such as whether to take the COVID-19 vaccine. There is the principle of beneficence: “We have an obligation to bring about good in all our actions”, though “this corollary principle frequently places us in direct conflict with respecting the autonomy of others.”

There is also the principle of non-malefience, the obligation not to harm others or “First do no harm”. We should seek to minimize harm to others through our decisions and certainly not to increase harm.

With the principle of justice, “we have an obligation to provide others with whatever they are owed or deserve... We have an obligation to treat all people equally, fairly and impartially.”

It is under this principle that the government is committed to equity in the distribution of the vaccine.

The Atlantic piece also observed of the rollout of vaccines: “There is nothing wrong with realism and caution, but effective communication requires a sense of proportion – distinguishing between due alarm and alarmism; warranted, measured caution and doombait; worst-case scenarios and claims of impending catastrophe…

“However, instead of balanced optimism since the launch of the vaccines, the public has been offered a lot of misguided fretting over new virus variants, subjected to misleading debates about the inferiority of certain vaccines… while media outlets wonder whether the pandemic will ever end.”

Sadly some, including some media figures, have been bent on the regurgitation of boring clichés, certain obsessions and unfettered arrogance, endless negativity and snide and snarky comments such as, “It’s about time the vaccine got here!”

But such narrowness, pettiness and immaturity by some stand in dramatic contrast to health care heroes like Nurse Ruth Bastian, who received the first vaccine last Sunday.

Nurse Bastian, a public health care nurse for many decades, is a woman of tremendous humility who has given stellar service to the public health system. She possesses an incandescent spirit, which is an example to us all and worthy of gratitude and high praise.