Not all popular policies are good policies. Prohibition (1920-1933), one of the most visible public policy failures in modern history, was wildly popular. There are lessons here.
Like vaccines mandates, Prohibition was rooted in the desire to achieve a positive social end, one its proponents felt couldn’t be achieved without legal coercion. It was widely supported by “the science.” The goal of Prohibition was not to reduce drinking, per se. Its goal was to reduce problems deemed to be caused by drinking—crime, poverty, domestic violence, etc. It was here where Prohibition failed so spectacularly; it exacerbated many of the ills it had hoped, not just to mitigate, but to cure.
Where Prohibitionists differed from our current crop of “Mandaters,” was in their consideration of unintended consequences. Prohibitionists knew that Prohibition would have a huge impact on federal revenues, a large portion of which came from excise taxes on alcohol. To address this concern, they first campaigned to pass the 16th amendment, which allowed for a federal income tax. History tells us there were many more unintended consequences they missed, but they did make some effort.
The unintended consequences of vaccine mandates, which seek to exclude tens of millions of people from society, don’t appear to have been considered at all. What are the costs of forcing people out of their jobs—especially at a time when we have a labor shortage? What are the costs of firing doctors and nurses as we go into another COVID season, of firing police officers when the murder rate is increasing at the fastest rate in our history? What are the costs of excluding large swaths of the population from restaurants and other entertainment venues? Are those costs exacerbated when they are borne disproportionately by minorities, who are vaccinated at lower levels than their white counterparts in every state in the U.S.—especially here in Massachusetts? The state of our current “debate” means that these questions, and many more are simply not being asked.
More troubling is that if enacted these mandates are unlikely to have any impact at all on the goal they seek to achieve—stopping coronavirus transmission. The CDC exploited regional differences in seasonality to demonize “the unvaccinated,” and claim that high vaccination rates would eliminate the disease. It was true in the summer—the south’s main “COVID season”—less vaccinated states like Alabama, Georgia and Florida had higher case rates than highly vaccinated states like Massachusetts.
But now that our “season” is approaching, that has flipped. We now have a significantly higher case rate than all three of those states. More rigorous analysis finds that higher vaccination rates do not reduce cases—they may slightly increase them—according to a recent study of 68 countries and ~3000 counties. We see this in real-world data, too. Here in Massachusetts, our cases are currently more than 2-fold higher than the same time last year. In England, infection rates are higher in vaccinated than unvaccinated groups in all age groups over 30. Testing protocols that exempt vaccinated people from testing, mean that both of these numbers are likely understated.
We can argue the degree to which vaccination rates reduce infection—the available data in the U.S. is atrocious. But it can no longer be claimed that they will eliminate the disease. In Iceland for example, which has more than 80% of its population vaccinated, cases are surging.
In colleges around the country, with close to 100% vaccination rates, cases are higher this year than last—at Cornell, cases are 5x higher than last year at the same time. This is despite continued indoor masking, weekly testing, and restrictions on socializing and travel.
Additionally, we do have experience with other non-sterilizing vaccines (vaccines that don’t stop infection), and in no case has a disease been eradicated with such a vaccine. The chickenpox vaccine is a non-sterilizing vaccine. Our vaccination rate for chicken pox is more than 90%. Despite this, chicken pox still circulates widely. For this reason, many countries, including the U.K. do not vaccinate widely for chicken pox, focusing vaccines instead only on high-risk populations.
A mandate this draconian can surely only be considered where there is unequivocal public benefit. That bar has not been met here—not even close. In an evolution typical of our new upside-down world, vaccinated people who are protected from COVID-19 by virtue of their vaccines, are now being told they need to be protected from unvaccinated people. That there is copious data available to refute this statement is unimportant. The goal is not to provide useful public health advice. The goal is to stoke fear and resentment until it reaches a pitch of righteous indignation.
Occasionally we hear that even if vaccination doesn’t reduce cases, we still need to force people to be vaccinated to avoid hospitals being overwhelmed. This is another red herring. Our hospitals were not even close to being overwhelmed during last year’s winter wave without a vaccine. During our winter peak, COVID patients occupied fewer than 13% of all beds—and staffed beds were reduced by 11%–not exactly an action you would take if you were feeling overwhelmed. Our ICU’s were so “overwhelmed,” they felt the need to reduce staffed beds by 30%.
We will likely have a significant winter COVID surge—that should be the lesson of the summer—that even with high levels of vaccinations among vulnerable populations, cases, hospitalizations and deaths can still surge. We are already seeing this in Europe. We should be preparing for this, not pretending it won’t happen due to our state’s high vaccination levels.
1 comment:
Prohibit oxygen and the masses will be putty in your hands.
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