Chapter Eight: Reopening

Frances Kamm (6 July 2020), “Moral Reasoning in a Pandemic” The Boston Review
Kamm considers arguments that ‘aggregate’ the lives lost from economic closures and those lost from COVID-19. Kamm suggests that this is not the best way to consider the issue and she instead proposes that we give priority to the worse off using “pairwise comparison.” Kamm also argues that wearing a mask is a matter of respect, and that failing to do so is disrespectful.

Ezra Klein (10 April 2020), “I’ve read the plans to reopen the economy. They’re scary,” Vox
Klein surveys and compares four plans for reopening the economy, from “the right-leaning American Enterprise Institute, the left-leaning Center for American Progress, Harvard University’s Safra Center for Ethics, and Nobel Prize-winning economist Paul Romer.” Klein finds each of these reopening plans to be worrisome.

Ridley Cooper (30 May 2020), “When Freedom Kills,” Medium [blog]
Does the debate about when to reopen economies pit those who value freedom against those who value safety? Cooper does not believe this is the correct way to frame the issue. Cooper thinks that it would be better to focus on “the consequences of restricting specific actions of people in a certain location at a certain time.” Moving away from inflammatory rhetoric about freedom allows us to do the hard work of looking at the data to study the consequences of various decisions.

Billy Binion (15 May 2020), “The Reopen Debate Is a False Dichotomy,” Reason
Binion argues that there is a middle ground between remaining in a complete economic slowdown and totally reopening economies and societies. Binion believes we should attend to the harms of the slowdowns, which include not merely economic woes but social and health costs as well.

Uri Alon, et al. (11 May 2020), “10-4: How to Reopen the Economy by Exploiting the Coronavirus’s Weak Spot,” The New York Times
In “A Harm Reduction Approach to Physical Distancing” (reading 8.3 of The Ethics of Pandemics), Daniel Weinstock recommends rethinking our use of time and space. Alon et al. provide one example of what this might look like. They note that a key feature of SARS-CoV-2 is its latent period, or “the three-day delay on average between the time a person is infected and the time he or she can infect others.” In light of this feature, we could conceivably allow people to work in two week-cycles: on the job for four days and then home for ten days. This would reduce the number of people circulating and also reduce the number of contacts an infected person might have.

Vaccination

Maxwell J Smith, Samuel Ujewe, Rachel Katz, and Ross E G Upshur (5 November 2020), “Emergency use authorisation for COVID-19 vaccines: lessons from Ebola,” The Lancet
Smith et al. consider the unique ethical issues raised by potential emergency use authorisations (EAUs) for COVID-19 vaccines, comparing our current situation to that of EAUs issued in the Ebola outbreak. They suggest that there are differences in transparency and vaccine nationalism that mark the two situations.

Nicole Hassoun (10 November 2020), “Buying a coronavirus vaccine for everyone on Earth, storing and shipping it, and giving it safely will all be hard and expensive,” The Conversation
Hassoun describes some of the practical challenges involved in rolling out a novel vaccine globally. She describes some current initiatives and their limitations.

Alberto Giubilini, Julian Savulescu, Dominic Wilkinson (11 November 2020), “Pandemic Ethics: Vaccine distribution ethics: monotheism or polytheism?,” Practical Ethics
Once an effective vaccine for COVID-19 has been approved for emergency or general use, the task of distributing the vaccine will be monumental. Giubilini et al. note that vaccine implementation will likely involve two phases, one in which there are more people wanting vaccination than there are available doses, and the other in which there are more doses than people requesting vaccination. Giubilini et al. focus on the first phase, which involves important moral questions about how to prioritize access.

Kwame Anthony Appiah (29 December 2020) “I Might Be Able to Jump the Vaccine Line. Should I?” The New York Times.
In this article, Appiah responds to questions from readers regarding ethical issues relating to vaccination. One reader wonders whether they should take advantage of an opportunity to circumvent their states’ vaccination priority guidelines in order to get vaccinated early. A second reader wonders about the ethics of catering for large gatherings.

Michael A. DeVita and Lisa S. Parker (26 January 2021) “Ethics Supports Seeking Population Immunity, Not Immunizing Priority Groups,” The Hastings Center Bioethics Forums.
Many vaccine distribution plans prioritize giving vaccines to those who are vulnerable to serious illness (the elderly and those with comorbidities) or those who are most likely to contract the virus (health care professionals and essential workers). DeVita and Parker argue that this targeted method of prioritization is inefficient and results in wasted vaccines. They argue that broader and quicker vaccine distribution will save more lives.

Ezekiel J. Emanuel, et al., (11 September 2020) “An Ethical Framework for Global Vaccine Allocation,” Science.
Emanuel and colleagues argue in favour of a Fair Priority model for global vaccine distribution. The Fair Priority model holds that “reasonable national partiality does not permit retaining more vaccine than the amount needed to keep the rate of transmission (Rt) below 1, when that vaccine could instead mitigate substantial COVID-19–related harms in other countries that have been unable to keep Rt below 1 through ongoing public-health efforts.” This model discourages vaccine nationalism while allowing some national prioritization. It aims to limit harm, prioritize the disadvantaged, and demonstrate equal moral concern.