There are plenty of facts and non-facts spreading around
about COVID-19 and its vaccines. There are also plenty of conspiracy theories
used to support arguments against getting the vaccine, and then there is the
politics which never adds any intelligence, value, or benefit to an issue. So,
it should be of no surprise that no one thinks about what the consequences of
various decisions, actions, and beliefs will be. I may be being a tad hard on
the healthcare professionals in so far as they are being inundated with the
reality of COVID and confronting the immediate crises, the changing conditions,
and try and anticipate what needs to be done next. So, that they may not be
looking at or thinking about some tangential aspects of the situation might be
expected.
But not everyone involved is a healthcare professional. Not
everyone is wholly occupied in carrying out COVID related tasks critical to
handling or managing issues related to its transmission, or in executing the
vaccination programs. There are some people who are engaged in conceiving how
to get the public to want to or agree to getting vaccinated. Then there are the
politicians. Some politicians spend some time doing the “get vaccinated”
promotions. Some politicians try and walk the line between being an advocate versus
an opponent. And some politicians are aligning with a denial mentality of the
dangers, risks, and consequences of any effort which does not serve their political
interests. So, you want to be wary of a healthcare decision based upon a
political mind-set.
As easy as the obvious questions are:
- Get vaccinated or not?
- Wear a mast or not?
- Wash your hands or not?
- Socially distance or not?
There are some facets to the COVID-19 pandemic which are
worthy of some contemplation from a broader and more nuanced consideration of implications
and consequences that the virus will or might produce. There are some facets that are
self-identifying. Take the segment of the Republican party that is effectively
an anti-vaccination sub-culture or the white evangelical groups that reject
COVID vaccinations (Note: there is a likely high correlation within these two
groups.) Let’s call this group: Republican Evangelical Deniers of Science
(REDS). Are there any implications to the REDS anti-vaccination stance decision
to that constituency? Are the consequences to the REDS population different
than the consequences to other population segments?
Assessing what consequences there may be depends upon what
we know about the REDS target-group that is also different from the rest of the
population. Are the REDS a younger, average, or older age group? If REDS are an
older group than there is an implication that goes with the age factor. If they
get infected with the COVID virus they are more likely to experience more
severe outcomes including the one that they hope leads to a journey upwards rather
than downwards. So, one implication should be quite simple, it’s just numeric. I
suppose the here-after may be worth the risk, but then that’s guaranteed to
happen eventually; and it comes at the cost of diminishing what can be done in
the here-and-now. It’s giving away something for nothing. That is not to say
that there are not some positives, just not for you. Most people probably can’t
figure out the positives but if you know someone who has any experience in doing
business cases, they can probably provide some insights.
What about the non-dying implications? Well, because COVID is a test, a test
from God as the creator of all things, there are consequences to the decisions
that everyone makes on this test just like on every other one. Some people
don’t die but they also don’t exactly recover. If you decided to not get
vaccinated, it’s like a long-lasting reminder that you may have failed the test.
But that is just for starters. You also may get to the opportunity to pay more
for your medical expenses. You may not be able to do some of the things that
you use to do just a little while ago. These implications are more of the
personal/individual ones. But remember we are discussing a sub-group of the
population. This means that there are implications that come from the
aggregation of the individual consequences.
That
aggregation can come in many flavors or layers. There is the family group(s),
the community group(s) both religious and civic, the political group(s) local,
state, national, and party; and of course, there is the American group (all of
us in total). With each decision by every individual the small consequences
combine along one or more of these layers. When some of the consequences become
large enough in aggregate, they produce their own consequences. This is where
things get interesting and important[TB1] .
This is where tipping point events can happen without anyone see them coming or
ever tracing back their source back to small decisions made by many individuals.
It’s why the mountain range that once was is now a beach of fine sand.
Now the
REDS are just one of the aggregations and even they come in multiple layers;
but there are others who can contribute to their own tipping points or merge together
where there is a commonality of consequences. The mountain does not just fall
to the rain, but the wind can bring it down also.
What
might be some of the consequences from these small individual decisions? Look
for aggregation points.
COVID has
a mortality rate and that rate differs along several factors. That means that
it aggregates along those factors differently. If the REDS as a group also coincide
with one or more of those factors than the potential for disproportionate
outcomes emerge, and even tipping points can occur. As a population REDS are
older on average than the rest of the nation. These two factors: age and
political-religious sect alignment have potential to create differential
outcomes if the decision to get vaccinated or to not get vaccinated produces a
differential COVID death rate for those vaccinated or not. The same aggregation
has implications which can extend to the non-fatal consequences that derive
from being in groups that get vaccinated or not.
All this would seem to be an: “Oh well, that may all be true but it only
affects those who die or are impaired, and don’t impact the majority of the
group who don’t.” Unless the implications have implications. If your political-religious
sect aligned group loses more than other groups, then the aggregate political
influence is diminished. If the diminution is just large enough you get a tipping
point.
Not all
the consequences are by default negative, there can also be beneficial
consequences. These consequences may not be to the particular sub-group that
experiences the negative outcomes but to other sub-groups or to the larger
population. The increased deaths among the older population that COVID has
produced and will continue to produce will result in consequences that are
positive in their impacts. For example, if the average lifespan is the US is temporarily
reduced and concentrated at the higher age ranges then costs associated with
that age group is reduced. It is not a benefit that the population would approve
of given the cost in lives and human impacts, but it occurs irrespective of
what would be desired.
What
other aggregation points may be relevant to understand? How about:
- · Insurance: Life and medical insurance businesses will be impacted. Whether the net from a business perspective will be a business loss or profit will have to be determined by how each different company and their respective customers aggregate under each company.
- · Politics has already been impacted from how the nation has responded to the crisis, how it has disrupted virtually every aspect of life and the nation. The change in the composition of constituencies and their changes in political views and issues will carry into the future. Tipping points.
- · Education has changed and there could be consequences which persist and more changes that will come about. Again, different groups may experience the consequences of those changes depending upon different factors that aggregate differently in their outcomes.
- · Religion could be an interesting arena which is impacted by aggregation consequences. Part of this could be a simple result of a connecting factor that links people and their religion to the decisions that they make related to that religion just through having closer association because of local community. You physically aggregate with your aggregate group locally. If your faith community promotes getting vaccinated and another faith community promotes not getting vaccinated, then there can be different outcomes. At some point some savvy economist, social researcher, insurance actuary, or government statistician will determine that some religious alignments resulted in better outcomes and other produced worse results.
- · As a last thought, there are future implications that will come the decisions people make. The difficulty here is that they include situations and events that are like the current COVID-19 event. No one will know that they are coming, even if there are a few individuals who study and work to be prepared for the unexpected. We were very fortunate that there was a level of STEM-based knowledge, expertise and capabilities that were able to respond quickly and effectively to the COVID virus. This is not guaranteed to always be the case. The choices that sub-groups make create opportunities for future implications. The emergent variations in the COVID-19 virus are examples of future implications. Choices related to getting vaccinated or not can result in implications which are just another opportunity for different population sub-groups to experience different outcomes.
At this
point you might be asking, so what is the point?
Well,
one point is that the very popular issues about the COVID virus are simple-minded,
short-sighted, and are mis-appropriated to the wrong context. COVID-19 is a
national healthcare issue and not a political one. This requires that choices
be made. Not just choices by individuals, but choices by the society. In the US
this means that our elected officials and governmental entities have to
determine what the “necessary and proper” public policies are, and deal with
any obstacles that inhibit or prevent those policies from being delivered. This
creates disagreements over the ‘my right’ versus ‘social obligation’ because
America always has to deal with dissent. This is where the implications come
in. The choices that people make have implications beyond their individual self.
If the risk to the society is high enough our society, government and
Constitution allows for the individual’s right to be subservient to the public’s
right. Fortunately, COVID-19 is not so deadly that even politicians can
determine that there is a societal imperative for public policies that give
little to no leeway to individual decisions. However, COVID-19 is not so benign
as to make individual choices inconsequential.
This
renders the decisions about America’s public policies related to COVID-19 a
quagmire of choices. In these circumstances the question moves more to one of “Who
and based on what criteria are the policies to be decided?” In these situations,
the answer should actually be what we constantly hear from political leaders,
but which doesn’t seem to actually be the case. The “we are following the
science” sounds fine but I don’t think “following the science” would tell us to
go left, go right and keep going forward all at the same time.
This is why leaders need to look at the implications of the
decisions beyond the immediate. When “the science” tells you something and you do
not do it then what do you think is going to result? If you are good with that outcome,
then you can defend it; but if you didn’t “know” that was going to happen “and
implication” then did you “listen to the science”?
No comments:
Post a Comment