What we owe anti-vaxxers in a life-threatening pandemic

A while ago, Nancy Gibbs penned an op-ed for the Washington Post arguing that medical providers should continue to provide even scarce intensive care to people who have refused the COVID-19 vaccine because—this is a slippery slope argument—many of us do things we shouldn’t or fail to do things we should. Once we exclude one group, people who have refused vaccines meant to control a life-threatening pandemic, where, really, do we draw the line? What, for example, about people who fail to quit cigarette smoking?[1]

In making this argument, however, Gibbs succumbs to the same fallacy as the anti-vaxxers. She fails, as they do, to meaningfully address that their “individual” decision affects many others, especially including the medical workers who would provide care. And she fails to address a scarcity of beds. Instead, she quotes New Mexico Health and Human Services Secretary David Scrase saying, “We’re going to have to choose who gets care and who doesn’t get care, and we don’t want to get to that point.”[2]

But even at the time she wrote that op-ed, we had already very clearly reached that point. People who suffer from conditions unrelated to COVID-19 are being turned away or are waiting while their conditions worsen because hospitals are already full of COVID-19 patients. Ambulances sometimes transport people across state lines trying to find less overwhelmed facilities. People, including children, are dying. And it is amply clear that the unvaccinated are to blame.[3]

And yet. Something still feels different about the debate over treating the unvaccinated. Health-care workers recount the trauma of too many shifts, too many deaths, too many avoidable tragedies. It’s soul-crushing to watch people die because they made bad choices. Partly it’s the maddening hypocrisy — the patients who proudly dismiss science right up until the moment their lives depend on it. Partly it’s the sanctimony, the assertion of personal freedom over any sense of public good.[4]

So I want to approach the issue more broadly, directly tackling the anti-vaxxer fallacy that Gibbs failed to meaningfully address. This is the fallacy that a vaccine is only meaningful for the recipient, not for others to whom the recipient might otherwise spread the disease. It assumes that the individual bears no responsibility to the group.

Yet humans are a social species, even if capitalism—and especially capitalist libertarians—encourage us to forget it. We depend upon each other, which probably has something to do with why we clustered into larger societies (with centralized authority) with the neolithic. In the context of COVID-19, people who, for some reason, truly cannot receive the vaccine or for whom the vaccine is, for some reason, less effective depend upon the rest of us to be vaccinated to protect them and we all depend on limiting the spread of COVID-19 to inhibit the development of variants that might further diminish the effectiveness of the vaccines we have.[5]

Which is to say, I really don’t want to hear about anybody’s religious exemptions.[6] Those who cite them are hypocrites.

People who refuse the vaccination for any non-medical reason break the social compact between us. They claim not to owe the rest of us anything. And it is time for us to reciprocally say we owe them nothing.

They certainly do not deserve the opportunity to put medical workers at risk (because no vaccine, even when administered to medical workers, is 100 percent effective). They certainly do not deserve the opportunity to put the vulnerable among us at risk. They do not deserve anything. Were it less expensive to do so, I would suggest they be exiled from the planet. I will not propose that they be exiled to deserts or distant oceans because of the environmental harm they would undoubtedly do in those places.

But I certainly resent still having to wear a mask for several hours per day as an Uber driver to protect them. I certainly resent that we still face this disease because they have refused any mitigation measures whatsoever. And I am appalled that people who urgently need care for non-psychopathic reasons have difficulty finding facilities. All of this is profoundly and obviously wrong.

As an oncologist friend explained to me, he does not shame lung cancer patients if they smoked for 30 years; nor does the emergency-room doc turn away from the drunk driver with lacerations or the gang member with the gunshot wound. We only ever have incomplete facts, and if caregivers shift from weighing who needs care most to who deserves it, the slope gets very slippery.[7]

Lung cancer patients, drunk drivers, and gang members have never overwhelmed emergency rooms or intensive care units across entire regions of the country the way COVID-19 patients have. They do not threaten the very people charged with their care the way that COVID-19 patients do. There is a difference and, though I think the morality here is exceedingly important, it isn’t simply a matter of moral judgment.

Medical workers are already making the choices Scrase warned us about. To divorce those choices from the morality and from the ethics of vaccine refusal is simply to bury one’s head in the sand; it is inevitably unjust to others who desperately need these facilities.

I will say it again: We owe anti-vaxxers absolutely nothing. Even when they can pay for it.

  1. [1]Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  2. [2]David Scrase, quoted in Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  3. [3]Timothy Bella, “Alabama man dies after being turned away from 43 hospitals as covid packs ICUs, family says,” Washington Post, September 12, 2021, https://www.washingtonpost.com/health/2021/09/12/alabama-ray-demonia-hospitals-icu/; Rebecca Boone, “COVID-19 surge forces health care rationing in parts of West,” ABC News, September 16, 2021, https://abcnews.go.com/Health/wireStory/idaho-rations-health-care-statewide-covid-surge-continues-80056295; Hailey Branson-Potts, “Mortuaries fill, hospitals clog in rural California towns with low vaccination rates,“ Los Angeles Times, August 28, 2021, https://www.latimes.com/california/story/2021-08-28/la-me-rural-california-covid-surge-vaccinations-lag; Jenny Deam, “A Boy Went to a COVID-Swamped ER. He Waited for Hours. Then His Appendix Burst,” ProPublica, September 15, 2021, https://www.propublica.org/article/a-boy-went-to-a-covid-swamped-er-he-waited-for-hours-then-his-appendix-burst; Marisa Fernandez, “As hospitals fill, more ambulances forced to wait,” Axios, August 27, 2021, https://www.axios.com/local-ems-covid-surge-wait-times-611657fc-8ddf-4b32-a6dc-c7f2eb799487.html; Emma Goldberg and Emily Anthes, “Hospitalizations for children sharply increase as Delta surges, C.D.C. studies find,” New York Times, September 3, 2021, https://www.nytimes.com/2021/09/03/health/delta-children-hospitalization-rates.html; Michael Hiltzik, “‘Death panels’ arrive — in COVID-stricken Republican Idaho,” Los Angeles Times, September 17, 2021, https://www.latimes.com/business/story/2021-09-17/death-panels-republican-covid-stricken-idaho; Michael McGough, “Sacramento hospitals ‘at capacity’ and COVID deaths at 6-month high as delta spreads,” Sacramento Bee, August 26, 2021, https://www.sacbee.com/news/coronavirus/article253761928.html; Luke Money, “ICU beds filling up in San Joaquin Valley, triggering hospital surge order,” Los Angeles Times, September 3, 2021, https://www.latimes.com/california/story/2021-09-03/icu-bed-filling-up-in-san-joaquin-valley-triggering-hospital-surge-order; Betsy Phillips, “I was supposed to have life-saving surgery. Tennessee’s covid-19 surge cost me a hospital bed,” Washington Post, September 14, 2021, https://www.washingtonpost.com/opinions/2021/09/14/tennessee-covid-19-surge-hospital-beds-surgery/; Lena H. Sun and Joel Achenbach, “Unvaccinated people were 11 times more likely to die of covid-19, CDC report finds,” Washington Post, September 10, 2021, https://www.washingtonpost.com/health/2021/09/10/moderna-most-effective-covid-vaccine-studies/; Sudhin Thanawala and Jay Reeves, “Virus surge breaks hospital records amid rising toll on kids,” Sacramento Bee, August 26, 2021, https://www.sacbee.com/news/article253764343.html
  4. [4]Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/
  5. [5]Maggie Fox, “Unvaccinated people are ‘variant factories,’ infectious diseases expert says,” CNN, July 3, 2021, https://www.cnn.com/2021/07/03/health/unvaccinated-variant-factories/index.html
  6. [6]Sarah Pulliam Bailey, “This pastor will sign a religious exemption for vaccines if you donate to his church,” Washington Post, September 15, 2021, https://www.washingtonpost.com/religion/2021/09/15/pastor-donate-vaccine-religious-exemption/
  7. [7]Nancy Gibbs, “Do the unvaccinated deserve scarce ICU beds?” Washington Post, September 1, 2021, https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.