COVID Booster Shot Meets Health Care Monopoly

This post is part of an occasional series on health care. Here’s the prologue to the series, which originally preceded the post below.

Here’s a fairly straightforward story from The New York Times from a few days back, reminding us of the fact that immunity from some of the COVID vaccinations is limited in time, and may well require a booster shot.

 WASHINGTON — Biden administration health officials increasingly think that vulnerable populations will need booster shots even as research continues into how long the coronavirus vaccines remain effective.

Senior officials now say they expect that people who are 65 and older or who have  compromised immune systems will most likely need a third shot from Pfizer-BioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far. That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.

On Thursday, a key official at the Centers for Disease Control and Prevention said  the agency is exploring options to give patients with compromised immune   systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for the Pfizer    vaccine.

Skipping a bit:

Pfizer’s continuing global study of its clinical trial participants shows that four to six months after the second dose, the vaccine’s effectiveness against symptomatic infection drops from a high of 95 percent to 84 percent, according to the company.

As a (then) full-time hospital worker actively exposed to high concentrations of COVID, I got my second dose of the Pfizer-BioNTech shot on January 6. If the vaccine’s effectiveness definitely drops from 95% to 84% in four to six months, then I’m well past my due date for a booster. Though I’m no longer a full-time hospital worker, I’ve been waiting for twelve weeks now for the paperwork to go through on my bid to work per diem for Hunterdon Medical Center’s OR. Assuming it goes through, I’ll be back in the COVID-intensive environment I previously inhabited. And if it doesn’t go through, I intend to apply to do the same work at a different hospital. So one way or another, I intend to make my way back to hospital work, and (by implication) to re-immerse myself in COVID.

Continue reading

Paul Krugman on Masks and Public Urination

I agree with Paul Krugman about masking, but he’s wrong about public urination, and wrong to use the laws against it as an analogue of the laws requiring masking in the COVID-19 pandemic:

Relieving yourself in public is illegal in every state. I assume that few readers are surprised to hear this; I also assume that many readers wonder why I feel the need to bring up this distasteful subject. But bear with me: There’s a moral here, and it’s one that has disturbing implications for our nation’s future.

Although we take these restrictions for granted, they can sometimes be inconvenient, as anyone out and about after having had too many cups of coffee can attest. But the inconvenience is trivial, and the case for such rules is compelling, both in terms of protecting public health and as a way to avoid causing public offense. And as far as I know there aren’t angry political activists, let alone armed protesters, demanding the right to do their business wherever they want.

Laws against public urination do not impose a merely trivial inconvenience. If someone has a medical condition that involves urinary frequency or urgency, and there are no public bathrooms available (as often there aren’t), discreet “public” urination becomes unavoidable. Likewise if someone is homeless. Continue reading

The Pfizer-Biontech Vaccine: Firstcomers and Latecomers

In a paper I’ve mentioned here before, Pierre LeMorvan and Barbara Stock discuss a moral dilemma that arises from the ubiquity, in health care, of what they call “the medical learning curve.” The idea is that neophyte health care workers face a learning curve that puts patients at risk: the earlier I am in my career as a health care worker, the less skilled and knowledgeable I’m apt to be, and the more prone to error. The more error-prone I am, the more likely to impose medically dangerous risks on patients. Since health care workers need to practice their knowledge and skills on patients in order to achieve proficiency, this situation is ineliminable, even with the best supervision by more experienced practitioners. Continue reading

Stand Up with Aristotle

When I first read Aristotle’s Nicomachean Ethics maybe thirty years ago, I was both puzzled and disappointed by his discussion of the moral virtues in Book IV–generosity, magnificence, friendliness, wit, and so on. It seemed a waste of space. A whole book on this? What were such banalities doing in a classic work of moral philosophy?

Aristotle’s (very brief) discussion of the place of humor in social life seemed a case in point. On Aristotle’s account, wit turned out to be a moral virtue, buffoonery and humorlessness, vices. 

Those who go to excess in raising laughs seem to be vulgar buffoons. They stop at nothing to raise a laugh, and care more about that than about saying what is seemly and avoiding pain to the victims of the joke. …

Those who joke in appropriate ways are called witty, or in other words, agile-witted. For these sorts of jokes seem to be movements of someone’s character, and characters are judged, as bodies are, by their movements (NE IV.8, 1128a5-12).

Really? That’s what morality requires? Telling the right jokes at the right time, in the right way, for the right reasons, etc. etc.? Continue reading

Thanksgiving, Gratitude, and the Flower of Life

Today is Thanksgiving, a day on which it’s appropriate to give public thanks for the gifts we’ve received from life itself. Until recently, I had great disdain for Thanksgiving–just last year, I wrote a bitchy attack on it–mostly because until recently, bitterness and resentment were my favorite go-to emotions.

Paradoxically, I had to lose a lot in the past few months to appreciate what I have, and to grasp the true meaning of gratitude: a job, a marriage, a house, a car, tens of thousands of dollars, hundreds of hours of labor, and a large handful of illusions, for starters. I sold the house, but stand to make very little from it, so I count it as a loss. I sold the car for a ridiculously lowball figure, so I regard that as a loss. I’m in litigation, make a nominal wage at a dirty job doing hard physical labor, and lack permanent housing or the means to pay for it. I have temporary housing, but it lacks running water. So there are challenges. And yet, life has never been better. Last year, I had everything I now lack, and made sure to get up bright and early “to take a crap on Thanksgiving.” Now I’m writing a paean to gratitude. What a difference a year makes. Continue reading

COVID-19, Risk, and Rights-Violations

This is a discussion that Michael Young and I started at my Facebook page on this article by Michael Tomasky in The New York Times (ht: Suleman Khawaja). Here’s Tomasky’s thesis in a sentence:

Freedom means the freedom not to get infected by the idiot who refuses to mask up.

I started the conversation, which we agreed to continue here instead of on Facebook. Continue reading

Mask Up or Drop Dead

Some readers may remember the dispute I had here back in April with Jason Brennan and Phil Magness over the use of lethal force to enforce social distancing orders. The issue was: are there any circumstances such that lethal force would be justified in enforcing such orders?

I said yes: if someone refuses compliance, and then not only resists an order to comply, but escalates resistance to the point of serious physical danger to others, it can be justifiable to shoot them dead. I say “shoot them dead” because under the rules of engagement that apply in police work, every shot is intended to be a kill shot: if an officer draws a weapon, it’s understood she had no choice but to do so; if she fires, she aims at the subject’s torso, which is the largest and most easily-hit target; and given the nature of standard police firearms, and the likelihood that the officer will fire more than once, the subject’s death is highly likely, whether literally intended or not. Continue reading

Natural Law Libertarianism in Two Flavours

My two latest Agoric Café videos:

In the first one, I chat with philosopher Eric Mack about walking out on Ayn Rand, clashing with Nazi Sikhs in Seneca Falls, libertarian rights theory, Kantian vs. Aristotelean approaches to fixing Randian ethics, Nozickian polymathy, the unselfishness of Samuel Johnson, the ethics of COVID lockdowns, physical distancing in Durango, the CIA as an argument against anarchism, shoving someone in front of a bus as a form of restitution, and the edibility of matter.

In the second video, I chat with philosopher Gary Chartier about Robin Hood, left-wing market anarchism, natural law, free speech and employer power, libertarian secularism, Seventh-day Adventism, religious epistemology, long-arc television, urban fantasy, Lawrence Durrell, Iris Murdoch, Whit Stillman, the evils of giving extra credit and taking attendance, and the attractions of being emperor.

COVID-19 Narratives (9): From Nebraska to New Jersey and Back

From Nebraska to New Jersey and Back: College Life Under Pandemic
Catherine Lentsch

The COVID-19 pandemic first became a reality for me when I was flying back from my home state of Nebraska to New Jersey after spring break. I was chatting with members of the Columbia University baseball team on our plane when they received a notification that Columbia was canceling school for the next few days, and would then be holding online classes for the next two weeks. We were all a bit shocked. It was a bit hard to believe that they’d cancel school over a virus. Nor was it clear what this meant for the future. Continue reading