Prioritizing who gets the vaccine first is difficult. One can argue that healthcare workers should be first as they are essential to society. If they are safe, everyone benefits. The argument for the elderly going first is straightforward: it will save more lives. As a population they are most severely impacted by Covid. Either could be a reasonable choice.
Ultimately, the choice comes down to whether preventing death or curbing the spread of the virus and returning to some semblance of normalcy is the highest priority. “If your goal is to maximize the preservation of human life, then you would bias the vaccine toward older Americans,” Dr. Scott Gottlieb, the former Food and Drug Administration commissioner, said recently. “If your goal is to reduce the rate of infection, then you would prioritize essential workers. So it depends what impact you’re trying to achieve.”
Last month the independent group experts who advises the CDC voted for “essential workers“ to be first. One would expect that the group looked at the science and made what is an undeniably difficult decision. Not exactly….
Historically, the committee relied on scientific evidence to inform its decisions. But now the members are weighing social justice concerns as well, noted Lisa A. Prosser, a professor of health policy and decision sciences at the University of Michigan.
“To me the issue of ethics is very significant, very important for this country,” Dr. Peter Szilagyi, a committee member and a pediatrics professor at the University of California, Los Angeles, said at the time, “and clearly favors the essential worker group because of the high proportion of minority, low-income and low-education workers among essential workers.”
Using race, class, and educational attainment is a horrible rationale for what is literally a life-or-death decision. Like most causes of discrimination, you can tell if something is awful by reversing the criteria. Here, if the committee had voted to first protect white, high income, college graduates there would have (rightly) been an uproar. These are not valid criteria for vaccine distribution.
Others disagree with how the committee voted as well:
That position runs counter to frameworks proposed by the World Health Organization, the National Academies of Sciences, Engineering, and Medicine, and many countries, which say that reducing deaths should be the unequivocal priority and that older and sicker people should thus go before the workers, a view shared by many in public health and medicine.
One wants to give the benefit of the doubt. Maybe the committee‘s vote was more science-based than the New York Times article indicates. Maybe the decision, though it appears to go against the committee’s own history and understanding of other healthcare organizations and countries, wasn‘t really as discriminatory as it sounds.
But then you get this and all hope for misunderstanding fades:
Harald Schmidt, an expert in ethics and health policy at the University of Pennsylvania, said that it is reasonable to put essential workers ahead of older adults, given their risks, and that they are disproportionately minorities. “Older populations are whiter,” Dr. Schmidt said. ‘Society is structured in a way that enables them to live longer. Instead of giving additional health benefits to those who already had more of them, we can start to level the playing field a bit.’”
Literally: We should sacrifice the elderly because they’re mostly white. That a person in this position would think this and then put words to it is almost stunning. But this is the level of idealogical capture at today’s academic institutions. Dr. Schmidt’s is not an outlying opinion. It’s considered normal, even respectable in higher education circles. Equality is dead; equity is paramount. (Never mind that “equity” is an impossible standard to meet.)
Look at the debate over whether teachers are “essential workers” (from the same article):
Marc Lipsitch, an infectious-disease epidemiologist at Harvard’s T.H. Chan School of Public Health, argued that teachers should not be included as essential workers, if a central goal of the committee is to reduce health inequities.
“Teachers have middle-class salaries, are very often white, and they have college degrees,” he said. “Of course they should be treated better, but they are not among the most mistreated of workers.”
Elise Gould, a senior economist at the Economic Policy Institute, disagreed. Teachers not only ensure that children don’t fall further behind in their education, she said, but are also critical to the work force at large.
“When you talk about disproportionate impact and you’re concerned about people getting back into the labor force, many are mothers, and they will have a harder time if their children don’t have a reliable place to go,” she said. “And if you think generally about people who have jobs where they can’t telework, they are disproportionately Black and brown. They’ll have more of a challenge when child care is an issue.”
So because teachers tend to be middle-class, white, and educated, the criterion we’re using as to whether teachers are essential or not hinges solely on the value they provide to minorities.
Racial discrimination is wrong. People should not be judged on immutable characteristics. Science not ideology should guide these decision-making processes. The American political left has abandoned these ideas and principles and, I hardly need add, the lessons of the Civil Rights movement. Given the authoritarian impulses of the Trumpian GOP, moderates and centrists are stuck in a political vice. But if you want to understand why so many people voted for Biden then down-ticket voted Republican, this entire mess should be Exhibit #1.