The Anti-Vax Ethos of ‘Live and Let Die’
How do you save people who do not want to be saved?
The state of the COVID pandemic in the United States has been pretty clear since early in the summer. The country has split, culturally, into two groups. About two-thirds of us rushed out to get the vaccines as soon as they were available. The other third decided they would accept mass death as the cost of going about their lives.
Early in the summer, I described this as accepting a higher level of risk, but that's no longer appropriate, because the idea of "risk" implies uncertainty. It implies that you cannot know the results. But we've now had several months of watching the Delta variant surge across the country and claim tens of thousands of additional lives. Almost all of these deaths were easily avoidable. Between February and July, for example, there were nearly 9,000 COVID deaths in Texas. Only 43 of those people were vaccinated.
These deaths are not the result of neglect. After a rapid rollout that outperformed most other large nations, the COVID vaccines are widely and easily available at no cost. Yet the unvaccinated have actively resisted a preventive measure that could save their lives, as well as the lives of others around them, and they are doing so with increasing belligerence.
There is a cantankerous streak in Americans that leads us to defy authority and want to make decisions for ourselves. But what do we do when that ethos of "live and let live" turns into an insistence that we live and let die?
The pockets of resistance to vaccination tend to be among blue-collar types with a belligerent distrust of experts, the sort of people who talk about "doing my own research" that doesn't mean reading the appendixes of scientific studies. Instead, what these people mean is that they watch videos by random people on YouTube, or read tweets about Nicki Minaj's cousin's friend. Consider the profile of a vaccine advocate in Florida who recently lost six members of her extended family to COVID because, "Everything was new, and they were just scared."
Some of the vaccine resisters are listening to politically motivated vaccine skeptics on talk radio and the Internet. The pandemic has been a vast natural experiment to determine whether there are people who would literally rather die than admit they were wrong about politics. I would have speculated ahead of time that such people exist, and in significant numbers. But now we know for sure. Hence the drumbeat of stories about outspoken vaccine opponents who are seriously ill or have died of COVID, most recently a Catholic cardinal and a conservative radio host who used to mock AIDS victims. The name of this gentleman’s show? "Real Science Radio." Somewhere in that story, there's a kind of poetic justice.
The New York Times notes that there is little political will for a return to strong mitigation measures. "'No one's wanting to go back to fight-Covid mode,' said Andrew Warlen, the director of the Health Department in Cass County, Missouri, who said some parents had resisted quarantining their students even after they were exposed to someone with the virus." This is partly because those who are most interested in protecting themselves have already done so by getting vaccinated, so they are less likely to fight for measures that would protect somebody else.
But that raises a question: How do you save people who do not want to be saved? And should we even be trying?
I suppose there is a certain grim resignation in taking a "live and let die" attitude toward the vaccine skeptics. But I am not so hard of heart that I can look complacently on cases like the California couple who died of COVID a few weeks apart, orphaning their five children, one of them a newborn. People keep telling me that they are capable of making their own decisions about the risks to take. Well, they might have a right to make those decisions—more on that in a moment—but the capability is evidently lacking, and many of the victims of these bad decisions, such as those five kids, didn't really have a choice about it.
Moreover, these people's carelessness with their own lives is turning out to have significant costs for the rest of us. Leaving aside the fact that some of us still have children too young to be vaccinated and elderly relatives for whom the vaccine is not as effective. (The vaccine primes the immune system, but this is less effective when the immune system is already weakened.) These remaining risks are relatively small, though in a massive national wave of infections, small risks become larger. Yet there are more direct impacts. The unvaccinated are overwhelming hospitals, brutally exploiting overworked doctors and nurses, and causing the vaccinated to have their care denied or delayed.
The unvaccinateds’ plan seems to be to live their lives as they like—and blithely take the risk that they could be letting others die from delayed care.
Some people, in frustration, have proposed simply denying treatment to the unvaccinated if they get COVID. If they don't trust modern medicine, they can do without it. But such a rule is unlikely to be implemented and seems unduly harsh even to a hard-core Ayn Rand fan such as myself. But this should be a reminder that browbeating the unvaccinated or having their employers require them to get the vaccine are the nice solutions to the problem they are causing.
Which leads us to the Biden administration's loudly announced (but still somewhat vague and unformed) plan for a national vaccine mandate. Scott Lincicome gathers together a pretty good case against the legality and constitutionality of such a mandate, and I expect the whole thing will get bogged down in the implementation.
Even the most strident advocates of liberty have usually recognized narrow exceptions for public health. There is no right to infect, and spreading a deadly disease to others because you failed to take basic precautions is arguably a form of assault. A federal vaccine mandate is probably wrong simply because it is federal, and thus impinges on public health powers that belong on the state level. But a state vaccine mandate would arguably be a legitimate power of government.
Yet here we face the same dilemma. The states most likely to impose or enforce vaccine mandates are also the ones most likely to already have high vaccination rates. The states that actually need mandates are most likely to resist them.
As the vaccination numbers have slowly ticked upwards in recent weeks, we're reaching the point of firm and total resistance from people who view any attempt to save them as tyranny. At some point soon, everyone who is even theoretically open to getting vaccinated will be. That percentage probably won’t be high enough to quash circulation of the Delta variant. Yet there will still be a significant percentage of people left who will not, under any circumstances, take the vaccine. Eventually we're going to have to accept this fact.
The practical end-point we're moving toward is a two-tier pandemic: One pandemic, inconvenient, but mostly not deadly, for those who protect themselves with vaccines. And another pandemic, raging all around us, for those who would literally rather die than admit they are wrong about politics.
We'll just have to get over the sickening irony that this policy of live and let die is imposed, not by the callous indifference of the living, but by the reckless stubbornness of the dying.