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The ethical dilemmas of preventing the next pandemic

La Trobe University Media Release

Could protecting one group of people from disease, and exposing another to it, be the best way to prevent as many deaths as possible and reduce the impact of a future pandemic?

A study led by some La Trobe academics says yes, but the ethical dilemmas it raises might not be worth it.

Disease Modellers have determined an effective way to reduce the impact of infectious diseases like COVID-19 – but the results are likely to pose an ethical dilemma for decision and policy makers.

The study, led by Dr Joel Miller, Associate Professor of Mathematics and Statistics at La Trobe University, found that locking down the most at-risk group of people for a significant period, while simultaneously promoting infection in other groups in order to reach herd immunity, could be the best way to protect the high-risk groups.

However, increasing the exposure of one group to a disease would create an ethical dilemma and potentially result in the most disadvantaged groups in the community – usually with the least political power – becoming the highly-infected group.

“With COVID-19, the elderly were at high risk, so if we were to isolate them for a period of time, during which we enact policies that would cause younger age groups to interact more (not less), then the disease likely would not spread well once the isolations were lifted and interactions returned to normal,” Dr Miller said.

“If we set aside the question of whether such a strategy is logistically feasible, in a sense this is an optimal intervention. However, there are major ethical challenges that result – the intervention makes younger age groups worse off from an infection point of view.

“Our goal in this paper is not to advocate for such a policy, but rather to highlight some ethical dilemmas that emerge from intervention strategies. It is important that policy makers recognise the trade-offs that an ‘optimal’ strategy might require.”

The paper, Ethical dilemma arises from optimising interventions for epidemics in heterogeneous populations, has been published in Royal Society Interface and includes co-authors from La Trobe University, University of Melbourne and Northeastern University London.

The researchers used “SIR and SIR-like models” which assume individuals in the population are Susceptible, Infected, or Recovered (with immunity) to study the optimal intervention, such as lockdowns and isolation, required in a community to reduce and delay the peak of an epidemic, and ensure there is no further risk of a future epidemic or second wave of infections. They explored what would happen if different groups within the population, such as different age groups, have different risk factors for severe infection.

Using data from a Netherlands survey that determined how often people in different age groups came into contact with each other, the researchers simulated different scenarios to determine the best outcome for an entire population, assuming that an intervention altering the contacts would be in place for a limited time.

It found that if the intervention did not reduce contacts sufficiently then a large epidemic would occur. However, if the intervention reduced contacts too much there would be a modest epidemic and once the intervention was lifted, many individuals would still be susceptible, and a second wave would occur.

The optimal intervention occurs where contacts are reduced so that the initial epidemic is as small as possible while still infecting enough people to prevent a second wave.

If there are multiple groups with varying risk, the same general principles apply, but sometimes the optimal intervention increased the number of infections in the lower-risk groups to reduce the risk of a second wave once the intervention would end.

“This calls for a discussion around the ethics of subjecting certain groups to a higher rate of disease incidence, and the feasibility of this policy,” the study says.

Dr Miller said this was the first study to consider the ethical implications of an increase in infections as a strategy for optimal outcomes, without the use of vaccines.

However, Dr Miller says choosing which groups to lockdown, and those in which to actively promote infection, was an ethical dilemma for governments and the community.

“Mathematical models of epidemics can throw light on possible choices of policy and may even help us pick the ones that lead to optimal outcomes. But the decisions made by policymakers are intertwined with political will, their popularity, and social attitudes,” the study says.

“These eventually determine whether a particular intervention is favoured by a decision-making body.

“Disadvantaged groups, across the world, do not exercise sufficient political power to represent their interests in decision-making bodies. In such a case, a decision-making body may find it convenient to subject a disadvantaged group to a higher final size in order to decrease the net final size for the whole population and achieve herd immunity.

“The intervention strategy presented here, always carries such risks with it; and representation of disadvantaged groups thus becomes essential, especially for a policy such as this one.”

 

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11 comments

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  1. Lambchop Simnel

    Covid reportage has shut down despite the reality.

    So many things end up in the too hard basket for politicians, resulting in an even more dumbed-down community.

  2. Pingback: The ethical dilemmas of preventing the next pandemic - independent news and commentary Australia

  3. New England Cocky

    Agreed. This proposal is NOT one of the better ideas to come out of any university.
    .
    Rather, it appears to be a computer game played by otherwise bored academics (LTU) using data collected elsewhere by somebody else (Netherlands) making dubious assumptions (SIR models) to speculate outcomes.
    .
    Interesting as a speculative game. Useful?? You decide.

  4. Bob

    Authorities, unless they are really really stupid, must understand one of the keys to averting naturally-occurring pandemics is good health. So ensure the essentials – clean air, water and nutritious food plus free access to vitamins and supplements. Yet why are they agreeing to Codex Alimentarius?

    Over the last 100 years sanitation improvements have led to most diseases being eliminated. What we’re left with now are mainly man-made diseases from weapons labs, which, when combined with Western diets high in sugar and the push to normalize artificial, Frankenstein foods made in vats from ‘immortal’ cell cultures (sounds better to label as ‘immortal’ rather than risk the public associating with ‘un-killable’ cells aka cancer), have led to a general weakening of health. Not that good health is much protection from engineered pathogens from a bio-lab.

    One question I have: is Disease X going to be released from Fort Detrick or Fort Wuhan?
    Perhaps part of the solution to ending pandemics is to shut down bio-weapons labs?

    And if those fearful-of-death trans-humanists are absolutely devoted to continuing to experiment on people, maybe require they use placebos that are actually placebos, ie. pure saline solution with no additives. The govt could impose a penalty of $10M per each person injected with other than pure saline solution. But in using pure placebos researchers are straying into an area of ethics, and as proven by the 1986 changes in legislation that gave immunity to drug companies to never be sued for faulty vaccine products*, well, who needs ethics? And Informed Consent, how about proper Informed Consent that includes a full list of known reactions and pathologies noted in trials and also comes without the threat of being sacked from your job? A novel idea, informed consent, not thought of much since Nuremberg some 75 years ago.

    2020, the year many scientists and medical researchers began the long walk back towards the cave.
    Feel free to join in the Great Leap Backwards, only requirements: an unthinking perspective & nodding agreement.

    vaccine products* – changes in the definition of ‘vaccine’ allows gene-therapy products inclusion in this class

  5. Clakka

    Wow! ‘SIR-like models’, yeah, interesting, but so many questions remain.. eg. the constant morphing of the virus, and reinfection, so, Susceptible to what? Infected by what? Recovered from what? … etc etc etc.

    I can’t help wondering why the researchers / modellers opted to call the whole caboodle a ‘policy’. Seems to stick out like dog’s balls that moniker was designed so as to abdicate ethical responsibility and point the foundational sine qua non at politicians, and like an advertisement for space travel to tweak the interest of rocket scientists.

    It is noteworthy that the promulgators admit the end-game gives rise to ‘ethical dilemmas’. I add that such hypotheses may be very dangerous in the hands of political desperadoes, and that the optional ‘solutions’ ethical dilemmas seem to amount to social engineering options.

    Social engineering is of course the stock-in-trade of politicians, and desperate politicians throughout history notoriously make calamitous decisions.

    But hey, it’s only peoples lives, rendered to ‘efficiency’ and bean-counters’ scoping of collateral damage. Seems it’s a dirty job, but someone’s gotta do it, even though it may amount to a pile of ossifying dog shit.

    Just saying.

  6. andyfiftysix

    i have a different take.
    We have bent over backwards to make modern medicine an extraordinarily beneficial industry.

    We have held back survival of the fittest and in doing so slowed down evolution.

    However, nature abhors a vacuum so it fights back with stupidity. Its using stupid people to cull the population.
    Unfortunately stupid doesnt discriminate so evolution is still held back……….we may have peaked intelligence……just saying

  7. andyfiftysix

    Clakka, i breifly saw a post in “New atlas” that described how covid virus remnant particles could over stimulate the immune system triggering all sorts of reactions. It disappeared just as quickly.
    I thought it was a logical hypothesis that explained a lot of things but the speed it got taken down has me wondering if it was genuine.
    Researchers are an amazing bunch of people who are never satisfied that they have the whole story. We on the other hand grab what ever is available. Politicians are no different. Lets face it Covid scared the shit out of everyone.

    Curing diseases is social engineering too. Flock immunity is social engineering. Its assuming survival of the fittest and die if you aint. Education is social engineering. Capitalism is social engineering. Communism is social engineering. So lets not hear anymore about social engineering and go for the juggular……fairness engineering……..hahahahaha

  8. Clakka

    A56 et al.

    Where (above) I said I can’t help wondering why the researchers / modellers opted to call the whole caboodle a ‘policy’, in fairness to the researchers / modellers, I should have said:

    I can’t help wondering why the promulgators opted to call the whole caboodle a ‘policy’

  9. leefe

    Actual natural herd immunity requires infection to lead to personal immunity. It diidn’t with CoVID; there’s no reason to assume it will with the next pandemic either.

  10. Peter

    The next pandemic will not be an ethical problem to humanity (like the Covid-19 debacle was / is), if “authorities” allow medical practitioners to prescribe medications that have been proven to be safe and effective. The best defense against another “pandemic” is to educate the public now on how to employ simple dietary supplements that we know will enhance immunity systems such that natural immunity is more likely to occur.

  11. Peter

    Bob reveals the truth about medical innovations that rely on mass vaccination. If you extend the “reduction of infectious disease since vaccination statistics” graphs backwards to include the annual notification rates going back 100 years then you will observe that the installation of modern water supply and sewerage disposal systems began the decline in communal infectious diseases to the “high” point where mass vaccinations began claim there God-given effectiveness. If you wish to see where such new phenomena as autism began to increase then look at when mass vaccinations of children began to increase. Autism was once 1:10,000 children but now in USA is 1:35 children (with 1:18 males). Causation or coincidence? Either way it is well worth it to intensively research this growing phenomenon.

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