The painful politics of vaccination
It isn’t often I receive an e-mail that makes me smoulder with rage. This one did, which was strange since it was perfectly polite. My correspondent wanted to know why he wasn’t allowed to meet his friends indoors for coffee. They were in their early 70s and vaccinated. Was there really a risk?
Inoffensive enough, you might think. But the question sat in my stomach and burnt. If you want to think clearly about the world, you need to notice your emotional responses to new information. I have become so convinced of this, I made it the central point of the first chapter of my book. So it was time to take my own advice. Why was I so angry?
It may have been a quick bit of mental arithmetic. The vaccines seem to be very good at preventing serious illness — just how good depends on the vaccine, and what exactly we mean by “serious illness”. But let’s assume they reduce the risk of death by a factor of 20.
The other thing that reduces the risk of Covid death by a factor of 20? Being about 20-25 years younger. A vaccinated 70year-old has roughly the same low risk of death as an unvaccinated 47-year-old. Those numbers may not be exactly right, but for this particular unvaccinated 47-year-old they were close enough to trigger a severe emotional reaction.
I have not been hanging out with my 47-year-old friends, and that is not because I fear death. It’s to prevent the virus from spreading, and thus protect the people who are most vulnerable. So it has been for all of us, on and off, for a year. And let’s not even talk about our fraying-under-the-strain children, vastly less at risk of Covid-19 complications than any 70year-old will ever be, no matter how well vaccinated.
That was why I smouldered. We have all been making extraordinary sacrifices to protect vulnerable people, and here was one of these people, suddenly feeling invulnerable (but, actually, no more invulnerable than I), complaining that his freedom had not instantly been restored.
Yet I was aware of the absurdity of my rage too. If we are all making sacrifices to protect the vulnerable, then surely when the vulnerable aren’t so vulnerable any more, we can think about stopping?
There will come a time when the restrictions must end. Not just yet, I think: there is not much more to lose from a few further weeks of partially constrained freedom, and a great deal to gain in terms of suppressing the virus to a low level and keeping it there with a broadly vaccinated population. But soon.
And my irrational fury indicates some of the painful politics that lie ahead. Will we give vaccinated people more freedoms than others? That is what is happening in Israel. And there is something to be said for that, both as an incentive to get vaccinated and to combine the maximum reopening with the minimum public health risk. It is efficient; the economist in me applauds that. As Deng Xiaoping put it as he liberalised the Chinese economy in the 1980s: “Let some people get rich first.”
But not even the Undercover Economist is just an economist. Fairness matters. There is something powerful about the idea that we are all in this together, that until the lockdowns can be eased for everyone, they should be eased for nobody. reaction It’s not to just the me UK ’who s geographical whines about unfairness. Ponder the tier system of late 2020. In principle, it made sense: places with high infection rates were restricted for their own good; those with low infection rates did not need such restrictions.
But most people instead saw regional tiers as punishments, invidious and arbitrary. National lockdown, for all its costs and its discontents, has never been seen that way.
I did not write an angry response to my correspondent. I simply reminded him that we do not yet have complete confidence that vaccinated people are not infectious. The latest numbers on that question look very encouraging, but we cannot yet be sure that vaccinated people pose no risk to others.
We humans can be self-centred. My correspondent didn’t show any concern for other people but I am sure that he does care. Most of us do. He just needs to be reminded that he is not only a potential victim of the virus, but a potential vector.
A few years ago the psychologists Adam Grant and David Hoffman studied the problem of hand hygiene in hospitals. They found that signs by the gel dispenser reminding doctors and nurses that “hand hygiene prevents you from catching diseases” did not work. What did work, dramatically, was reminding them instead that “hand hygiene prevents patients from catching diseases”.
We are self-centred, yes. But we are not selfish. We just need the occasional reminder to look out for each other.
And as we enter a new phase of the pandemic, one in which some are vaccinated and some are not, and at a time when even an economist can lose his temper, we must not forget why we have made such painful sacrifices.
THERE IS SOMETHING POWERFUL ABOUT THE IDEA THAT WE ARE ALL IN THIS TOGETHER