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Yong’s “Anatomy of An American Failure”

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One of Yong’s more interesting characterizations 

is to describe the Trump administration as a “COVID-19 comorbidity.” We haven’t looked that closely at the liability of the state in either administering or providing healthcare. Yong emphasizes that the American healthcare system is particularly susceptible to breakdown in situations of pandemic due to its largely private character. Most hospitals try to limit their baseline staffing and capacity given the economic exigencies of running a private hospital. They tend to be prepared for treatments that have been provided recently or would be more profitable generally. 

At the same time Yong rightly points out that many of the world’s most able and expert medical practitioners work in the American hospital system and/or domestic scientific research. He thinks that the inability and unwillingness  to tap this resource of expertise was not only unfortunate but also a direct contributor to the deaths of many. For superficial political reasons, the Trump administration removed American WHO appointees who had been present in China not long before the Covid outbreak and. In addition, predictions of pandemic which had been provided to the administration by people such as Yong himself, had been shelved for reasons that had yet to be explained. This otherwise inexplicable behavior was only exacerbated by the Trump administration’s response to the foreign and then domestic spread of the virus which was to suppress evidence of its transmission and to restrain any effort on the part of a federal agency to provide coherent policy in the early stages of the pandemic. 

All of this is clearly evidence of mismanagement and politically inspired equivocation. Yong makes the additional statement — which is incredibly relevant not only to our assessment of this historic event but also to the liability of current government officials — that the Trump administration was a comorbidity just as smoking might have been. Since tobacco companies and insulation manufacturers have been found liable for deaths resulting from their negligence. Might it also be possible that those who administer public health policy might be liable for negligence when they suppress information about the danger about a situation that they’re responsible for or promote public health policy that is not reasonable given how informed they might be of the relevant scientific data. Why should a physician be culpable for malpractice but not a public health official who is also compensated for his or her work and therefore has an obligation to conduct him or herself without negligence. There are two possible ways of understanding this failure. One is in the structural sense in which the American healthcare system is poorly equipped to deal with a pandemic because of the profit motives that are ultimately most determinative. We could also assess liability in a more specific way by looking at particular individuals who have been tasked with administering policy which is not political anymore than the treatment of a given doctor is political, but should be assessed according to medical health criteria. Rarely before has there been such medical disregard in the midst of such a health crisis, but this might provide incentive to articulate a more coherent policy of oversight for public health officials. 

America’s Defeat: Covid-19 Analysis

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Ed Yong is admirably frank in this Atlantic article, asserting that Covid-19 in the U.S. was an utter failure. Yong defends this argument with abundant statistics, stark comparisons to other nations, and historical parallels which make his case hard to contest. In practically every action taken (and lack thereof), the United States went wrong, and the consequences are extensive. Is the blame really on President Trump? Or is it on his supporters and other Americans who neglect the importance of public health? Both, it seems, went hand in hand.

I appreciate Yong’s claim that the “normal” life we were so used to is what actually led to this pandemic. In many ways, this global crisis is a wake-up call to fundamentally change lifestyle norms which are unnatural, especially in the United States. The elemental American belief that health is a matter of personal responsibility rather than a collective good was the first strike that led to our downfall. The capitalistic system contradicts many ethical pillars of allocation of healthcare in itself. In a pandemic, this exacerbates. Yong notes, “Black people have higher rates of chronic illnesses that predispose them to fatal cases of COVID‑19. When they go to hospitals, they’re less likely to be treated. The care they do receive tends to be poorer.” It’s hard not to think of Henrietta Lacks and the countless other people of color who have been mistreated from this affair. The selfish every-man-for-themself notion inevitably hurts certain groups who come from a nation built on specific oppression. Yong also flips the value of capitalism on its head. America may be the richest country in the world, “but dollar bills alone are no match against a virus.” In summation, our country has been deservedly humbled.

Americans are used to waking up to notifications with statistics on their phone. News headlines such as, “America tops 200,000 new cases” is now nothing unusual to us, but it’s important to think about the lives behind the numbers and the consequences of this normalization. In many ways, social media inflamed this pandemic, and it does not seem to be declining whatsoever in the near future. With evidence that media is impactful, it adds another layer of accountability for our leaders to handle their platforms maturely. If, say Hillary Clinton, had won the 2016 election and served as our president during this time, how different would the outcome have been? We can only wonder…

Anatomy of an American Failure Reply

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Ed Young highlights the myriad of ways the pandemic has been mishandled in his article, An Anatomy of American Failure. He highlights the intersection of problems that have exacerbated the pandemic, such as weak public health infrastructure, conspiracy theories, and a tenuously connected global supply chain. Moreover, the pandemic has disproportionately affected minority communities, such as African Americans, the elderly, and immunocompromised. All of these factors have created an almost apocalyptic landscape for many Americans. 

Additionally, Young also highlights the role the president had in determining the scale of the pandemic. As he says “Trump is a comorbidity of the COVID‑19 pandemic. He isn’t solely responsible for America’s fiasco, but he is central to it”. This is an undeniable fact about the pandemic. In a time of crisis, a leader is supposed to ensure safety to all people – not just his supporters. By any standard, Trump’s actions have been unethical. Though Young doesn’t touch on this, he robbed the American people of informed consent when he lied about the danger of COVID-19. In February, he publically downplayed COVID-19 as only being as dangerous as the flu while privately confessing to Bob Woodward that it was a seriously deadly disease. Some may say Trump didn’t have a moral obligation to disclose this information as he isn’t a medical professional, but as Commander in Chief, I feel he takes on the same level of responsibility for the entirety of the American people.

Though this is a turbulent time, I feel it is quintessential that we evaluate the morals of our elected leaders today. Putting aside political affiliations, Ed Young lays bare the myriad of ways Trump has acted unethically – just concerning the pandemic. With this in mind, it is important to consider how we ought to move forward as a county. In this class, we have been tools to evaluate actions plainly as being ethical or unethical. We have analyzed case studies and debated them in class, but these are real tools that we can use outside the classroom. Thus, as we wait to see what the future of our country holds, I urge everyone to truly evaluate his actions. Simultaneously, I wonder, beyond political action, how we can repair the damage this administration has caused and restore trust in our public health system? Currently, I am overwhelmed by watching the election results and have no idea how we can move past this politicization of the pandemic. If anyone could offer a sliver of comfort, it would be greatly appreciated. 

Ed Young’s “Anatomy of an American Failure” Commentary

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Ed Young’s article detailing the “failure” of America’s response to the Covid-19 pandemic highlights many of the inequalities and healthcare problems pervading our country. He explains that women, the elderly, dementia patients, people with mental disabilities, Asian Americans, Black Americans, Native Americans, and Hispanic Americans have all been disproportionately affected. Young continues to expand on how Black Americans have been impacted, explaining that they account for 30% of the 3.1 Million people in America who cannot afford health insurance and claiming that this is a modern day continuation of Jim Crow when hospitals were not built around Black communities and Black patients were separated into separate hospital wings if they were able to seek treatment. Former slave states, he cites, were some of the first to lift social distancing measures around Covid and invest the lowest amount of money in public health. The result? Covid has disproportionately affected the Black community as a result of the medical disadvantages already in place, higher rates of chronic illnesses, and their roles as low paid, essential workers. All the “existing inequities stack the odds in favor of the virus.”

The parallels between Black American’s lives now, spotlighted through Covid-19, and Henrietta Lacks’ story 70 years ago are shamefully similar, because she as well as her family faced numerous inequalities when seeking medical treatment, were effectively being forced to work and live in unhealthy environments, and possessed distrust in medicine resulting from their experiences. Henrietta had to drive or walk a very far distance to get to Johns Hopkins, because there were no hospitals near her that would treat black patients. They lived next to toxic factories and the men worked there to support their families. Additionally, all the Lacks were wary of going to the doctors because of fear at how they would be treated, exactly similar to a patient in Young’s article. The fact that Black patients, and really all Americans, are still not being treated equitably in regards to medical treatment is a disgrace. It makes me think back to Daniel’s article, stating that everyone is entitled to the necessary resources to achieve “normal functioning” in society and compete, as equally possible, for opportunities. Healthcare is thus a right to achieve said normal functioning, and it not being available impedes citizens ability to thrive. The question again however thus arises, what really is “normal functioning” and even if it is achieved, how do we address the problem of people continually being exposed to Covid-19 because of their area of work?

COVID 19 and collectivism

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Ed Yong explores various ways in which the U.S has failed to tackle the coronavirus pandemic, and during this exploration, reveals several ethical dilemmas and issues that was either highlighted due to the pandemic, or arose in the midst of responding to the pandemic. Issues such as the president’s lack of awareness and immediate action and the health care system not being funded properly can be thought to be caused by the country’s lack of care for the health care system, and their view on health care as an individual responsibility rather than a collective good.

Other issues, such as more cases of COVID 19 occurring in prisons and nursing homes due to a weak and vulnerable system can be seen as an ethical issue, as the system may be seen as directly endangering the health of the individuals located within the system, and thus violating their basic human rights to be protected and receive the minimal health care treatment that could prevent obvious and easily preventable spread of the disease.

Lastly, the article focuses on how the already existing inequalities within the United States, such as health care systems not being readily available for black patients due to Jim Crow influenced policies that purposefully distance health care treatment from these people, or the Native Americans who are unable to enact basic disease preventing actions such as washing hands or receiving sanitization due to a lack of water source.

I believe that all the issues discussed above are fundamentally caused by the deeply rooted individualism and a lack of care for the common good which is necessary when dealing with issues such as health care. By arguing for the emphasis on the common good, I do not necessarily mean that the U.S should completely except collectivist ideologies proposed by people such as Karl Marx or Hegel, which emphasizes the need for a sovereign state and control of the population by the government, as this would fundamentally diminish the freedom and autonomy that Americans are able to have today.

Although a full outright control of people’s actions by the government with the intention of giving the best health care would be ideal for solely steepening the COVID 19 curve, I believe that instead of relying on the power of the state, such as how China utilizes by manipulating the media in order to maintain a good reputation, we should rely on our rational mind and the good will that we have towards the people that are part of the society. Perhaps, it may be useful to consider this common goal to provide health care and prevent the disease in terms of Kant. But even in an individualistic sense, it is in the best interest of individuals to act collectively in order to prevent the spread of COVID.

Utilitarianism, capitalist hierarchy, and vaccine distribution

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In late July, Sarah Zhang published an article on The Atlanticthat detailed the many infrastructural shortcomings of the United States’ handling of the novel Corona Virus. Simple preventative measures, like mask wearing and social distancing, have been met with strong pushback from particular groups, claiming that these preventative measures are an attack on their liberties. We observe much of the mishandling through the lens of media platforms, but many of the negative implications of the virus fall into the complex web of institutional misprioritization of American lives. These misgivings in the hierarchal prioritization of handling the virus are well explained in Zhang’s article. As the attention of the general public is directed toward a vaccine as a solution to the pandemic, conversations of ethical distribution must be had to ensure the welfare of the American people. Personally, I would take on the framework of distribution through a utilitarian lens. Utilitarianism seeks the greatest benefit for the most amount of people, which, to me, serves as a good ethical base point to maneuver the intricate complications associated with the virus. Testing and vaccination should be provided at a rate conditional with the amount of exposure and cases that populations face, to ensure the greatest level of care. Underfunded communities with inevitably more potential contact points with the virus should be accommodated for. Currently, we observe affluence and access to capital to be a contributing factor to access to testing and care, which inherently takes resources away from many of the groups that need them the most. In the distribution of the vaccine, I suggest that we must insure a proportionally and equitably sound approach, so that the most people can benefit from the potential cure to the pandemic. At-risk groups, like healthcare and essential workers, should be afforded the vaccine at a prioritized rate, so as to slow the overall spread of the virus while maintaining the businesses that keep us fed and healthy. What we’ve seen in the past in access to testing, and even through the evaluation of previous diseases, is that the best care is afforded to affluent groups. Groups who exist on the wealthier side of the socio-economic infrastructure have had better access to care and preventative measures than those in low income communities. From a utilitarian perspective, the trope of allocating the best resources and prioritizing vaccination for these groups is seen as unethical, and something we should push back against if and when it comes to be the case. 

The Politics of COVID-19 and the Race for a Vaccine

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Earlier this summer, when the coronavirus was finally being accepted as our new reality, and media politicians and prominent government figures were attempting to debunk the seriousness of the virus, an article by Sarah Zhang, entitled “A Vaccine Reality Check” was published in the Atlantic. Within this article, Zhang describes the then current climate of COVID-19 and the responses it was garnering from all sides. Most importantly, she dove into the ethical issues that these sides were battling with and gave her perspective on the matter.

Furthermore, Zhang begins by telling readers the reality-a COVID-19 vaccine will not be arriving soon, especially not in October, which was predicted. This destruction of false hope is essential in all crisis scenarios because although it may decrease one’s will, it is an opportunity to help someone realize the reality of a situation and prepare for it. The fact of the matter is that the world has never seen anything like COVID-19. In addition, since every science laboratory in the world is working on a vaccine, resources are already scarce, and the competition to monetize this vaccine is unprecedented.

However, regardless of these harsh realities, what matters most is that a vaccine is being developed around the world. Yet, one of the other issues highlighted by Chang is the prioritization of vaccination. Zhang recalls the protocol used back in 2009 when the H1N1 vaccine was being developed and was rolling out. It was essential that people received the vaccine in waves since they were not all in the same risk-of-contraction category. This is also true for the rolling out of the the COVID-19 vaccine since, as we’ve seen for months, the virus attacks people differently due to their age and health history.

Lastly, the political aspect of COVID-19 is discussed in every paragraph of this op-ed, and with every month since its release, it is clear that politics have played a major role in the reception of COVID-19 as a global pandemic. Although Zhang spoke on the terrible deceptions presented by President Trump, it is important to note what she said about the CDC being awfully quiet during these times. This was notable to be because in another class we learned about the CDC’s political affiliations and how those have influenced their decisions to talk about the virus and the cases associated with it. All in all, this virus is starting to expose the U.S, of not actually being 100% about the people, but more so about the people with much more power above and their financial interests. Essentially, these times have been a reminder that “cash rules everything around us” and propaganda is willing to be spewed in order to protect the flow of cash throughout the economy and so much more. This brings us back full-circle to the questions raised in Zhang’s article, who will get to control the COVID-19 vaccine? Will it be affordable and readily available? Why is such an important vaccine for the world being valued more for its monetary benefits compared to its health benefits for the globe? These are questions that make us question the intentions of those in power around the world.

A Rawlsian Analysis of the COVID-19 Vaccine

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In “A Vaccine Reality Check,” writer Sarah Zhang provides a thorough exegesis on the current stage of the Coronavirus Vaccine, while using a complex array of historical precedents and contemporary analyses to examine the effectiveness and distribution of the vaccine. To briefly lay out the major points within the article, she examines the definition of a vaccine in general, elaborates on their implementation with respiratory illness, speaks on the specific development of various COVID vaccines, and examines the political implications of these developments. While these points clearly provide valuable insight into this issue, especially with the election nearing, I found the ethical dilemmas and theories that dictate the narrative within the article to be vastly more fascinating. 

With regards to development specifically, the question of ownership begins to govern how society views medical innovation: is it proprietary or collective? Zhang describes how the Trump Administration is encouraging many vaccine makers to invest in infrastructure and manufacturing systems to already prepare for FDA approval of the vaccine; while this may decrease the lag time between approval and availability, it raises the question of power imbalance in ownership once the vaccine is created. The two struggles are constantly at odds: the dichotomy between serving the public good by making these vaccines extremely affordable and the profit incentives for these companies to continue investing in manufacturing and infrastructure. If the medicine becomes specifically proprietary, then that allows companies to prioritize profits over public safety, but if the incentive of profit is removed, it reduces the economic interest of companies to invest in the first place. This ties back heavily to not only the ethical concept of ownership, but also to the essential idea of value-ordering. This will dictate how companies will act. In my opinion, a nuanced solution to this issue is a bit more free-market based. Instead of mandating companies to act a certain way, which I believe will largely de-incentivize their involvement to begin with, I believe the government should provide more market incentives for companies that make the vaccine more affordable. This may involve certain subsidies, but it will be more conducive to creating an economic equilibrium that also expedites the production of the vaccine. I strongly believe ethical principles should apply to institutions as well, because institutions are, in essence, a collective of individuals. Therefore, in respecting the autonomy of these collectives, I believe even more stringent government mandates would be a breach in the moral sense as well. Viewing pharmaceutical companies this way allows society to humanize them, and from that point, extrapolate a more nuanced solution. 

In terms of distribution of the vaccine, I could largely extrapolate ethical subtexts of utility and societal responsibility. The question then revolves around who receives the vaccines first, or at all. Zhang specifically describes a tactic used in 2009, in which states and hospitals used a system of priority status to determine high-risk individuals such as health care workers to get the vaccine first, in order to save the most lives. I felt uncertain about prescribing priority to anyone during a public health crisis, but I also realized that people must be prioritized due to medical scarcity and developmental struggle. So the ethical question shifted: how do we decide who gets the vaccine first? This intrinsic dilemma draws back on two central ethical tools from our study of John Rawls. The first dictates action, and the second prescribes it. This dilemma can be examined through the difference principle, or alternative distributive justice. Essentially, Rawls prescribes that it is okay, and at times expedient, for communities to stray from strict equality, as long as the lower echelons of society are better off than they would be under strict equality. Using this perspective, it makes sense that healthcare workers and high risk individuals would receive the vaccines first, because if strict equality was imposed, the scarcity that ensued would induce a distribution that would not benefit the lowest echelons of society. Saving the lives of healthcare workers, specifically in minority and underprivileged communities, directly helps save more lives, so the lowest strata are lifted up as well with this system of priority status. The second Rawlsian tool that would be most helpful with distribution is the Veil of Ignorance. While improbable, encouraging interest groups and various identities to examine how they would want this vaccine distributed if they did not know their medical details (i.e. age, predisposition, compromised immunity) would allow societies to determine who should receive the vaccine first. 

The article also evoked certain personal dilemmas from me. Zhang mentions that this virus can be used politically and the vaccine is no different. She also mentions the ensuing storm of misinformation and politicking that will follow. So I pondered how I could be helpful in a situation like this, and the most immediate solution that came to mind was voting. In exercising my constitutional right, I am not only electing a leader for the country, but also a global physician in a way. The next president will determine how the virus and the vaccine is handled, and it is an extremely important choice. I also wondered how this issue would play into systemic inequalities in the modern American paradigm. Having just finished The Immortal Life, I wondered how historically marginalized groups, Black Americans in particular would be affected by an improper distribution strategy. These questions only led me back to my first realization: it is extremely important that the will of the people is pronounced on Tuesday. In a moment of historic proportions, democracy is all we can look to for answers. 

COVID Vaccine: A Matter of Trust

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Since the COVID-19 pandemic began almost nine months ago, people around the world have been begging for an answer to the same question: when will a vaccine be developed so we can return to our normal lives? As numerous companies begin to claim they are close to developing working vaccines, many are starting to feel hopeful about this “return to normal.” However, in an article published in July in The Atlantic, Sarah Zhang suggests that we may be asking all the wrong questions about this vaccine.

Zhang points out that just because a vaccine is developed, our lives won’t go back to how they were before COVID immediately. It’s likely the vaccine will require more than one dose to be effective, making distribution a major complication. Additionally, many Americans have already stated that they are unwilling or unsure about whether or not they would choose to receive the vaccine.

To me, this brings about a very important question of trust: at what point should we all feel comfortable getting vaccinated? Who should we trust for the most accurate information about the safety and effectiveness of such a vaccine? The entire pandemic has become extremely politicized, and many people feel a great level of distrust towards our current leadership, consequently saying that they wouldn’t get the vaccine if President Trump told them it was safe: they’d prefer to hear it from a doctor. While those feelings are valid, I don’t think they should change depending on who is in office.

Politicians and physicians are two completely different occupations, and the line between them has been blurred to a point that could be detrimental for many Americans. There is a tremendous safety risk in taking medical advice from a politician, whether it be one you agree with on other issues or not. This is not the job they have been trained or elected to do. For any medical issue, especially one on this large of a scale, nobody should be taking any COVID vaccine until it’s been approved by medical experts. Politicians encouraging people to take vaccines not backed by medical professionals is a violation of informed consent. By using their power and influence over citizens who are otherwise uninformed on the subject, these politicians have the means to convince people to receive a vaccine that has not been proven as safe.

As we get closer and closer to finding a vaccine, it’s important to decide where the line can be drawn: at what point in time can we feel safe receiving brand-new medicines like this vaccine? Who can we fully trust to give us the most accurate information regarding the vaccine’s safety? Should government leaders be able to declare a vaccine as “safe” with no formal medical training?

Spread of misinformation and the politicization of the COVID pandemic

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More than seven months into the current COVID pandemic, a number of ethical concerns have been and are still in the process of being disputed. Some of the most substantial debates have been about the politicization of public health issues, the spread of misinformation, and personal autonomy vs duty. These ethical issues have only become more pressing with hope for a vaccine just on the horizon.

First, the politicization of COVID has also led to widespread misinformation, not only about the effectiveness of mask and social distancing guidelines, but also on the speed at which a vaccine will be available to the public. In order to keep people optimistic, the national government has put a huge emphasis on speed of production. However, with worries of speed potentially causing errors in a process that usually takes years, some pharmaceutical companies have pushed back against claims of a vaccine that will be widely available in a month’s time. The ethical debate, then, is whether it is worth withholding factual information from the public for the sake of keeping spirits high. Based on Kant’s Categorical Imperative, the act of lying is always bad in and of itself because it could not become a universal law. In the long run, such misinformation and/or a botched rollout of the vaccine could cause the public to lose trust in the national government and public-health experts, making it even more difficult to distribute vaccines in future epidemics/pandemics. 

Additionally, the debate of personal autonomy vs duty will continue to be relevant with a COVID vaccination. Currently, this debate mostly surrounds mask-wearing and social distancing guidelines. Scientific experts across the world have encouraged such measures, but because concepts of individual freedom are so instilled in the current American system, these measures have not been nationally enforced and therefore, many refuse to follow the suggested guidelines. However, I think it’s important to recognize that one’s rights are only justifiable insofar as they do not infringe upon another’s rights. Because it is scientifically proven that widespread wearing of a mask and social distancing significantly reduces spread, not taking these precautions under the justification of individual autonomy essentially infringes on others’ rights to life, which is why it is so dangerous for public health issues like this to be politicized. Similarly, in the context of a vaccine, many Americans will refuse to even receive the vaccine, so the question becomes: should receiving a vaccine be up to one’s discretion, or is it one’s duty to receive a vaccine, not only for themselves but also for prevention of spread to the rest of society? And more generally, are there situations in which individual autonomy should not be upheld, and if so, where is the line drawn?