On Rational Economic Decision-Making In The Age Of Covid-19 Following Our Latest Community Transmission

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Earlier this week, we had ourselves some chilling news. A new case of Covid-19 community transmission – without a clear link to a quarantine or isolation facility. Worse, it turned out that the worker in question had gone to work whilst infectious.

Now, the natural impulse for much of humanity in such circumstances is to cast about to find somebody to blame. This is psychologically helpful (for us, at least) – as it means we feel like we’re actively doing something. “We’re Helping”, indeed. Even if the tangible form that “help” may take looks occasionally like some form of online not-quite-lynch-mob.

However, while there was some chagrin about the worker and their situation – that was as nothing compared to what’s been unfolding in the direction of her employer. And perhaps understandably, again, so.

After all, initial reports had said employer stating they were aware the worker was pending a Covid-19 test, the inference being they’d told them to come in anyway; with the most recent line that, and I quote: “Chen said Chinese people were very cautious and said she never expected a small cold would turn into Covid-19“, not sounding too terribly much better.

Yet while “blame” is psychologically cathartic – it’s another word that is actually rather more useful (and even occasionally coterminous): “Explain”.

The thing we need to do now is to work out what went wrong, where, and how we prevent there from being yet another repeat in a week or a month or in the next crisis at some indeterminate point in the future.

This isn’t about the situation wherein the virus presumably breached quarantine or isolation to reach the worker. Other people are handling that. Top men.

But rather – it’s about the bit wherein a person, already infected, massively increases the ongoing community transmission risk … by going to work, and interacting with other people, whilst awaiting a Covid-19 rest and result.

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Is that on them? I don’t know how much agency they had in the situation. It is easy from an armchair to insist that somebody who feels even a bit sick (sick enough to go in for a Covid-19 test, definitely) to ‘stay home, save lives’. It’s a no-brainer in fact. Except in that actual situation itself … things can suddenly start to look a bit murky. You may feel it’s ‘not that bad’, or that it’s unlikely you’ve got it (which, as I say, doesn’t appear to be what’s gone on here – it was serious enough to voluntarily opt for a test off her own initiative). More concerningly – while you might think you’re in a risky situation, your employer may disagree. Occasionally rather strenuously. Potentially putting some pressure, perhaps even pseudo-legal pressure upon you to come in and fulfil your contractual obligations.

That shouldn’t happen. And “shouldn’t happen” – especially come 2020 – appears to mean “does happen”, with some depressing degree of frequency.

Could the state do more to compel employers (and, for that matter, workers) to make good ‘decisions’ and stay home where there’s even a semi-plausible likelihood of infection? Probably. Although as this case demonstrates – that’s all hindsight (which is, as we all know, generally of far greater clarity and perspicacity than as the vantage-point things are happening). ‘Support’ rather than ‘compel’ is nicer language – and presumably more likely to be more sustainable in the long term (hence why our own Covid-19 relative success story has been based around ‘taking the people with you’ from the Government … and the UK and much of the US and Europe are flailing due to population fatigue with being carried along in endless evidently iffily ineffectual measures). It would therefore be tempting to investigate whether subsidies for sudden Covid-19 related sick-days were sufficiently available/publicized in this case – although that doesn’t actually help an employer immediately access a substitute worker to fill in for the one that’s now housebound pending their test.

However, one of the simplest things we can do, which is also one of the most dramatically efficacious interventions – is changing the way people think. Which does not necessarily require the expenditure of money in subsidies or law-changes so as to ‘alter the playing-field’ and condition what is plausible, let alone viable to do.

Effectively, you’re changing what it is that’s ‘rational’ to do – either by changing the direct incentives (via economic or legal impetus), or by changing the perceptions of things (increasing knowledge, understanding). Both of these elements – ‘rationality’ and ‘knowledge’ – are cornerstones of how an idealized ‘capitalism’ is supposed to function.

The current Covid-19 retail outlet controversy demonstrates that many of the actors in question do not possess this rationality; at least partially due to imperfect information and differing, questionable perceptions.

Consider this: on the surface, from the employer’s perspective, evidently it seems pretty rational to insist that a retail worker comes into work, even if they’re sick, right?

Except we’re in the midst of a global pandemic, there’s been two community transmission cases in the past week happening literally just down the road, and if it does turn out that your retail worker whom you’re requesting to come in has the virus … you’re quite likely to wind up “Mt Roskill Evangelical Church”‘d or “Coldstore’d”, and have a cluster named after your business.

Now, with rationality in mind … that’s something which most business-owners would probably prefer to avoid. Not all publicity, as they say, is good publicity.

But evidently, either these considerations weren’t front-and-center for the management who requested the worker come in regardless of illness … or they rationally decided that the risk of the illness actually being Covid-19 was sufficiently remote to just have her back in anyway rather than finding a replacement staffer for the day or closing up shop.

Either way – it looks a bit irrational in retrospect. But, then, things viewed in hindsight almost invariably often do. Objects in the rear-view mirror are closer than they appear, however, so it’s an act likely to have consequences going forward for everybody involved.

We can do various things to try and ‘tip the scales’ a bit – and make it more viable for an employer to make what is now, in retrospect, the right call: not calling in a worker awaiting a Covid-19 test, potentially closing up for the day if they can’t run the shop without a single retail worker. These include those aforementioned subsidies – acting on the presumption that by eliminating the economic hit for making the ‘virtuous’ call, you encourage it to actually happen. It’s an unfortunate side-point that some employers don’t actually make their decisions based on such things (either the economics or ‘virtue’) and instead prefer to prioritize fixed and rigid projections of what employees ‘should’ behave like … but more upon that some other time (it’s partially why uneconomical self-service checkouts keep being rolled out to replace human staff at supermarkets even though they cost more and facilitate vastly greater losses through shoplifting – because for these sorts of employers, it’s about power, not economics).

But in the mean-time, and alongside all of that … I think it’s probably a great time to be reminding everybody – both employers and employees alike – that actions have consequences, even the unintended ones; that seemingly minor impositions can have major ‘ripple effects’ that splash-back. And that like it or not, we really are all in this together.

In the Age of Covid-19 – We are ALL our Brother’s Keeper, now.

3 COMMENTS

  1. Cutting through the hype, Charles Hugh Smith tells us exactly how it is with so-called vaccines, and confirms our suspicions:

    http://charleshughsmith.blogspot.com/2020/11/everything-you-dont-want-to-know-about.html

    WEDNESDAY, NOVEMBER 11, 2020

    Everything You Don’t Want to Know About Covid Vaccines (Because You Can’t Be Bullish Anymore)

    In such a highly polarized, politicized environment, is such a scrupulously objective study even possible?

    Now that we’ve had the happy-talk about Pfizer’s messenger-RNA (mRNA) vaccine (and noted that Pfizer’s CEO sold the majority of his shares in the company immediately after the happy-talk), let’s dig into messenger-RNA (mRNA) vaccines which are fast approaching regulatory approval.

    Some people have concluded vaccines are not safe, regardless of their source or mechanisms. These people will never take any Covid vaccine.

    Others will also decline a vaccine because they’ve concluded Covid is overblown.

    Fair enough. But many other people conclude Covid is dangerous, partly because so little is known about its long-term effects (Long-Covid, Long-Haulers). Covid’s low mortality rate may be distracting us from its other more insidious consequences.

    Authorities desperate to restart the economy and reassure the populace are poised to approve novel vaccines using a new mechanism to generate an immune response: messenger RNA (mRNA) vaccines.

    I am not a scientist or clinician but I have followed scientific developments closely for the past 40 years and so I have a basic understanding of this new pathway.

    I’m posting links below to articles that describe the mRNA vaccines in greater detail. All these sources are respected journals or media outlets.

    Vaccines against viruses work by introducing an inactive virus or viral particle into the bloodstream where this new foreign particle activates our immune system to create antibodies against this specific virus. If the live virus infects us at some later date, our immune systems are already primed to identify and destroy the dangerous virus.

    Messenger RNA was only discovered in 1961. DNA is the set of instructions, the “blueprint”, and mRNA is a key part of the cellular machinery that copies a strand of the DNA “blueprint” and builds a protein based on the DNA instructions.

    Messenger RNA vaccines don’t introduce a viral particle to our immune systems–they deliver cellular instructions (i.e. a “blueprint”) for a viral particle which our cells reproduce once the mRNA enters our cells and delivers the “blueprint” for assembling the viral particle.

    Here’s a recent description of this mechanism from The Atlantic magazine:
    “Moderna works on RNA vaccines–injecting not proteins but the molecules of nucleic acid that encode the instructions for building the proteins. Your cells use RNA to instruct their builders to make proteins all the time; the RNA is like the blueprints or schematics that tell the workers on the factory floor what to build.”
    COVID-19 Vaccines Are Coming, but They’re Not What You Think. (March 2020)

    And here’s another description by a doctor writing in the independent.co.uk:
    This is the hard-to-swallow truth about a future coronavirus vaccine (and yes, I’m a doctor)
    “Moderna’s messenger RNA vaccine, on the other hand, is completely new and revolutionary to say the least. It uses a sequence of genetic RNA material produced in a lab that, when injected into your body, must invade your cells and hijack your cells’ protein-making machinery called ribosomes to produce the viral components that subsequently train your immune system to fight the virus. In this case, Moderna’s mRNA-1273 is programmed to make your cells produce the coronavirus’ infamous spike protein that gives the virus its crown-like appearance (‘corona’ is crown in Latin) for which it is named.”

    Many in the field see the potential for mRNA to deliver superior vaccines because they can generate T-Cell responses as well as the conventional immune responses to viral particles. They are also easier and cheaper to manufacture, and may be stable at room temperature for a week, unlike the Pfizer vaccine which must be refrigerated at extremely cold temperatures.

    The Super Cold Covid Vaccine Distribution Problem

    But these are the first mRNA vaccines ever seeking approval for human use, and so there are no long-term studies of what might go wrong down the road.

    One concern is the possibility that mRNA vaccines could trigger a generalized immune response (interferon, etc.) rather than just a specific immune response to a specific virus (antibodies, etc.).

    Our immune system is extremely complex and I make no claim to have a complete understanding of it. That said, the immune system has several levels of response. A conventional vaccine triggers the production of a specific antibody that “recognizes” a specific invader. In other cases, the immune system can activate an “all hands on deck” generalized response.

    The danger is that the mRNA could trigger an “all hands on deck” response that could then cascade into autoimmune disorders in which the immune system goes haywire and starts attacking the body’s own cells rather than limiting its destructive capabilities to foreign viruses, bacteria, etc.

    One of my MD correspondents recently sent me an email which encapsulates these concerns.

    “I’ve been reading about the Pfizer vaccine.

    I’ve known for a while that it is an mRNA vaccine but it just hit me that it will be the first mRNA vaccine ever approved for human use.

    If COVID was a ‘Steven King’ (kills-everyone) virus, sure, go for it–prevent the deaths and take what comes.

    But mortality is low, acute treatments are improving, transmission is preventable, and the greatest risk now appears to be longer term morbidity.

    mRNA vaccines by the very nature of their components elicit an interferon response that triggers generalized autoimmunity. This may, in fact, be part of the mechanism of longer term morbidity associated with COVID infection.

    Mass introduction of mRNA strands into the populations may indeed reduce acute COVID morbidity and mortality, but how many autoimmune complications will result?

    No one knows.

    It’s never been done before–ever.

    It would take years of carefully controlled and limited trials across all ethnic groups to find out.

    Is the net good from a vaccine that fewer people die up front but a whole lot more folks suffer long term problems on the back end–especially (as seems likely) boosters will be required.

    Shouldn’t there be a discussion before ‘immunity passports’ are mandated?

    For that matter, shouldn’t we discover how long natural immunity lasts before trying to provoke induced immunity?

    I’m dumbstruck that, with the proposed approval timetable, this path is even being considered at a population level, let alone considered without an extensive discussion.

    First do no harm.”

    Indeed. And then there’s the self-interest of those seeking rapid approval of the vaccines. As noted in the independent.co.uk article referenced above:
    “But perhaps the most important question to ask about Moderna’s new messenger RNA vaccine is not scientific nor technical but one of ethics and morality. When it comes to the United States and its private healthcare system, pharmaceutical companies have a long and sordid history of putting profits over people and human lives.”

    Why would anyone trust that Big Pharma corporations will act in the public good rather than in pursuit of maximizing profits?

    The mad rush of profiteering Big Pharma corporations to own the first vaccine approved will create needless and potentially dangerous confusion about which vaccine actually works best over the longer term.

    First, A Vaccine Approval. Then “Chaos and Confusion.” (NY Times)
    “It has not yet dawned on hardly anybody the amount of complexity and chaos and confusion that will happen in a few short months,” said Dr. Gregory Poland, the director of the Vaccine Research Group at the Mayo Clinic.

    “I can see people reading a lot into even minor differences that could just be statistical chance,” said Natalie Dean, a biostatistician at the University of Florida.”

    The FDA has set the bar very low for Covid vaccines: the vaccine only has to be effective for 50% of those taking it to be approved. But as noted above, Big Pharma companies have mastered the art of statistical legerdemain that skew results so they look far more conclusive than they actually are.

    If you’ve actually pored over Phase III drug trial results (I have), you find uncertainties have been papered over with statistical analysis techniques. Many medications are approved that only work less than half of the time in the real world.

    Another healthcare professional correspondent recommended the book Tainted Truth: The Manipulation of Fact In America as a source for understanding how study data are manipulated to get the desired results.

    The danger here in my view is the poorly-informed, politically polarized general public will assume a Covid vaccine is essentially 100% effective like a measles vaccine, when the real-world efficacy might be considerably less certain. Maybe the vaccines will only work for 75% of the recipients. How will anyone be able to tell if they’re one of the 25% for whom the vaccine offers only false confidence?

    No one knows how long the immunity generated by these vaccines will last. These two uncertainties generate insurmountable doubts, very likely muddying the waters and making it more difficult to ascertain which vaccines actually work and for how long they offer immunity.

    America’s choice to optimize healthcare profiteering (a.k.a. “shareholder value”) over the public good is about to reap a whirlwind. Our educational deficiencies won’t help, as a populace which has a limited grasp of statistics and basic biology has few means to sort the wheat of real-world results from the chaff of self-interested PR.

    Maybe the mRNA vaccines will fulfill their promise the first time out of the gate, with near-perfect efficacy and long-lasting immunity. The problem is it will take a long time and careful, de-politicized, independently confirmed studies to reach any trustworthy conclusions.

    In such a highly polarized, politicized environment, is such a scrupulously objective study even possible? In a system that rewards self-serving statistical analysis and “first to market,” a system where Big Pharma insiders reap millions of dollars selling their stock on the PR of happy-talk, is it even possible to have truly objective studies of a vaccine’s efficacy and long-term effects?

    It seems doubtful. And that’s a problem that extends far beyond the unknowns of mRNA vaccines.

    • Fascinating and insightful post AFKTT. Be good to hear a contradictory point of view from the many on here who just cant wait to receive their jab of a life giving mRNA, but they seem pretty quiet.

  2. We are given news on US and UK vaccine efforts but without critical detail.
    But we are not given news on the Chinese stage 3 vaccine which seems to be taking a safer path.
    Which brings me to a question . If NZ seeks a vaccine who will research the best selection of options. Politicians , commercial dealers or a pool of independent NZ scientists.
    Big Pharma just cannot be trusted as has been demonstrated on numerous occasions.

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