Tuesday, December 29, 2020

the trolley problem revisited

Way back on 4/26 I quoted one of the YU Roshei Yeshiva who wrote that trying to mitigate the effects of the virus was not an acceptable approach, as the Torah prohibits acting in a way that puts life in danger "under any circumstances."  I argued that what this made no sense, as the choice we faced was not saving lives vs. not saving lives, as experts even months ago predicted that the lockdown itself would cost lives.  The choice we faced was akin to a trolley problem, and the only sensible strategy under those circumstances would be to consider how to best mitigate the loss of life, as eliminating loss of life was impossible.

Fast forward to the present and read this article by Dr. Ari Joffe, someone who has a whole lot of credentials to his name, in which he calculates the cost-benefit of lockdown using a metric called quality adjusted life years and finds that the cost of lockdowns to be "at least five to ten times higher than the benefit."

Lockdowns have put many sustainable development goals out of reach. In many parts of the world there have been interruptions in childhood vaccinations, education, detection and treatment of infectious diseases (for example, tuberculosis, malaria, and HIV), and prevention of under 5-year-old and maternal mortality, projected to cost many millions of lives in the coming years. These interruptions in economic activity and supply chains are estimated to cause more than 83 million people to become food insecure, and over 70 million people to enter severe poverty (living on less than US$1.90/day), both likely to cost many more millions of lives in the coming years. Violence against women, including intimate partner violence, female genital mutilation, and child marriage are projected to also increase by many millions of cases.

In high-income countries other collateral damage from lockdowns is occurring. Fear of attending hospitals resulted in 50 percent declines in visits for heart attacks and strokes, meaning missed opportunity for time-critical treatments. ‘Non-urgent’ surgery and cancer diagnosis/treatment were delayed, with backlogs that will take years of catch-up and untold effects on prognoses. Of excess mortality during the pandemic, 20-50 percent has not been due to COVID-19 (see Kontis et al. 2020; Docherty et all 2020; and Postill et al 2020); much of that excess is likely attributable to these collateral effects. An unexplained increase in deaths of people with dementia in the US and UK also likely arose from deterioration due to loneliness. Over time, suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation are projected to cause millions of years of life lost in Canada alone.

The Great Barrington Declaration, signed by hundreds of expects, took factors like this into consideration in declaring, "Current lockdown policies are producing devastating effects on short and long-term public health...Keeping these measures in place until a vaccine is available will cause irreparable damage..."

5 comments:

  1. risk/reward evaluation 101. once you declare quality adjusted life years as your priority, the rest is just basic math. the point is one of the YU Roshei Yeshiva disagrees with that assumption.
    kt

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    1. Not sure what you are saying, so can you please clarify: Do you mean that they don't care if 70 million people are thrust into poverty, have food shortages, under 5 child mortality increases, more people die of cancer and heart attacks and strokes, etc.? So basically save one life no matter what the future cost is, even if 10x the number are guaranteed to die?

      Or do they think the experts are just making these numbers up and they have no validity?

      Or perhaps they are simply unaware of this evidence?

      I am not aware of their ever having addressed this issue and clarified what they hold, but if they have, pls point me in the right direction to where. Thanks

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  2. think of not handing over one to bandits even if 100 will die- it's deontology vs consequentialism
    kt

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    Replies
    1. you are undermining your own argument -- not handing a person over means shev v'al taaseh because we don't trade lives for lives. Forcing people into a lockdown that causes them harm is kum v'aseh sacrificing some people's well being in order to "save" others.

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    2. deontology vs consequentialism. I'll leave it at that
      KT

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