Outrageous Covid 19 vaccine recommendation
 

The recommendation below is admitted to result in more total deaths especially for the elderly and medically impaired but none the less was forwarded to the CDC.
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The committee typically relies on science to inform decisions, but this time, social justice concerns have come up as well.

Harald Schmidt, an expert in ethics and health policy at the University of Pennsylvania, told the New York Times essential workers should be prioritized over older adults because "Older populations are whiter."
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Post-Vaccine Outlook
The Elderly vs. Essential Workers: Who Should Get the Coronavirus Vaccine First?
The C.D.C. will soon decide which group to recommend next, and the debate over the trade-offs is growing heated. Ultimately, states will determine whom to include.
Updated Dec. 15, 2020
With the coronavirus pandemic surging and initial vaccine supplies limited, the United States faces a hard choice: Should the country’s immunization program focus in the early months on the elderly and people with serious medical conditions, who are dying of the virus at the highest rates, or on essential workers, an expansive category encompassing Americans who have borne the greatest risk of infection?

Health care workers and the frailest of the elderly — residents of long-term-care facilities — will almost certainly get the first shots, under guidelines the Centers for Disease Control and Prevention issued on Thursday. But with vaccination expected to start this month, the debate among federal and state health officials about who goes next, and lobbying from outside groups to be included, is growing more urgent.

It’s a question increasingly guided by concerns over the inequities laid bare by the pandemic, from disproportionately high rates of infection and death among poor people and people of color to disparate access to testing, child care and technology for online schooling.

“It’s damnable that we are even being placed in this position that we have to make these choices,” said the Rev. William J. Barber II, a co-chairman of the Poor People’s Campaign, a national coalition that calls attention to the challenges of the working poor. “But if we have to make the choice, we cannot once again leave poor and low-wealth essential workers to be last.”

omg, it sounds like some kind of gag

Being whiter isn't the issue. As explained here, the probability of being impacted by the virus is.

https://www.washingtonpost.com/healt...racial-equity/

You are wrong. It has everything to do with race. If you look at the actual numbers and percentages, they completely correspond to the population of the country. This particular virus is age related, not so much race related. Believe me, I have experienced in my lifetime way too much of this racial equality stuff to know it when I see it.

Just so you know, I have been denied jobs, because I was white.
I have been denied promotions, because I was white.
I actually heard a black manager over the phone say: "I wouldn't hire that white B****h if my life depended on it.

By the way, they made no bones about telling me that was the reason for the various jobs and promotions.

"If you look at the actual numbers and percentages, they completely correspond to the population of the country."

Incorrect. Please take the time to read the link.

"Haywood County, a majority-Black community not far from Memphis, has one health department, one nursing home and no hospitals. The fatality rate of covid-19, the disease caused by the coronavirus, is 50 percent higher than the state average.

A Centers for Disease Control and Prevention advisory group has signaled it will recommend prioritization of certain essential workers, in part to address racial disparities exposed by the pandemic. People of color are overrepresented in industries such as food processing and transit, in jobs impossible to do from home."

As for your anecdotal experience, how many more people of color do you think have experienced the same exact thing in their lifetimes?

I am truly thankful that it is not my decision. Any choice made will be criticized. Ethics and so many of the things we argue, oops discuss, are impossible to define. The declaration of independence. Life, liberty and the pursuit of happiness. Powerful words. What do they mean? We can all discuss-argue. We will quickly realize different things to each of us.

The vaccine. Much of what we are being told does not make sense. We are told 94% effective. The flu shot is like 60% effective in a good year. Covid 19 is a virus. Viruses quickly mutate. Months ago I read somewhere that there were then 94 different strains of covid 19. If that was true then it has mutated exponentially. A radio story this morning.
Covid 19 perhaps as in Florida is spreading more rapidly than expected. The story, if correct, said it is a new strain.

What to do? You can only do the best you can. Teasing a bit-don't blame me. I chose not to be in charge.

You can't use the flu to draw conclusions about the efficacy of the coronavirus vaccines or the impact of mutations on their efficacy.The mutation characteristics are different between the flu and the coronavirus. Some viruses, such as measles, are pretty stable where it matters so the vaccine continues to work. The developers are expecting the vaccines to be viable for a longer period of time than the flu vaccines. How long? We will see. There is a lot of information available about the Pfizer/BioNTech and the Moderna vaccines.

Not entirely, but it's all we have in general. COVID-19 has mutation characteristics closer to H3N2 influenza than H1N1 strains. But this vaccine is so different from traditional "flu shots" that we are in uncharted territory. Early studies based on 42,000 test subjects showed a 95% efficacy (162 in the placebo group contracted COVID, 9 severe as opposed to 8 in the treatment group, 1 severe)

So one guy, the professor at U PA makes a racial statement and as usual the media presents it out of many other more important options to present.

And then it is picked up by some and turned into a general condition.

The elderly are most vulnerable to dying when contracting the virus. And yes, like every other statistical presentation there are more whites......Hmmmnnn......whites are 76.3% of the total USA population.

Thank you so much that over the years you have said the same thing over and over and I HAVE LISTENED about being so fixated on the miniscule in conversations, in politics and in life that we are ignoring all of the things that have already been put in place to make things to me anyway, MORE THAN FAIR.

On this issue, early on, my uneducated opinion was that it is entirely possible that some people with a certain blood type may get sicker or less sick with Covid-19. I have nothing to back this up. It is just a feeling, a hunch, a guess. We women have them all of the time.

I just quoted one person on the committee but the entire committee recommendation to the CDC is going to be to put white seniors farther back in the vaccination line based on social justice as they interpret it. Minorities in low paying jobs will skip ahead of us even though on average they recover instead of dying as many seniors do. If you are 80 or older your chance of getting covid19 and dying from it is 8 %. If you are black your chance is 0.1 %.

I believe the actual decision is left up to the states. I have already seen the Florida Plan and health care workers and those at risk are at the top of the list. Those 65 and over will follow.

One problem that I, personally, have on here is presentation of only a partial part of anything.

The quote in the OP is way out of context, and to JOHN41's credit, he attempted later to insure you know this was one man, who has a job title of "Assistant Professor of Medical Ethics & Health Policy" thus he brings his strength to the table in a very complex discussion.

The New York Times has a long, interesting article on the situation, and for the record, this professor has publicly stated since "Note: 1) never espoused race-only prioritization; 2) Key: many 65+ can live socially distanced safely, w relatively less inconvenience until vax. But far more among essential workers can’t, esp frontline workers.". This is from the professors twitter account.

This is complicated when trying to do what is right for the country, and this is why so many are frightened at the shoving aside of people, like scientists, etc. that have the knowledge and expertise to do this without the ramifications, and knee jerk responses we seem to be used to.

We can do it correctly, or we can allow outside influences screw it up also.

It was not a racial statement, and it was not presented improperly. It was presented on this forum as “outrageous” without any context. You take aim at the wrong people and YOU are the one making generalization. This is what happens when nobody cares about context, and are so ready to jump in what they think, with no investigation, may validate something they want to believe.

I would link The NY Times article, but you need a subscription, and the general media (I have seen it on NY Post and National Review, not known for context) but IN CONTEXT NOTHING “outrageous” at all. Academic discussion for the good of the country.

I must completely disagree with the premise of this thread. The gentleman in question sees things through a prism that accentuates so-called "diversity", ie: segregation of humans based on politically made definitions.

There is only ONE race, the HUMAN race. Time we started fighting back against the forces who would divide us based on false designations. Everyone will have access to the vaccines by March so no need to create a false narrative of "racism".

The quote termed “outrageous” was part of an important vital conversation relative to how to best serve our country.

It is being presented here totally and completely “on an island” which is outrageous in itself.

This is not something to be discussed by us amateurs and non professionals, and I think putting words out that do not reflect reality or truth is 100% wrong.

By the way, these kind of discussions always take place (and should) on varied subjects. Somebody decided to “stir the pot” and readers on this forum simply accented what they wanted to for whatever reason.

???? The word "outrageous" is nowhere in my post. And your response makes no sense.

I have now included that NYT article in my original post as you suggested for context. Per that article the choice of who gets the vaccine next depends on whether saving lives of seniors or reducing infections in minorities is more important. To me letting more seniors die for that social purpose is what's outrageous.

OUTRAGEOUS is in the thread title. Never mentioned your post.

The OP is totally and completely out of context, and you can’t respond unless you read more and know in what context.

Suggesting read the Times article on this discussion. It was comprehensive and was meant to present how this is being decided . It is of import to this country, and taking excerpts to fit whatever fits an agenda is unfair.

Very simply stated...perhaps to simply. It was one persons comment...one person, who has already clarified in detail his meaning.

Presenting the “outrageous” proposal, which it is not is unfair.

And now the media fans the flames of racism and dividing our country.
There is most certainly a more educated description of how and why ( which obviously would not be as sensational or agenda focused).

Half of US states want to prioritize black and Hispanic people in vaccine rollout | Daily Mail Online

Read the Daily Mail at your own risk.

Owned by tgevsame folks who own the gossip tabloids in England.

Try reading reputable sources.

It is insulting to have the Daily Mail referred to as the "media"

Hope someday, we get back to real journalistic sires. Must be true when it is said that so many simply search out those sources that validate what they already think.

If you believe martians are here, you can find some sort of "edit to agree with you. So much life missed by reading trash....real honest news has reality, and does not feed fantasy.

They are not anecdotal and I can also add some other experiences. I have never in my life thought of attacking because of ethnicity. As a teenager, I was attacked because I was white. My mother was attacked because she was white; and lastly my daughter was attacked because she was white. So don't hand me any anecdotal experiences crap.

affirmative action cuts both ways. my daughter's childhood friend was overlooked for a job because: 'they already had enough african-americans & needed more asians.' it's insanity. never mind the young lady spent all of her years studying hard & getting really good grades in a field she always hoped to work in, --she just had the wrong physical attributes, & didn't hesitate to let her know. :ohdear:

I would propose a 2-level solution. The main objective is to achieve the best health outcome for ALL of society. You have to attack the disease where it has spread or will spread the most (now that it is raging). So, hospital staff should be 1st. They are indoors and they have the greatest need because of up-close work with patients who either have CV or may have CV. Office types and management that do not see patients should NOT be 1st or early to get the vaccine. 2nd, I would vaccinate residents and staff of long-term care facilities - because they are indoors, packed in close, and older. Prisons would be in the same situation. Not that inmates DESERVE it early, but prisons would be a perfect incubator area for the CV with the staff then spreading it to the general population.
...... 3rd, I would allocate the vaccine to the 1st responders and front line workers that can NOT work from home...........my 4th group would be the over-65 US residents.

Notice that I would give ZERO consideration to which groups were made up of more or less whites, blacks, or browns. That is like a "red herring". It is meaningless to argue about that or try to change culture with a vaccine. You attack the DISEASE where it exists in quantity and thus protect the maximum members of ALL society. The DISEASE is going to go to the weakest links of society where it can spread the most, regardless of skin color.

The 2nd level of the solution would be if there is not enough vaccine to do ALL of those 4 groups mentioned. Then within those classifications of groups, you use a LOTTERY system or chance to determine which INDIVIDUALS get it. So, first set priority groups and then use a chance or lottery system for individuals......... also, I would use a lottery system for the rest of the GENERAL population.

Maybe only on TOTV, does a thread falsely founded, presented because of one comment, without any discussion about the total picture and academic, scientific discussions over how best for the country to distribute vaccine for Covid dissolve into a discussion of race in general, and/or attacks on the media.

Tells you what is important to folks.

Remember this discussion was presented in The NY Times in a comprehensive way, loaded with many quotess and ideas.

This one quote is what seems to interest TOTV posters

You may want to check the definition of anecdotal.

One major mystery about CV is WHY children get it much less often. They are not immune, but they have some (?) natural resistance. Dr. Fauci stated that studies are underway to determine IF the vaccines will convey immunity to children and cut down their spreading of the disease. Lots of questions and research needed!

That may be true. Your statements seem to say that the vaccines should be directed to those groups that are in MOST danger of dying from CV. That is logical. And I would agree IF NOT for the fact that the CV is raging now today. By raging - I mean 250,000 new cases in one day, yesterday. Because the US has SUCH a high emergency, I would humbly suggest that it might be better to concentrate on putting out the disease as if it were a SPREADING FIRE. Put out that FIRE first (control the spread) and then work out the vaccine delivery based on groups likely to die the most. The plus age 65 group is more likely to be hunkered down at home and not rolling around society and SPREADING CV ( some are at the TV Land squares), most should NOT be. Your front-line workers, police, teachers, and firefighters can NOT work from home or hunker down. Therefore, they should get the vaccine before the plus-age 65 citizens - in order to dampen the SPREAD.

Great post about a serious distribution problem that must take into consideration a boatload of factors, some of which generate emotions. And it will be done state-by-state, which will add to the confusion. What could possibly go wrong?

Good news BUT the next Surgeon General already had excuses why he can't meet the April timeframe for distributing the vaccine to the general public per Operation Warp Speed. Remember when the media said it would be a miracle to have a covid19 vaccine by years end. Well the miracle happened.... But no more.

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Excerpt from CDC Advisory Committee
A major ethical issue in front of the committee has been how it's considered racial and ethnic minorities, groups that have been disproportionately affected by Covid-19. But according to data presented at the ACIP meeting, front-line essential workers first in line, in Phase 1B, are more likely to be white Americans, while there is significant representation of minority groups in other essential workers, in Phase 1C.

Altogether, Phase 1C totals about 129 million people. The recommendations may need to be adapted over the coming months as the vaccine supplies fluctuate.

Dr. Nancy Messonnier, who leads the CDC's work on vaccines for Covid-19, explained during the meeting Sunday that her staff has tried to "walk a careful line" by offering explanations for the agency's recommendations, while leaving some room for "those on the front lines of jurisdictions that actually have to translate this into implementable guidance." States will ultimately make those final decisions.

One measure that can be used in distribution of a scarce resource is its effect on Years of Potential Lives Lost YPLL. YPLL calculates how many years of living the victim of a disease or accident lost as a result of that disease or accident.

An action taken to save a 10 year old has a much greater effect on YPLL than that same action taken to save an 85 year old. Similarly you can consider cost benefit. A person disabled by Covid and living for 5 years costs far less than someone getting the same level of disability and living for 40 years. Morbidity alone is not the only factor that can ethically be used in decision making.

While my death from Covid might be more likely to be prevented by a vaccine than my child's death, I and likely all of you if there were only one dose left to be given and you could get it or give it to your child - would pass it on.

If that is an easy choice because you love your child, I'd simply point out that your choice was based on an ethical construct, what is best for your family. Women and children first into the lifeboat... ethical choice. Is all of society our family? Does love your neighbor mean anything in this context?

If you leave race out of it, an ethical justification can be found for protecting essential young workers, especially those with children over elderly persons with limited YPLL benefits and no one dependent on them. If it turns out that those young essential workers are much more likely to be not white than the elderly at risk group, it is fair to mention that fact and not be accused of making a racist statement.

The calculation of benefit is not as simple as who is more likely to die if not vaccinated. It is the job of an ethicist to bring differing options and approaches to the discussion. The Children's hospital where I attended had ethicists. They came into difficult decision making situations not to tell the families or doctors what to do, rather to present all the factors which could ethically be used in making one of many reasonable choices.

That's the "let grandma die" strategy of Utility Theory with a constant, equal marginal utility per year for everyone. But suppose grandma has a PhD in microbology and still works in her profession. Shouldn't her marginal utility be higher than a child who has a low IQ ? Shouldn't grandma get the vaccine?

I agree that rationing scarce resources invo!ves an ethical decision but ascertaining the correct uti!ity functions is more complex than appears at first glance.

Geronticide, Senilicide, Senicide? Pretty drastic and scary.

Senicide - Wikipedia

Facing Senilicide | Psychology Today

This looks pretty reasonable to me. https://www.cdc.gov/vaccines/acip/me...ID-Dooling.pdf