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by harrybr 1649 days ago
What is the duration of a "natural life"? For someone with a disability? For someone born with an autoimmune disease? For anyone except the young and fit?

The comment was offensive because it defines a segment of society who the author feels does not deserve to live.

1 comments

It seems that your qualm is not actually with the author, whose phrasing is not unusual at least to my eye, but with the very concept of age-adjusted mortality as a metric.

Public health in concerned in part with:

1) Giving years to life 2) Giving life to years

In order to be able to draw conclusions about the relative risks of particular epidemics (whether caused by an infectious pathogen, or lifestyle, or many other causes), it is necessary to determine how much life the epidemic is taking (via projections of age-adjusted mortality in the subpopulations in question), and the degree of detriment in quality of life that occurs beforehand.

Generally speaking, if an intervention can save lives of a cohort who is likely to life 50 more years on average, it is viewed as more valuable than an intervention that can only save lives of a cohort who is expected to live 5 more years on average.

These are absolutely reasonable and mainstream discussions that happen all the time in the relevant fields.

This conversation is not about an abstract trolley problem of years to life / life to years. It's about reality today.

The post I was quoting ended with "Why do we still have these silly mandates?? How much longer do people want to do this?"

The issue at hand is whether a person is willing to get vaxxed, wear a mask, observe local mandates and do various other things for the benefit of others - particularly those who are clinically vulnerable. It really is offensive to refer to someone who is clinically vulnerable as "at the end of their natural lives anyway".

If, as a society, we can do a few unselfish things, this will reduce the burden on health systems so people who need care can get it. An over-burdened health system is one that can't service anyone, regardless of the source of their problem.

> The issue at hand is whether a person is willing to get vaxxed, wear a mask, observe local mandates and do various other things for the benefit of others - particularly those who are clinically vulnerable

You are incorrect that this is the issue at hand, at least with respect to policy decisions about interventions. Public health decisions are not made to facilitate a fantasy world of perfect compliance, but with controls and adjustments made for real-world levels of compliance. I don't mean to sound rude, but this is not some specialized piece of knowledge imparted after years of study; this is basic high-school civics stuff.

So, instead of bizarre wishful thinking with respect to compliance with half-assed measures that never even really had substantial support among public health professionals, let's look at the actual, pressing issues of life-and-death here:

Horizontal interdiction efforts come at an enormous cost, and their effects even to add years to lives are dubious and unproven.

Outside the bubbles of affluence and privilege, hundreds of millions - perhaps over a billion - children have lost nearly two years of education. Very few serious experts ever advised this, and every accepted pandemic plan crafted prior to 2020 advised against it.

This is only one example; there are many. This organization, founded by several of the top echelon of experts in this field at the elite institutions of medicine, has begun tracking them: https://collateralglobal.org/

> It really is offensive to refer to someone who is clinically vulnerable as "at the end of their natural lives anyway".

Offensive is asking children to make dramatic, life-altering sacrifices to shield adults. Offensive is labeling those already marginalized in society as "essential workers" and asking them to be biological shields to protect wealthier people without regard to their stratified risk level. Offensive is closing schools, playgrounds, parks, community centers, gyms, places of art and music, without evidence and without a plan to achieve more acute spread in the low-risk tier so as to hasten endemic equilibrium (you know, the consensus written pandemic plan at CDC and WHO prior to 2020).

If you are so tidally offended by basic, established, well-founded, evidence-based stratification inherent to compassionate public health responses, then perhaps it's better to make decisions based on outcomes rather than your personal sensibilities of what is or isn't offensive.

There is nothing wrong with pointing out that delaying exposure to SARS-CoV-2 for any given individual is unlikely to save many years of life. And there is nothing wrong with using this knowledge to craft policy which maximally saves lives and quality of life instead of optimizing for being unoffensive in the face of the brashest takes the internet has to offer.