Choice and vaccination

In a piece about tennis players as a population being less likely to be vaccinated than the actual U.S. population as a whole, French tennis player Gilles Simon is quoted as saying, "I’m not very scared of Covid, actually. My basic philosophy is: If you’re afraid of it, you get vaccinated; if not, no. It’s still a choice."

It's still a choice. A lot of people think that, especially in the U.S. Variations on "my body, my choice" are the rallying cry with regard to vaccination (for CoViD-19 and maybe all vaccines) among people who, I would guess, don't believe that when it comes to a woman's right to choose whether or not to have an abortion. But I digress.

Here's the thing, though. If you choose not to wear a seat belt, any bad consequence will be yours alone. Ditto if you choose to eat foods harmful to your health, or to go rock-climbing solo.

However, some choices don't just affect you. Cigarette smoke spreads beyond the smoker. Driving under the influence can injure or kill other motorists or pedestrians. And remaining unvaccinated just because you're "not afraid" of SARS-CoV-2 means you are more likely to catch and to spread it to others, especially those who can't be vaccinated or whose natural immunity is compromised.

And then there's the very high likelihood of getting seriously ill yourself. Think that only affects you? Not if you're in a relationship or need to be hospitalized. A lot of other people might have to endure the consequences of your illness.

In the U.S., for better or worse, getting vaccinated is a choice, yes. The government isn't going to strap you down and inject you.

But like driving drunk, your choice to remain unvaccinated "just because" or "because freedom" (another rationale, if one can use that term) puts others at risk.

As a country we put up with drunk driving for decades, apparently because it was a sacred freedom to be able to get behind the wheel without being able to control it. We finally wised up. Now driving drunk is despicable and you're a grade-Z putz if you do.

We're well on the way to the same consensus on choosing not to be vaccinated against CoViD-19. For the same reason: the risk isn't yours alone. You have no right to risk other lives.

Ed Yong clarifies where the U.S. is in the pandemic

The Atlantic's Ed Yong is credited as "a staff writer" who "covers science". That doesn't do him justice. He's really an acute, clear-eyed observer of not just science but the American political response to the natural world — particularly to CoViD-19.

In a quickie newsletter, he cuts through much of the fog of reporting surrounding the Delta variant. The result is a sober explanation of a few bottom-line facts:

• "Vaccinated people are not fully safe ... but they're much safer than unvaccinated people."
• "Breakthrough infections are relatively rare ... but won't feel rare."
• "Vaccinated people are unlikely to transmit Delta as easily as unvaccinated people ... but they can probably still spread it."
• "We are not back to square one ... but we're not out of the woods."

If you're dissatisfied with the foregoing — if you crave facts that don't leave so much room for interpretation — sorry. That's not how things are.

In a quietly devastating analysis last fall of why the U.S. response to CoViD-19 was so appallingly bad, Yong observed (among many other things) that we have a habit of assuming we can invent our way out of crises. That leads us to seek out, and to expect, magical technological fixes.

My instinct is to call such an expectation simplistic and foolish. However, that's too harsh. Looking for magic bullets bespeaks an optimism that is part of the national character, an optimism that even I must admit is crucial not just for the nation, but for humanity at large.

That said, we often let that optimism blind us to the need to take crucial action before any magic bullets are found. If you don't yet have a cure for zombieism, you'd better do what you can to avoid being turned into one. And you can't rely on just one defense: you have to have multiple layers of defenses, because those zombies will probably overwhelm or circumvent any single obstacle.

Vaccination is not a magic bullet for CoViD-19. It's a key defensive layer, though, just in case you become infected. To minimize the chance of becoming infected, you wear a mask (or masks), stay away from crowds if possible, wash your hands before touching your eyes, etc. — all the things you're tired of hearing about but that remain best practices no matter what you think. Taking all these steps gives defense in depth, which is the best you can hope for in the real world.

So that's where we are. It's neither as great as vaccine proponents hoped nor as dire as some fearmongering pundits think. The world isn't black and white: it's full of grays.

(The 5 August 2021 newsletter is a good summary of where we are, but if you want to know how we botched things as a country so badly, you must read the long piece from last year. He identifies multiple flaws in the national character that will cause us more suffering if we don't recognize and correct them.)

Don't trust Emergent BioSolutions

A few days ago the FDA approved the reopening of the Baltimore facility owned and operated by Emergent BioSolutions that originally was slated to produce large amounts of Johnson & Johnson's CoViD-19 vaccine.

As a reminder of why this matters:

The F.D.A. had halted production at the factory in late March after it was discovered that workers had accidentally contaminated a batch of Johnson & Johnson’s vaccine with a key ingredient used in AstraZeneca’s, then made at the same site.

I never got around to posting about Emergent BioSolutions before this but I've followed news of its travails with anger and disgust.

This NYT piece discusses how Emergent came to exploit the federal government's worry over anthrax even as the nation faced shortages of personal protective equipment in the early days of CoViD-19. The company sucked up a lot of money that might have been more productively spent.

Because Emergent was the sole manufacturer of a product deemed critical to national security, the company has played what one former executive described to The Times as “the we’re-going-to-go-bankrupt card.”

Profiteering isn't necessarily a crime but it isn't exactly morally upright, either.

Another NYT piece, "U.S. Bet Big on Covid Vaccine Manufacturer Even as Problems Mounted", revealed yet more damning facts about Emergent.

More than eight years ago, the federal government invested in an insurance policy against vaccine shortages during a pandemic. It paid Emergent BioSolutions, a Maryland biotech firm known for producing anthrax vaccines, to have a factory in Baltimore always at the ready.

When the coronavirus pandemic arrived, the factory became the main U.S. location for manufacturing Covid-19 vaccines developed by Johnson & Johnson and AstraZeneca, churning out about 150 million doses as of last week.

But so far not a single dose has been usable because regulators have not yet certified the factory to allow the vaccines to be distributed to the public. Last week, Emergent said it would destroy up to 15 million doses’ worth of the Johnson & Johnson vaccine after contamination with the AstraZeneca vaccine was discovered.

Why and how did the company blunder into this and other disastrous fiascos documented in this article?

... four former company officials, speaking on the condition of anonymity because they had signed nondisclosure agreements or feared retaliation, described an environment where top Emergent leadership tolerated and even encouraged the flouting of federal standards for manufacturing and marketing products.

One of the former officials said that as the company scrambled to meet the heavy demands of vaccine production, a senior manufacturing supervisor often responded to reports of quality errors by asking: “Do you want me to make drugs or fix issues? I don’t have time to do both.”

This second Times piece is required reading if you want to understand why you shouldn't feel relieved the Baltimore plant is reopening. The story behind its original closure reveals a management team that put profits above quality and responsibility, and a governmental bureaucracy that let the company get away with its recklessness (and make a ton of money in the process) despite being charged with protecting the public.

From the piece about the Baltimore plant's reopening (the first article I referenced):

“The American people should have high expectations of the partners its government chooses to help prepare them for disaster, and we have even higher expectations of ourselves,” Robert Kramer, the chief executive of Emergent, said in a statement on Thursday.

Bullshit. Pardon my French, Kramer, but bullshit.

From that same piece:

Mr. Kramer announced that Sean Kirk, a longtime Emergent executive overseeing manufacturing who went on personal leave earlier this year after regulators found a host of problems at the Baltimore site, would be leaving the company.

Was Kirk solely responsible for the plant's terrible history of mismanagement? The article is silent about that, presumably because Kramer was, too. Emergent hasn't issued a report explaining how its Baltimore plant came to be such a disaster area, and I doubt it ever will of its own accord. In the absence of radical transparency from this outfit, how can we possibly believe, much less trust, that Kirk was the only bad apple?

I sure as hell don't think all the wasted time, money, and other resources were the result of just one executive's misdeeds and inaction. Emergent has a corrupt corporate culture and firing one executive is a laughably inadequate response to this episode.

J & J is assuming oversight of the Baltimore plant but that doesn't mean Emergent BioSolutions shouldn't face a reckoning. The federal government can't let one more penny slip into the company's coffers until there's a public accounting of who did what, and an objective assessment of how the hundreds of millions of dollars Emergent has received was spent. Anybody responsible for squandering that money, including by pocketing it while covering up fraud, has to be held accountable.