An ethics lesson in the midst of a pandemic

Here is a hypothetical situation concerning getting the vaccine against the coronavirus. A hospital department contacts its employees late on a Saturday evening to let them know that if they want, they can get the vaccine that evening. The only thing the department employees are told is that the vaccine expiration date is the following day--Sunday, so the vaccines must be used up quickly. Around two hundred employees show up to take the vaccine; all are wearing masks, and all are trying to practice social distancing while waiting in line. One of the organizers walks around counting heads and telling the employees in a loud voice to remember to stand six feet apart. It is only when each employee is sitting with the vaccinator that he or she is told that the vaccines had not been stored at the right temperature and that there is a question as to whether or not they will be effective at producing antibodies against the virus. In other words, showing up for the vaccine dose may mean that the trip was a wasted effort. The vaccine may work, which would be good news, and it may not work, which is not good news. The latter means waiting for a new first vaccine dose; for some employees, this is a rather bitter pill to swallow because some of them lose their place in the regular vaccine line sponsored by the city municipality where they live or the hospital where they work. The hospital department that arranged the vaccinations has apparently not contacted upper hospital management about their vaccination program arranged on the fly; in other words, the left hand doesn't know what the right hand is doing. The hospital department decides to arrange for antibody testing starting around seventeen days after the vaccination date; it will call in each employee for a blood test and test for the production of antibodies against the virus. This could take some time--both the blood collections and the antibody tests--so it is uncertain when the results of the tests will be available. In the meantime, older employees (circa sixty-five to seventy-five years old) are being called in by the city municipality to get vaccinated. The municipality has no idea that these employees have been vaccinated with a possible ineffective vaccine dose. The employees are stressed because they are unsure of what to do--wait for the department to arrange everything, or take the new vaccine dose offered them. If they don't take the latter offer, they may lose their place in line and may have to wait another month or more to get a functioning vaccine. During a pandemic, the stress factor is high and nerves are frayed. It would be best to give employees the whole story, right from the start. 

If you were one of these employees and were a student in an ethics class, you might broach the following questions for discussion:

• Why weren't the employees told the whole story--that the vaccines might be ineffective?
• Why were only some few leaders told the whole story, and why didn't they inform all employees?
• Why wasn't there a general announcement that evening before vaccinations started that the vaccines might be ineffective?
• Are the results of these vaccinations going to be used in a research article of some sort? If so, all employees must consent to the use of their data in an eventual article. Some may choose not to.
• Even if the information gained from such a project is useful and informative, which it actually is, it would have been better to have fully informed employees about what they were signing up for. 
• Does this type of behavior help to build employee trust in management?

This is as it turns out, a true story. While all the employees will eventually get vaccinated with a second dose if the vaccine they received proves effective, and there is good reason to believe that it is effective, it would have been far better to have fully informed all employees. Some leaders will say 'what's the big deal? It all worked out well. Why are employees dissatisfied?' The answer is that they're happy to have been vaccinated, but dissatisfied with the way it went down. It's a learning experience for all leaders. The next time, they should make sure that all employees are fully-informed. That way, it's win-win for everyone. 

More pandemic humor

Pearls Before Swine is probably my favorite comic strip at this point in time. Stephan Pastis has had so many good commentaries on the pandemic in which we find ourselves trapped. Here are some recent strips that are pretty funny. 

 

Pandemic humor

My friend Stef has been sending me coronavirus-inspired cartoons and memes since shortly after the pandemic started. These two made me laugh out loud......

A year of the pandemic

Mid-March will mark the one-year anniversary of the month in 2020 when life as we knew it came to a grinding halt. Normalcy disappeared, replaced by uncertainty and a fair amount of gloom and doom. People were told to work from home if they could. Day-care centers closed, likewise most schools and universities. Restaurants, bars, theaters, movie theaters, malls and shops also closed. Plane travel ceased, as did international travel. Supermarkets remained open, as did shops deemed essential for the daily lives of men and women. Norway did not institute a curfew, but all of the above closings constituted a lockdown of society, however partial. 

When the pandemic first began, my husband and I were glued to all the news programs we could find about the coronavirus. We watched the news religiously, and read the rapidly multiplying scientific articles about the virus. We wanted to learn as much about it as we could. Norwegian immunology and virology experts weighed in with their opinions. Politicians and health officials collaborated on a daily basis. I watched Andrew Cuomo and Anthony Fauci in the USA update the public on the latest about the virus and the numbers of people infected as well as the number of deaths. Intensive care units in hospitals were overwhelmed, as were funeral homes. The media photos of mass burials around the world will stay in my mind for always. 

There was nowhere to go, so we went nowhere. We ordered food delivered to our home from time to time. I stocked up on face masks in anticipation of the coming winter; I knew the pandemic would not be over by then. Last March, however, I had a different kind of hope than I do now. Having never experienced a pandemic before, I went into it, probably like many others, with expectations that the scientists would have it covered and that it might also just die out like the flu viruses often do after wintertime. But the infection rate of this virus didn't seem to wax and wane with the seasons. It worsened after vacation times, whether it was summer vacation, autumn vacation, or Christmas vacation. 

The pandemic was the year that Trump got louder and louder, and grew bigger and bigger until he finally burst. He lost the presidential election, refused to accept that loss, and fomented a rebellion and a capitol invasion that will forever in my mind be linked to the year of the pandemic. People lost their minds, literally, and followed an unstable man into an unstable and divided future. 

I worked from home, and found out that I enjoyed it, until I realized that it might be a permanent situation. But I stayed focused and got my work done, usually by 3 pm each day. That left time in March for watching the HBO series My Brilliant Friend, which I looked forward to watching each day like I used to do when I followed specific soap operas on television many moons ago. When April came, I went to work in my garden after my workday was done. That got me outdoors and kept me physically active and busy so I had no time to think about the virus. It stayed that way until early November, when the garden was closed for the winter. And then came Christmas, followed by the months of January and February which I liken to a wasteland for all they contribute to my life at present. But we are healthy so I can't complain. As the one-year anniversary approaches, I am also glad for Netflix and HBO--for all the movies and series they offer--some of them excellent. There is always something to watch on the streaming channels, unlike regular television channels that are a complete wasteland and waste of time. I also have mostly given up listening to the news--it's depressing and keeps us stuck in the same mindset.

I've realized that having a garden and being to work in it from April until November kept me sane. It got me outdoors together with my fellow gardeners, and we could chat with each other at safe distances. No one took any stupid chances; we behaved and followed the rules for not getting infected. It worked. I am grateful for my garden because it saved me. It provided peace of mind when I could not find it anywhere else. Besides the activities one has to do in a garden in order for it to flourish, the garden let me think of other things, like why did the honeybees gather at the birdbath to drink water. At times there were twenty or thirty of them lined up on the rim of the birdbath. It was an incredible sight to behold, and I loved it. Or the day when the sparrows decided to bathe together en masse in the birdbath--chirping and flapping their wings while enjoying their bath. And then they would all fly away together, and then fly back to the birdbath together. It was truly a communal bee- and bird-bath last summer. 

I bring this up now because I cannot wait to be able to get back to my garden this year. January and February have had me climbing the walls of our apartment. It was bitter cold for most of January, so going outdoors was a chore. I did so anyway since the sun shone and the days were lovely. But cold it was. Just being outdoors kept me sane, even if I froze doing it. But I miss the interactions with other people. Humans are not made for isolation. I went back to work more during the past few months, despite the continued recommendation to work from home. I needed to see co-workers in person. I discovered that I hate zoom meetings and most things digital as far as work-related activities are concerned. I want real-life people that I can physically relate to in real-time, not virtual. I would prefer a room full of masked people that had gathered for a meeting, rather than a zoom meeting. My heart goes out to all those who live alone; it must be difficult whether you are young or old. I feel for students and young people whose social lives have been severely restricted. And yet, what else is there to look forward to if we don't follow the rules? My sense of hope has changed; it is tinged with a sorrow for mankind in case life never really returns to normal. I hope it does, but you never know. And some of that sorrow is for myself, since I never for one moment considered that my yearly trip to NY would disappear last summer and most likely this summer. I miss the other life I have in NY with my good friends and my family. 

I feel for people who don't have a haven, a refuge to go to, to get away from the news, the virus, the regulations and restrictions, the slow vaccination process, the new virus mutant variants, the constant talk about how many people are infected and how many have died. It's all too much, and it overwhelms the mind. I've talked to several people about fuzzy brain function lately, due to the anxiety and stress of living with the pandemic day in and day out. One can only hope that it comes to an end very soon. 

The new normal

We will see what the winter brings in terms of the severity of a second wave of Covid-19 virus. Europe is currently dealing with the second wave, as is the USA. Here in Norway, the health authorities do their best to control the situation, but of course no one can predict what the winter will bring. 

I envision permanent changes in how we live. For starters, the disinfecting and sanitizing that go on will likely continue, both at home and in public places. And that's fine with me. Better too much of it than too little. I think we had gotten a bit lax with keeping public places clean. It's good to have the reminder that public bathrooms in workplaces, restaurants, malls and other places need to be cleaned regularly. Ditto for elevators, stairwells, escalators--any of the places where people are constantly touching buttons, railings, etc. My workplace had cut back on office cleaning each day to save money; the cleaning lady was coming in a few times a week. Now I see her there each day if I have gone into work a few days in a row, as has happened during the past few weeks. She cleans the hallway floors each day as well. 

Working from home a few days a week will be the new normal for many people who are able to do their work from home (like me). I go into work when I need to, either for a small meeting or to update files on my workplace server. I will alternate between home and office for the time being. As I've written many times, I enjoy working from home, as long as I have access to necessary email accounts and files. It hasn't been a problem thus far. The only thing I really dislike are zoom/skype meetings; mostly because there are technical problems, without fail. Someone's microphone or video or both doesn't/don't work, or the video is squiggly, or the sound breaks up. An optimal way to communicate? No. I'd rather have a socially-distanced meeting in a large room, and have said as much to those who arrange meetings. 

Wearing masks will probably also be something that most people will incorporate into their daily lives. I took one of Oslo's trams yesterday for the first time in ages. Masks are required on board all buses, trams, and trains. Most people comply with the guidelines; some few don't, as always. I carry a cloth mask and disposable masks in my backpack with me at all times, as well as hand disinfectant. I find the cloth mask more comfortable to wear and easier to breathe with, so that's my go-to mask. The disposable ones are ok but a bit more stifling. The nice thing with cloth masks is that they are not disposable, they can be washed with soap and dried and used over and over. That appeals to the environmentally-conscious part of me. This pandemic has been terrible for the environment; just take a look around the next time you are at a bus or tram stop, at all of the garbage cans overflowing with disposable masks. Ditto for the single-use wipes at home. I try to limit their use, but it's difficult at times because they're so accessible. Not a good excuse, I know. 

Stores and restaurants in Oslo have been good about social distancing; chairs and tables are placed at a good distance from neighboring tables. Plexiglass shields have become commonplace to separate shoppers from cashiers. Supermarkets had already gone over to checkout scanners a few years ago, so the stores have placed plexiglass shields between each of the scanners to protect shoppers. Screens are wiped down regularly. Hand disinfectant bottles are placed strategically at each checkout scanner. and at the entrances and exits of most supermarkets and stores. It all works, and it is interesting to observe what we can actually get used to without too much moaning and groaning. 

Visits to doctors and dentists have not been a problem. Both doctors and dentists have their procedures for how they receive patients, and following them is not a big deal. If such procedures continue even after the pandemic is over, it will be fine with me. We are all more attentive now to good hygiene in our homes and public places; as I mentioned above, many places had become lax when it came to good hygiene, in order to save money. 

I have not gone to the movies since before the pandemic started. I miss doing that. The theaters are open again and are advertising films and encouraging us to go to the movies. So I will. I'll have my mask with me and I'll sit where we're told to sit. Fine with me. The same with churchgoing; churches reopened at the end of the summer after having been closed since mid-March. Their procedure for attendance is to dispense tickets for the masses. I haven't been back yet, but I'm planning on it. I don't know what traveling will be like by next summer; I'm hoping to be able to get to the States for a wedding, among other things, next July. We'll see. I'm crossing my fingers that it all works out. 

So little by little, life returns to some semblance of normalcy. Albeit a different normalcy--the new normal, which if followed for the next few years, will become just normal. Humans can adapt; we do so in order to carry on with the business of living. 

Past the halfway mark and moving toward 2021

 

Reflections on the pandemic

Pandemics seem to bring out the stranger and hitherto hidden sides of people. Visions of a dystopian world or even an apocalyptic one have created paranoia on the one hand and an intense need for control on the other. Some people walk around with a simmering rage, as seen in the many news stories of late about people who deliberately spit and cough on others or become violent toward others for either wearing a face mask or not wearing one. Others have sunk into a low-grade depression, convinced that nothing they do will make a difference one way or another. I’ve watched enough apocalyptic sci-fi movies to know that the word ‘control’ loses all meaning when mankind is faced with extinction of one sort or another. Or perhaps more aptly put, control becomes more about creating a kind of order in one’s life rather than trying to create order and control in society at large. Because the truth is that the idea of ‘control’ is an illusion in the best of times; chronic illness can wipe away that control over our own lives in no time. Just ask any patient with a chronic degenerative neurological disease, or terminal cancer. The diseases make the rules, patients don’t. We are lucky to live in well-ordered societies that function because there is a modicum of laws that keep it functioning, but it doesn’t take much to wipe a law-abiding society away. All you need is an emphasis on ‘me first’, ‘my rights’, ‘I am entitled to’, ‘my freedoms’ when the health authorities ask people to maintain social distancing, not travel, and to wear masks. The latter hasn’t occurred yet in Oslo, but it will, mark my words. The emphasis on ‘my freedoms trump your rules’ is paramount in our society. You just need to look around and witness the large numbers of young people who ignore the social distancing rules, who party and carry on as though there was no pandemic. Or the people you meet on the city sidewalks, mostly young but some old, who walk three abreast and don’t budge an inch as you pass. More often than not, it’s me who moves to the side to create distance between us. My best guesstimate is that two of ten people follow the suggested rules for social distancing. Even some of the elderly seem not to care about social distancing. One nice exception was a middle-aged couple that began to walk single-file when they saw me coming, and we acknowledged each other as we passed each other. It’s as though those who ‘get it’ are part of a secret club when we meet each other; we exchange knowing glances. Because we know that the rest of society doesn’t get it. I’ve watched and read enough apocalyptic sci-fi shows and books respectively to know that this is how the world really is. The majority of people carry on as though nothing has happened, or that what has happened doesn’t really affect them personally. Until it does. And by then it’s usually too late. If people could at least follow these simple rules, we could maintain some semblance of control—the idea of control in any case. The coronavirus doesn’t care about any of it; it will continue doing what viruses do, infecting hosts and making them sick, until it is stopped in one way or another.

I try to follow the advice given by the health authorities. I have purchased face masks in the event that we are asked to use them. Come autumn and winter, I will use them when I go grocery shopping or out to any crowded place. Right now it’s summer and I’m in my garden, alone for the most part. That God-given haven disappears in wintertime. I will continue to work from home, shop online, and grocery shop once a week. I am not sure what winter will be like in the psychological sense; every now and then I get inklings of what a world plagued by a long-term pandemic could really be like. I know there are a lot of mentally-fragile and anxious people in the world, and their needs cannot be ignored. I fear sometimes that the healthcare systems will be overwhelmed not only with virus sufferers but also with people who cannot cope with the current restricted life, especially if that type of life continues for another year or two. I don’t know the future, but I can imagine it. At present, a second coronavirus wave is building in Europe and no one knows how deadly that could be. Without a vaccine, I cannot see how we are going to get past this pandemic. Until that time, we can keep the virus in check by abiding by the rules laid out for us by the health authorities. One can hope that we have learned something from the first coronavirus wave.   

Some links to useful articles about the coronavirus

For those of you who might want more in-depth information and reporting about the coronavirus pandemic, these links to articles in The Atlantic will prove useful. 

https://www.theatlantic.com/category/what-you-need-know-coronavirus/

I've included the list of articles to give you an idea of what they are about. I've read a few of them already and they are well-written and informative. 

The Atlantic’s guide to understanding COVID-19

• The Coronavirus Is Never Going Away

  No matter what happens now, the virus will continue to circulate around the world.

  • SARAH ZHANG
   
  • 7:00 AM ET

• How the Pandemic Defeated America

  A virus has brought the world’s most powerful country to its knees.

  • ED YONG
   
  • SEPTEMBER 2020 ISSUE

• A Vaccine Reality Check

  So much hope is riding on a breakthrough, but a vaccine is only the beginning of the end.

  • SARAH ZHANG
   
  • JULY 24, 2020

• A Second Coronavirus Death Surge Is Coming

  There was always a logical explanation for why cases rose through the end of June while deaths did not.

  • ALEXIS C. MADRIGAL
   
  • JULY 15, 2020

• America Should Prepare for a Double Pandemic

  COVID-19 has steamrolled the country. What happens if another pandemic starts before this one is over?

  • ED YONG
   
  • JULY 15, 2020

• All the President’s Lies About the Coronavirus

  An unfinished compendium of Trump’s overwhelming dishonesty during a national emergency

  • CHRISTIAN PAZ
   
  • JULY 13, 2020

• A New Understanding of Herd Immunity

  The portion of the population that needs to get sick is not fixed. We can change it.

  • JAMES HAMBLIN
   
  • JULY 13, 2020

• A Dire Warning From COVID-19 Test Providers

  U.S. coronavirus testing could fail again, as surging demand creates new backlogs and delays.

  • ALEXIS C. MADRIGAL AND ROBINSON MEYER
   
  • JUNE 30, 2020

• A State-by-State Coronavirus Tracker

  The latest number of confirmed cases everywhere in the U.S.

  • JUNE 25, 2020

• A Devastating New Stage of the Pandemic

  The U.S. has seen more cases in the past week than in any week since the pandemic began.

  • ROBINSON MEYER AND ALEXIS C. MADRIGAL
   
  • JUNE 25, 2020

• Paging Dr. Hamblin: My Brother Is Having 150 People at His Wedding Next Week

  No one should be expected to attend an in-person gathering right now.

  • JAMES HAMBLIN
   
  • JUNE 17, 2020

• America Is Giving Up on the Pandemic

  Businesses are reopening. Protests are erupting nationwide. But the virus isn’t done with us.

  • ALEXIS C. MADRIGAL AND ROBINSON MEYER
   
  • JUNE 7, 2020

• COVID-19 Can Last for Several Months

  The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends.

  • ED YONG
   
  • JUNE 4, 2020

• Paging Dr. Hamblin: Does Vitamin D Help Fight COVID-19?

  Evidence is slowly mounting. Some researchers think that’s enough to recommend it.

  • JAMES HAMBLIN
   
  • JUNE 3, 2020

• A Hidden COVID-19 Risk Factor: Your Boss

  America’s flawed approach to sick leave is making the pandemic worse.

  • OLGA KHAZAN
   
  • JUNE 1, 2020

• So, What Can We Do Now?

  A guide to staying safe this summer

  • AMANDA MULL
   
  • MAY 27, 2020

• We Don’t Even Have a COVID-19 Vaccine, and Yet the Conspiracies Are Here

  Even as vaccines for the disease are being held up as the last hope for a return to normalcy, misinformation about them is spreading.

  • SARAH ZHANG
   
  • MAY 24, 2020

• Is Everyone Depressed?

  Suddenly, many people meet the criteria for clinical depression. Doctors are scrambling to determine who needs urgent intervention, and who is simply the new normal.

  • JAMES HAMBLIN
   
  • MAY 22, 2020

• Social Distancing Is Not Enough

  We will need a comprehensive strategy to reduce the sort of interactions that can lead to more infections.

  • DEREK THOMPSON
   
  • MAY 22, 2020

• ‘How Could the CDC Make That Mistake?’

  The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same.

  • ALEXIS C. MADRIGAL AND ROBINSON MEYER
   
  • MAY 21, 2020

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