The epidemiology of moral bioenhancement

R. B. Gibson

Medicine, Health Care and Philosophy 

https://doi.org/10.1007/s11019-020-09980-1

Abstract 

In their 2008 paper, Persson and Savulescu suggest that for moral bioenhancement (MBE) to be effective at eliminating the danger of ‘ultimate harm’ the intervention would need to be compulsory. This is because those most in need of MBE would be least likely to undergo the intervention voluntarily. By drawing on concepts and theories from epidemiology, this paper will suggest that MBE may not need to be universal and compulsory to be effective at significantly improving the collective moral standing of a human populace and reducing the threat of ultimate harm. It will identify similarities between the mechanisms that allow biological contagions (such as a virus) and behaviours (such as those concerned with ethical and unethical actions) to develop, spread, and be reinforced within a population. It will then go onto suggest that, just as with the epidemiological principle of herd immunity, if enough people underwent MBE to reach a minimum threshold then the incidence and spread of immoral behaviours could be significantly reduced, even in those who have not received MBE.

Conclusion 

The phenomenon of herd immunity is one that is critical in the field of vaccine epidemiology and public health. Once it takes effect, even those individuals who are unable to undergo vaccination are still able to benefit from a functional immunity from a biological agent. As such, a compulsory and universal programme of vaccination is not always necessary to achieve a sufficient protection rate against a contagious biological agent. It is this same line of reasoning which this paper has sought to employ, envisioning MBE as a form of vaccination against those types of behaviour that would lead to the realisation of UH (Ultimate Harm). Consequentially, this allows for the possibility of sufficient protection against the undesirable behaviours that would lead to UH without a need for a universal and compulsory enhancement programme.

A pdf can be found here.

San Quentin’s coronavirus outbreak shows why ‘herd immunity’ could mean disaster

Rong-Gong Lin II and Kim Christensen
The Los Angeles Times
Originally published 11 August 20

Here are two excerpts:

San Quentin is an imperfect setting to help understand when herd immunity might be achieved. Prisons are crowded settings that will promote coronavirus transmission more so than among people in other settings, like those who live in single-family homes.

But the San Quentin experience — as well as other data — does show that, in the absence of a vaccine, “in order to get to something that approaches herd immunity, we’re going to have to get something well on the far side of 50% of people infected,” Rutherford said. “Which comes with a resultant large cost in mortality and severe morbidity.

“If you believe the San Quentin stuff, you got to get up to way-up-there before you start seeing slowing of transmission,” Rutherford said.

Dr. Anthony Fauci, the U.S. government’s top infectious diseases expert, last week guessed it will probably require 50% to 75% of a population to be immune before achieving herd immunity — a goal that should be achieved not just through infected people recovering but also through vaccination.

California has a long way to go before the vast majority of residents have been infected.

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Sweden famously pursued a herd immunity strategy when it decided not to impose a severe lockdown.

But now, Sweden has among the highest mortality rates among European countries, and has a worse rate than that of the United States.

The info is here.

What is herd immunity?

Joshua Krisch
Live Science
Originally published July 2020

Here is an excerpt:

Herd immunity doesn't always work

The ingredients for achieving herd immunity naturally are well understood. "You want a disease that is guaranteed to produce robust immunity with largely asymptomatic spread, and have a low R0," Altmann told Live Science. But even if the R0 is relatively high and most patients are symptomatic, herd immunity is still possible with an effective vaccine, and a vaccine program that immunizes the population en masse. "Think of our big, public-health vaccination success-stories: Smallpox and polio, both entirely due to massive, sustained vaccine programs with simple, highly effective vaccines," he said.

Robust immunity is necessary to ensure that those who become immune stay that way long enough for the pathogen to die out. Asymptomatic spread helps, because it means that fewer people are likely to die while the population waits for herd immunity to take hold — and increases the likelihood that there will be enough survivors to affect herd immunity in the first place. A low R0, of course, lowers the bar for how many individuals need to be immune before we see the infection rate flatten and decline.

Nonetheless, some diseases that are seemingly strong candidates for herd immunity never quite achieve it. Despite widespread infection and vaccination, chicken pox, for instance, has never been entirely eradicated from the population. That's because the virus that causes chicken pox remains latent in the nerve roots of those who are infected by it, even after they recover and acquire immunity to the disease. As once-infected individuals grow older their immune systems weaken and the virus can reactivate, causing shingles, which can, in turn, cause chicken pox.

"You might have eradicated chicken pox in a small island community, but then somebody's granny gets an attack of shingles and, over a matter of weeks, every kid on the island gets chicken pox," Hunter said. "You've achieved herd immunity, and [it appears] the virus has died out, but it's actually waiting to come out." Similar phenomena have been observed with tuberculosis, according to the WHO.

Vaccine-induced herd immunity can also fail when a vaccine results in only short-lived immunity within a population. Pertussis and mumps recently reappeared long after vaccine programs were assumed to have eradicated these diseases, and studies suggest that, while vaccine noncompliance played a role, the outbreaks were in part due to the vaccines losing effectiveness over time. "In the past few years we've had both pertussis and mumps outbreaks, and those have primarily resulted from waning immunity over time," Poland said.

The info is here.

Immunity to Covid-19 could be lost in months, UK study suggests

Ian Sample
The Guardian
Originally posted 12 July 20

People who have recovered from Covid-19 may lose their immunity to the disease within months, according to research suggesting the virus could reinfect people year after year, like common colds.

In the first longitudinal study of its kind, scientists analysed the immune response of more than 90 patients and healthcare workers at Guy’s and St Thomas’ NHS foundation trust and found levels of antibodies that can destroy the virus peaked about three weeks after the onset of symptoms then swiftly declined.

Blood tests revealed that while 60% of people marshalled a “potent” antibody response at the height of their battle with the virus, only 17% retained the same potency three months later. Antibody levels fell as much as 23-fold over the period. In some cases, they became undetectable.

“People are producing a reasonable antibody response to the virus, but it’s waning over a short period of time and depending on how high your peak is, that determines how long the antibodies are staying around,” said Dr Katie Doores, lead author on the study at King’s College London.

The study has implications for the development of a vaccine, and for the pursuit of “herd immunity” in the community over time.

The immune system has multiple ways to fight the coronavirus but if antibodies are the main line of defence, the findings suggested people could become reinfected in seasonal waves and that vaccines may not protect them for long.

The info is here.