Showing posts with label flu vaccine. Show all posts
Showing posts with label flu vaccine. Show all posts

Thursday, April 17, 2008

You don't want to go to Barbados today ...

Not sure about that one? Why wouldn't one want to go to Barbados today? Well, my friend (let's call him John Doe) is flying today from Toronto to Barbados, coughing and sneezing like there's no tomorrow, happily spreading the flu virus across the (sadly main) cabin. So, if you happen to be unfortunate enough to be on that flight, and you forgot or chose not to (like he did) get your flu shots in time, you're fairly likely to find yourself sick like the proverbial dog in a few days, probably half-way thru your vacation on the island.

Fair enough, you might say, that isn't nice, but there's probably other sick people on that flight. However, that response is surely begging an interesting moral question: should he (and them) have canceled their trip in order to prevent innocent other air travelers from getting infected by the flu virus? I think that there can be no doubt, passing knowingly such an infection on to other parties in a confined space such an airplane for the duration of several hours constitutes a case of harm to others. Nobody on the plane volunteered to be subjected to that sort of infection risk and almost certainly everybody (not already vaccinated) on that particular flight would have preferred not to have been on that flight, considering the risk of reasonably serious disease. It's not that the flu is 'just' a nasty illness keeping us sick for 10-14 days, no, it actually kills a lot of people each year. Up to 1500 people die each year of flu related complications in Canada alone. Worse, those people infected on the plane, doing what people usually do when they go on Caribbean vacations (eg drink, increase the skin cancer risk by means of roasting in the sun for no good reason, have sex), will almost certainly ensure that folks on Barbados will also pick up the flu from them. A lot of people will get sick as a result of Mr Doe's decision to board a flight to Barbados today.

Well, before the divorce papers arrive in the mail, what reasons could be deployed against this analysis: For starters, the volenti non fit iniuria principle can probably be deployed. After all, we all know prior to boarding planes that there's bound to be some irresponsible passenger or other who dragged his infectious illness onto the plane. Unlike with multiple drug-resistant TB, of course, we can actually protect ourselves against the flu reasonably well, and at low risk for ourselves, simply by getting vaccinated. So, if we board a plane anyway, voluntarily and unprotected, this can arguably be read as consenting to the risk of catching an infection. That doesn't mean that we want it, but we surely didn't go out of our way to prevent it from happening. Another reason in support of Mr Doe's decision to fly anyway, is that most airlines will almost certainly not reimburse for tickets canceled that late in the day, so he would have suffered a substantial financial loss had he chosen to stay in bed. Corporate policies in other words, incentivise people to follow courses of action that are detrimental to public health. Quite possibly some employers might have required him to take his leave anyway, as scheduled, instead of taking sick leave.

All of that is regrettable. Surely we should have policies in place that reward people like Mr Doe for behaving responsibly and in a slightly more caring manner toward fellow travelers. That we do not is remarkably short-sighted.

Monday, November 12, 2007

Flu vaccination

I'm sure, those of us who ever had the flu will know that it is quite desirable to undergo the annual vaccination routine. Depending on what country one lives in there's different rule re access to flu vaccines. For instance, in the UK the NHS limits access to vaccines. GPs are required to prioritize along the lines of age (people above 50 years of age, young kids as well - surprise, surprise - folks working in the NHS). Us teachers, even though we spend hours meeting oodles of people, or bus drivers and such workers, are not a priority according to the NHS.
'Priority' ... that's, of course a pseudo-allocation type of activity. The NHS has decided that it's not worth purchasing sufficient supplies of vaccine, hence the annual scramble to prioritize. In South Africa local pharmacies sell the vaccine to anyone capable of purchasing it. Of course, it would make perfectly sense to simply vaccinate everyone. The incidence of suffering and disease as well as the amount of a given society's productivity losses due to illness could be very significantly reduced. So, for essentially stingy governments to limit access is counter productive. They are failing their citizens health needs.

Equally, I never understood why people who know of themselves to have the flu venture
back to places populated by large numbers of people (school and university class, work places, that sort of thing). Given that the people they mingle with cannot protect themselves against the flu virus spread by people knowing to be infected, I think it's fair to say that a clear cut case can be made in support of the idea that such infected people actively harm their work colleagues, fellow students, fellow aircraft passengers, and so on and so forth. We might be well advised to establish policies that - at a minimum- permit such folks to stay at home (and so contain the spread of the infection).

The good news for me. While I was just about today to enter Daffy's (ever hunting for a bargain) on Broadway and 34th, some guy pushed a leaflet into my hand. Unlike many other folks I always grab such materials and briefly check them (just so I don't miss a bargain). Well, today it paid off. I got a leaflet inviting me to pick up free flu shots that were offered in Manhattan by the American Lung Association. So, instead of going to Daffy's (actually... to be honest ... I simply postponed by 30 min), I got my free flu shots. What a pleasant difference to the nonsense going on in the UK NHS. For once I didn't need to weasel my way into getting access to a flu vaccine that I should be receiving from the public health services or private medical aid schemes anyway. Long live the American Lung Association!

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