Time to Reclaim the Right to Choose

One of the more entertaining features of the late pandemic period is the ongoing battle between the Democrats’ State Media (CNN, Washington Post) and Red State Governors (Ron DeSantis, Greg Abbott). The latest blow was struck this week after the media alighted on Governor DeSantis’s recent comments to the effect that whether you get vaccinated or not “is about your health and whether you want that protection or not. It really doesn’t impact me or anyone else.”

CNN immediately declared the assertion “false” (a now-standard label for opinions they don’t approve of) and trotted Anthony Fauci out to declare that “when you have a virus that’s circulating in the community and you’re not vaccinated, you are part of the problem.”

Hours later, Governor DeSantis responded by pointing out that the virus is surging even where there are high rates of vaccination. In other words, the “herd immunity” that Dr. Fauci and many others predicted would result from widespread vaccination has not materialized:

What I said was, if you’re going to force vaccine mandates on people, just to understand that what the data is showing us about the vaccine, the data is showing us you’re much less likely to be hospitalized or die if you’re vaccinated. That is true. And I think you see it in the statistics. However, the vaccinations have not created herd immunity. So if the idea is that . . . you force everyone to do this, and that will create a herd immunity, that has not happened. . . . Fauci also said if 50% were vaccinated, you would not see any surges anymore. Well, that isn’t true.

High levels of immunity (from both vaccination and people who recovered from infection) have not slowed down the spread of the virus in successive waves of variants, and likely never will, because the virus has become endemic. Hence, DeSantis’s point is that getting vaccinated will protect you, but will not meaningfully increase protections for those around you who are susceptible to infection. If they’re susceptible, they’re going to get it sooner or later, because the virus is already too widespread in too many variants, and it’s spreading even among people who are vaccinated.

Dr. Fauci probably doesn’t disagree with any of that, and it’s not the only way their disagreement is more apparent than real. People do lots of things that impose costs on society as a whole; for example, driving. Not only does every additional car on the road add to the risks faced by other drivers, but if you get into a car accident, society will have to spend money healing you and the others involved. Society is full of regulations designed to balance personal freedom and public safety. And as I argued here at NRO near the start of the pandemic, it is the public, not experts, who ultimately decide where the balance should be struck.

A colleague points me to another aspect of the problem, illuminated by Ronald Coase in the essay for which he won the Nobel Prize, “The Problem of Social Cost.” Coase’s basic insight was that social cost is reciprocal. You may think it obvious that driving through downtown increases the risks to pedestrians, but in order for that to be true, pedestrians must have chosen to be there rather than somewhere else, and their choices are just as important in calculating the aggregate risk.

The Coasian analysis is always an important theoretical perspective on regulatory design, but several factors give it huge practical importance here.

First, while it is true that going about town unvaccinated increases your chances of carrying the disease, and hence of spreading it to others, other people do not have an evenly distributed chance of getting it from you. On the contrary. Many are vaccinated, and many others have had COVID-19 and recovered from it; those two groups are fairly immune to getting infected but are almost totally immune to severe illness if they do get infected. That’s why, as Governor DeSantis points out, the vast majority of hospitalized COVID-19 patients are unvaccinated.

But even among those who have no immunity, the susceptibility to severe disease is highly concentrated in specific groups, chiefly the very elderly and those with significant cardiovascular or respiratory conditions. For the vast majority of people, COVID-19 is no more dangerous than the flu or common cold; among children, studies suggest it is actually less dangerous than the flu.

The “debate” between DeSantis and Fauci is similar to the debate we had in this country with the appearance of the automobile. Up until that time, people could freely cross the street wherever and whenever they wanted, without much risk of getting run over by horses or horse-drawn carriages, which were also generally traveling at walking speed. Once the automobile appeared on the scene, however, it became really dangerous to cross the street. At that point, society had a choice: Restrict the automobiles’ freedom of movement, restrict the pedestrians’ freedom of movement, or both. As could have been predicted, society chose to restrict both.

The lesson here, as with many other difficult issues in the realm of public policy, is that no single priority can be implemented absolutely without vitiating others. Priorities must be balanced.

From the start of the lockdowns, societies around the world chose to impose severe restrictions on the many in order to protect a much smaller number of severely at-risk people, chiefly because even that smaller number was still huge, and because the efficacy of various measures was not yet clear. COVID-19 was the third leading cause of death in the United States last year, even though it only became statistically significant in March; in late 2020 and early 2021 it was actually the leading cause of death in the U.S., beating out both cancer and heart disease. There is no doubt about it: The COVID-19 pandemic is among the most deadly in history.

But as the months passed, it became clear that lockdowns were of dubious utility. Comparing measures taken around the world, one Stanford University study found virtually no correlation between severity of lockdowns and rates of infection or death.

Consider the mask mandates. Masks reduce the risk of infection, but mostly for others, not for the mask-wearer, as the CDC has explained. And one widely reported study shows that masks only really work in the case of surgical masks, not cloth masks, and only if it they are worn properly. Even if those conditions are met, masks reduce the chances of infection by only about a third among elderly people, and most instances of mask-wearing probably fail one or both of those criteria. Add to that the many situations in which mask-wearing is totally defeated by other behavior, for example the tragicomical spectacle (a common sight here in Miami, Fla.) of people wearing masks inside air-conditioned cars with the windows up.

Similarly, studies have shown that, among the unvaccinated and vaccinated alike, those who are infected but asymptomatic are much less likely to infect others than those with symptoms. And among the small number of those who are vaccinated and have suffered “breakthrough infections,” the chances of infecting others if you are asymptomatic are close to zero, making a mockery of the CDC’s guidance that vaccinated people should continue to wear masks.

On the other side of the ledger are the well-understood costs of lockdowns. Low-income communities have been particularly hard-hit, with those workers most unlikely to be able to work remotely and most likely to get laid off. As for the children that teachers’ unions claim to protect, we are only starting to understand the staggering setbacks in educational and social development they have suffered as a result of the school shutdowns that those same unions insisted on far past the point when it was obvious that schools should reopen.

But even conceding Fauci’s point that the unvaccinated are “part of the problem,” the principle at stake is one that progressives ignore all the time. How many progressives accuse people on welfare of being “part of the problem” of budget deficits and crime because of the choices they make? Reducing the speed limit to 5 mph on the highway would save perhaps 40,000 lives every year, but how many progressives support that? Prohibiting alcohol could save about as many, but how many progressives would support that?

Read the full article at National Review.