The New Sickness Unto Death
November 02, 2021
A reply to Chris Billows' blog-letter Everything Counts at Death as part of the Republic of Bloggers (15 minute read).
Dear Chris,
It is a strange time to talk about 'sickness'... it seems as if only one kind of illness matters right now. A shame, because the sickness we are expected to focus upon is not quite the one I want to talk about in this letter. I shall do as required, though, and dutifully discuss that disease, or rather I will discuss the scientific problems concerning vaccination against that disease, and the political disasters unleashed in its wake. But what I most want to reflect upon in this letter is the sickness spoken about by the Danish existentialist philosopher, Søren Kierkegaard, the one that haunts every troubled heart, and brings great suffering upon all who fall prey of it. The 'sickness unto death', as he called it. It is spreading so far and so fast now, even my idealistic optimism is barely proof against this rising tide of hatred and despair. But I cannot submit to this. And neither, I hope, can you.
Firstly, I must thank you for keeping the Republic of Bloggers away from its final end with your blog-letter to me, Everything Counts at Death. I sometimes fear you and I are all that is left of this form of discourse, but I I suppose I could be mistaken. I also think it most strange that these days we have all but eliminated the exchange of ideas. Newspapers accept letters as comment, but they are not willing or able to promote discussion in that way; the news is happy to quote Tweets, but again, not able to promote discussion; academic papers... well, don't get me started. Why have we stopped talking? Perhaps because social media scratches the itch to respond all too well, but solely when we are angered by what we read. Everything else just glides by, ignored, or eliciting nothing more than a brief approving nod and perhaps a click of a 'like' icon. It is as if we are cultivating a world where engagement can only happen at the very places where mindful discussion cannot.
You are quite right, of course, when you say that I do pitch some positions precisely in the hope that somebody will engage - it appears, sadly, to be the only way to provoke a response - although I hope it is clear that the principle 'every cause of death matters' I wrote about previously is utterly heartfelt. If we can regain democracy - and alas, my faith wavers! - reigniting our ideals of equality will be essential, and this issue over causes of death is so enormous, on so many levels, not least of which would be the question of poverty that you wisely draw attention to. Could there be any greater contributor to human death? Could there be a topic more consistently brushed under the political carpet...? And it's an awfully lumpy rug these days.
I want to talk about sickness, but I shall come upon the sickness I want to talk about rather slowly, for reasons that I trust will soon become apparent. Rather, I want to begin with my immense sadness at what I have been reading about the situation in the Republic of Senegal, where an ill-advised lockdown policy led to a government power grab. Long-term lockdowns might have saved the lives of some Europeans and North Americans able to work from home (although even that isn't as clear cut as is often assumed), but they cannot possibly help those living hand-to-mouth, who are merely being ordered to starve to death and cannot plausibly comply. In Senegal, the imposition of lockdowns has achieved nothing except plunging the citizens of that great country even further into poverty while lining the pockets of the corrupt. As Mamadou Ndiaye laments:
There’s no democracy in Senegal anymore, even though Senegal was always singled out before as a strong African democracy. If you are one of them, you can do what you want. There’s no justice. It’s only in Africa that you can find a state official making millions.
Meanwhile, the New York Times and other 'Trusted News' providers run stories about the Paris-Dakar rally, or the shortage of COVID-19 vaccines in Senegal. How can this possibly be the story we should tell here? The excellent Our World in Data site that you justly praise can provide some bitter perspective on this lack of vision. At time of writing, Senegal had lost 1,855 of its good people to SARS-CoV2. Yet every year in Senegal, roughly 9,000 people (nearly five times as many) die from unsafe drinking water, nearly 17,000 people (more than nine times as many) die from causes related to air pollution, and nearly 22,000 children under the age of five (nearly twelve times as many) die from preventable pneumonia. We are somehow required to see Senegal as a 'country of interest' only in connection with COVID-19 vaccination (or motorsports)... this obsession with one specific cause of death is not only logically insane when it comes to nations like Senegal, but through the pointless imposition of lockdowns that its people could not possibly afford to pursue we have inadvertently shattered one of the few strong democracies in Africa.
Black Lives Matter, we are told... we are doing a rather terrible job of showing it.
Every expectation has now been upended by this monomaniacal fear of an infection that is certainly serious enough to warrant action, yet nowhere near dangerous enough to warrant abandoning democracy. If you had told me two years ago that black and Hispanic citizens of the United States would be denied public service jobs or turned away from restaurants in New York as unclean and unwelcome I would have thought you drunk on conspiracy wine. Yet here we are! A vaccination with excellent results at preventing hospitalisation and death but demonstrably weak at preventing infections is being made a requirement of participation in civil life, with the result that ethnic minorities are back to being excluded and reviled - but it's supposedly okay, because people aren't hating them for being black or (dare we say it, even in jest?) foreign, just for not aligning with medical strictures created at the behest of mostly white folks to maintain their preferred concepts of health and cleanliness by force.
Vaccine mandates are not a scientific measure, they are a political one - and the data suggests the unsurprising conclusion that attempting to force people to vaccinate risks counter-productively hardening their resolve to resist instead. The problem at heart is a lack of trust, a situation that is poorly addressed by simply demanding that people do as they are told. As Tiffany Green remarked of the effects of vaccine segregation upon ethnic minorities in the United States:
We can’t expect that medical systems who have earned the mistrust of many marginalized groups will now be trusted because of Covid. It doesn’t work that way.
Similarly, Liz Wolfe questions whether this authoritarian turn by New York mayor, Bill De Blasio's, is in any way helpful:
De Blasio's order will disproportionately exclude members of minority groups—including people who distrust the medical establishment, lack confidence in a new vaccine, or don't have time to take off work in the event of bad side effects—from public life... It is unclear whom de Blasio's order will help. The vaccinated already are well-protected from severe illness or death, even if they contract a breakthrough infection. Eradicating the disease entirely no longer seems like an option... If the idea is to give vaccinated New Yorkers peace of mind that they can socialize with minimal risk of becoming dangerously ill, they have that already thanks to the vaccine.
Advocates of 'vaccine passports' (and I fear you are one) verge upon being utterly disconnected from scientific process as they attempt to justify them. While the vaccines are not 'poison', as opponents of all kinds of vaccination decry, they're not miraculous either: they must be subjected to rigorous scientific evaluation just like any other medical intervention. The data from both Israel and Sweden confirm that vaccine efficacy against infection wanes substantially after about six months, while all the recent vaccine surveillance reports for the United Kingdom clearly show that the infection rate has been substantially higher here among the vaccinated than the unvaccinated, with large negative figures for unadjusted vaccine efficacy, in some demographics worse than -100%. That doesn't mean the vaccines don't work - they are still effective against hospitalisation and death - but it does mean the data doesn't support the logical premises of vaccine mandates.
We can no longer support the prior assumption that these vaccines are highly effective against spread (let alone more effective than natural infection, as the CDC bizarrely and falsely claimed), and we can no more expect to eliminate SARs-CoV2 with these vaccines than we can hope to eradicate influenza. Yet we are not permitted to say these things, because we must pretend that all vaccines are exactly the same, even though they patently are not, and we must maintain at all costs the (largely true) story that vaccines are safe, even though what makes vaccines 'safe', in the way we usually use that term, is the acquisition of long-term data about their safety. As Jennie Bristow cogently argued, acting rashly over new vaccines where only partial data exists risks driving up vaccine hesitancy for our successful childhood vaccination programmes that carry far greater community benefits. In this regard, diehard pro-vaxxers have become precisely that which they hate: spreaders of vaccine disinformation that risks discouraging life-saving vaccination programmes.
How did we leap straight to the imposition of these vaccines upon everyone, when we are still establishing the long-term safety and efficacy of these vaccines? Even the British Medical Journal raised an eyebrow when the FDA in the United States abruptly decided to declare 'these new vaccines are now approved', as if waving a magic wand to make the need for longitudinal studies disappear. Peter Doshi, senior editor at the BMJ was forced to remark regarding the draft proposal:
Prior to the preprint, my view, along with a group of around 30 clinicians, scientists, and patient advocates, was that there were simply too many open questions about all covid-19 vaccines to support approving any this year... I reiterate our call: "slow down and get the science right—there is no legitimate reason to hurry to grant a license to a coronavirus vaccine."
I am sympathetic to the terror people feel about this disease, a fear fostered by the irresponsible way the pandemic has been reported - some even mistakenly believe SARS-CoV2 is as deadly as smallpox. It's actually a hundred times less fatal, 0.3% versus 30% infection fatality rate. That doesn't mean this isn't a serious disease - measles typically has a comparable 0.2% infection fatality rate and we take that seriously - but neither does it mean we can avoid the role of evidence in both making and revising our decisions. We simply cannot afford to sacrifice good scientific practice to our fear, and like everything else in this miserably mishandled pandemic, we all swiftly jumped to our preferred conclusions early on and then proceeded to forcibly discount any and all evidence to the contrary.
We made this catastrophe together by shattering open scientific discourse through the same ugly, partisan politics that have blighted civic discourse for decades. If we could put a thousandth of the effort invested in denouncing our political opponents towards pursuing answers to the research ambiguities, we might have actually saved lives instead of just squabbling. Even now, rather than examining the data and debating which policy changes might protect the vulnerable, some continue to exacerbate this destructive divide by falsely claiming that unvaccinated US citizens are 'overwhelming' hospitals. Yet at time of writing, Department of Health and Human Services data shows that only 15% of beds are occupied by COVID-19 patients, and the September JAIC report shows that in the crucial 65+ age demographic, 71% of hospital patients for this disease were already vaccinated (up from 60% in August). That's not evidence the vaccines don't work - the age group was 80% vaccinated, which skews the ratios. But it is evidence that demonising the unvaccinated is little more than hateful scapegoating.
As I argued in my piece for the AIER (an organisation I never thought I would be writing for!), slow science is strong science. When we rush our understanding, we get it wrong. And not just the scientific implications, we get the moral implications wrong too. We kick black and Hispanic citizens out of society because they did not panic in the way that white people required them to panic. We unjustly dismiss the loyal service of police officers and nurses even after they heroically bore the risks of the pandemic through their dedicated service to us. We declare that the only good people are those who react to a new medical intervention with an unquestioning zeal that goes far beyond the evidence.
Worst of all, we destroy democracy in Africa over a disease that is far, far more serious in the global north. In the countries where you and I dwell, people are lucky enough to live to be over 80 and thus die of respiratory infections in their sunset years, rather than dying from preventable pneumonia under the age of five like those 22,000 black children who die in Senegal every year, whose black lives apparently do not matter one jot. Millions of poor children around the world die like this, as much from poverty as from the pneumonia that actually ends their lives. There's more than one kind of sickness worth worrying about.
On a more pleasant note, I must say that it is a perverse pleasure to hear you write openly about being "a religious person". For most people I talk to, that phrase means "Christian", and most Buddhists I know shy away from using the term 'religious' for that very reason. Wouldn't want to associate with Christians, would we... they, after all, are the most likely US citizens to decline the opportunity to vaccinate against SARS-CoV2. That is partly why
As you know, I'm moving back to the United States - at least, I will be as soon as my papers come through, which could take another year. My family has already been there for two months, and I miss them greatly. But I can't help but worry about the grave missteps being taken by the great country they are now living in. I worry especially about these measures that segregate the unvaccinated, which feels like the most shocking thing the US has done to its own citizens in my lifetime. Given that these vaccines are less effective than natural immunity at preventing spread, and given how many people have already carried the infection, why would we institute such unjust measures rather than just encouraging the vulnerable to get vaccinated for their own benefit? As Stanford university health economist Jay Bhattacharya laments: "Businesses that exclude the unvaccinated are, in effect, discriminating against the working class and the poor who have already suffered through the disease." Have we not inflicted enough harm on those who live on the edge of poverty without this further indignity?
I have been vaccinated against SARS-CoV2; I never got the infection to my knowledge, and at my age of not-quite-fifty the data shows I stand to benefit from substantially reduced risks of death or hospitalisation. But even though I've had the 'jab', and encourage others to do so where the benefits are clear-cut, I will not be able to comply with these monstrous policies that discriminate against the unvaccinated as if they were unclean, rather than merely at greater risk of dying from one specific cause of death (and not even that, if they already carried the infection!). I have had to resign my position at LCAD in California since they have decided to segregate and I simply cannot support an organisation that has chosen to do so, not under these circumstances. How could I look anyone in the eye knowing that I had endorsed segregation? And how can I see this as anything but segregation when I look at the data for this disease and for these vaccines...?
You tell me that it is wrong to call it segregation, because it is justified on medical grounds. But if that is so, then doesn't it follow that if those medical grounds are shown to rest upon mistaken assumptions (as they do), we should indeed call it segregation? You also tell me that we've done this before - but when? When have we forced vaccines that were still untested long-term onto anyone, much less upon everyone - even children for whom the risk-benefit calculus for these vaccines is so far from reasonable expectations that it would ordinarily constitute a scandal? When have we ever compelled the healthy, rather than the sick, to quarantine, unless you count the Jewish ghettos of the Middle Ages? Even in medieval epidemics, those doors that were marked as 'harbouring the plague' were those that were actually infected, although then too some who were seen as different were unjustly persecuted and blamed for what was happening... Then as now, we are projecting our fear of the virus onto those who we mark as 'unclean' and trying to foist blame onto them for nothing more than holding different values.
I realise there are many who will vociferously object to the way I am characterising these issues - perhaps including you yourself. Indeed, we have already clashed on Twitter over these vaccines and over my insistence on using the inflammatory (yet apposite) term 'segregation'. I might even get banned from Twitter for sharing this, for all I know, since it most certainly disagrees with their chosen interpretation of the data, and that is a global censoring offence these days. But I invite all those who disagree with me, as I invite anyone and everyone at all times, to write to me, and to discuss this immensely difficult topic with me in a civil and thoughtful manner. Help me to understand why it is acceptable for white people in wealthy nations to enforce their inadequately-researched doctrines of public health onto the world in such a way as it excludes large numbers of black and Hispanic citizens from participating in their own society, forces loyal public servants with natural immunity to lose their jobs for no good reason, and destroys democracy in African nations that had previously shown such beauty and hope.
You talk about 'karma' in your letter... As you know, I like to identify as a Zen Sufi Hindu Christian Discordian, and the concept of 'karma' I follow comes not from my Buddhist tradition (Zen) but from the Hindu traditions. Karma for many Hindus is a straightforward concept of cause and effect. It does not even require a mystical element, although it is often afforded that dimension. When we cause harm, harm returns to us, not by straight roads, but through the web of causality that links all things together. Karma for me, and for some other Hindus, is not a positive concept, it is the damage we cause through our actions; harms that we seek to keep as small and inconsequential as we can.
My Hindu concept of karma dovetails with my Christian concept of sin through the writings of the philosopher Søren Kierkegaard, after whom my first born is named. Kierkegaard writes of "the sickness unto death", by which he does not mean infection, but despair, which is what 'sin' means to him:
When death is the greatest danger, one hopes for life. But when one learns to know the even more horrifying danger, one hopes for death. When the danger is so great that death has become the hope, then despair is the hopelessness of not even being able to die.
So it is superficial... to remark of someone in despair, as though it were the penalty of despair, ‘They are eating themselves up.’ For that is just what they despair of doing, that is just what to their torment they cannot do, since with despair a fire takes hold in something that cannot burn, or cannot be burned up – the self.
This concept of sin, not as transgressions against a cosmic law but as suffering and as self-inflicted suffering aligns with the understanding of karma I get from Hindu scripture, because of course the despair we inflict upon ourselves all too often becomes a despair we inflict upon others, most evidently with suicide. And this is what I am seeing everywhere now - a great despair we have inflicted upon ourselves that we seem insistent must be inflicted everywhere. The new sickness unto death. Alienation from our love for one another, the collapse of the mutual respect upon which democracy depends, and an explosion of bigotry and scapegoating so hateful that we now rejoice at the deaths of those who disagree with us, instead of weeping together at every tragic loss of life. We can no longer find the solidarity championed by Ghandi or Martin Luther King, the universal love that for both Hindu and Christian is alone deserving of the hallowed name 'God' (Brahman). This infectious hatred of others is a disease far more dangerous than COVID-19, since the virus only threatens us with death yet this other sickness entails the far greater risk of utterly destroying our ability to live together.
It's not fashionable to talk of God. And it is rarely fashionable to talk about God in ways that straddle traditions. But I have never cared much for fashion. What I care about is people, our planet that we share, and the future that we might build together. That's why I don't care whether people have one religion, no religion, or many religions. I only care about caring, and striving to avoid causing inadvertent harm through our attempts to care - the ever-present yet oft-ignored risk at the very heart of this crisis. So I let myself care about everyone, and I cannot and will not set a limit on that love, nor exclude some arbitrary set of people from the universal love that flows through me from nowhere or from everywhere, depending upon how you choose to see it.
This new sickness unto death is as great a threat to what matters as anything that came before. I must oppose it with the only weapon I can permit myself to draw: my compassion. It is my fervent wish that you and others will come to stand in solidarity with me as we form a line to resist the darkness that engulfs our world. Hope is still kindled in my heart, and perhaps in yours, and no doubt in others too. Let us stand together in love against every despair that threatens our capacity to live together in peace.
With unlimited love,
Chris.