There's a famous puzzler in popular moral philosophy known as the trolley problem. A runaway trolley is barreling down a street, aimed straight at a group of five innocent pedestrians. If nothing stops the trolley, the pedestrians will be struck and killed. You can save them, but only by pulling a lever that will divert the trolley down another street — and that street also features an innocent pedestrian. So the only way you can save the five innocent people is via an action that will definitely kill another innocent person. Is it morally right to do so?
I'm thinking about this philosophical abstraction because much of Europe is in the process of executing a new and perverse variant thereof. Starting with Denmark, and now including the three largest EU members — Germany, France, and Italy — country after country have decided to stop using the AstraZeneca-Oxford vaccine because of safety concerns, even as a new wave of infections begins to build across the continent. In so doing, they're diverting the trolley away from a street that may be completely empty, and onto a path that is packed with pedestrians, many of whom have still not recovered from the impact of previous trolleys.
The safety concerns in question revolve around a handful of cases of abnormal blood clotting observed in people in the U.K. and elsewhere who received the vaccine. So far, though, it doesn't look like the numbers of such cases are out of line with the incidence in the general population. In other words, there isn't even evidence yet of an increase in abnormal blood clots, much less proof linking them to the vaccine. The European Medicines Agency has reaffirmed its conclusion that the vaccines are safe, as has the World Health Organization. The U.S. Food and Drug Administration still hasn't approved them for use in the U.S., but the expectation is that the approval will be forthcoming in April, notwithstanding the recent concerns in Europe.
In normal circumstances, then, the decision to pause would likely be criticized as an overabundance of caution that would cost lives. But these are not normal circumstances. In a pandemic, it is normal to cut a variety of corners — using smaller-than-recommended doses of the vaccine, for example — to halt the spread of the disease, because the trolley really is going to hit a whole lot of pedestrians if it isn't stopped as quickly as possible. In that regard, what makes the European pause especially maddening is that abnormal blood clotting is a well-documented symptom of COVID-19 itself, which the AstraZeneca-Oxford vaccine has been demonstrably effective at preventing. Even if every case of abnormal clotting observed in the vaccinated population were due to the vaccine, the virus would cause them at a rate nearly a hundred times higher — and if it continues to rage unchecked, most of Europe's population will get it.
Moreover, the pace of the pandemic in Europe is about to accelerate. Cases are rising again across the continent, even as they continue to drop in the U.K. and Israel, both countries that made rapid vaccination a clear priority — and both countries where the new, more contagious and more deadly British variant is now dominant, as it increasingly is in Europe as well. Europe is already far behind both these leading countries, as well as the U.S., in vaccinating their population, partly because of lack of supplies due to poor procurement decisions at the EU level, and partly because of vaccine hesitancy that is much more widespread in Europe than in the U.S. They need a massive boost to their effort, not additional obstacles — particularly not ones that reinforce the obstacles they already have.
So why on Earth have so many European governments decided to give the virus a greater lease on life? The answer might be politics: the desire to deflect blame for limited supplies and to tarnish the reputation of a company based in the land of Brexit. It's notable therefore that national governments, which are more responsive to the voters than Brussels bureaucrats, are the ones pulling the lever this time. If politics is the motivation, these governments must be convinced that their electorates will reward them for taking action ostensibly on their behalf, and won't punish them for the consequences in terms of future lockdowns and an economic recovery that lags East Asia and North America — to say nothing of a higher ultimate death toll. In other words, they're betting that people only notice when someone pulls a lever, not how many people get hit by the trolley.
If so, then it's up to the electorate in those countries to raise their outraged voices in response. Meanwhile, the best thing we can do is to redouble our efforts to increase the vaccine throughput here in America, to save lives, to restore normalcy, and to demonstrate that both are possible. Who knows? Maybe the best way to combat vaccine hesitancy among American Trump-voters will be to tell people that if they refuse get a shot, they're acting like the French.
