Body autonomy is defined as the right of self-governance over one’s body and is a fundamental human right. Will this core of our personal freedoms be maintained or challenged in order to assuage public fears about COVID-19?
Tech billionaire and philanthropist Bill Gates has recommended maintaining some of the quarantine restrictions until a COVID-19 vaccine is prepared in 16 to 18 months. If governments were to take the advice of this self-appointed pandemic guru, what would be their response to those people who choose not to vaccinate?
With the massive attention and resources given to the COVID-19 pandemic, I fear that our basic human right to body autonomy may be called into question. During this pandemic, public fear has been fueled by exponentially exaggerated models and an initially high and then diminishing death rate.
Early in this pandemic, it was the wildly overestimated death rates driven by models that justified many of the actions taken. Early models predicted more than 2 million deaths in the United States alone, then 200,000 and then finally less than 100,000.
Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases (NIAID) director said: “Data trumps any models…modeling is an inherently imperfect science and as you get real data you rely more on that data than the model.”
Our leaders are aware of this, but are governments revising their plans as the real data comes in?
The most current COVID-19 death rate is hovering right around 0.7 percent—though that number is based on vast under-reporting of infection rates in China. At that rate, however, the virus is about seven times more deadly than your average annual flu pandemic. The death rate has dropped to 1 percent from as high as 4 percent and continues to drop as we have learned more about this virus.
The first problem was how deaths associated with COVID-19 were counted. Both causative or incidental cases of COVID-19 infection were counted in countries all over the world. The second problem was an overestimation of death rate by underestimating the total number of positive cases—specifically the large number of asymptomatic cases.
The COVID-19 death rate reporting has the unique feature that individuals dying from the virus are not distinguished from those dying with the virus. Dr. Deborah Birx, the White House coronavirus response coordinator, referring to U.S. COVID-19 deaths stated, “If someone dies with COVID-19, we are counting that as a COVID-19 death.” Professor Walter Ricciardi, advisor to the Italian Health Minister, referring to Italian COVID-19 deaths, has stated, “All the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.”
In other words, if the patient was deathly ill before infection, COVID-19 would have only been incidental in their death, but it could be counted as the main cause by the use of this generous methodology.
The new COVID-19 ICD-10 code (U07.1) guidelines were written without distinction between confirmed and suspected cases. In cases where there is uncertainty, the guidance states: “If the death certificate reports terms such as “probable COVID-19” or “likely COVID-19,” these terms would be assigned the new ICD code.
Regarding the total number of cases, a study is currently underway in the Heisenberg district of Germany. The study participants were chosen to represent the region’s population of 250,000 people. Some preliminary results have found a large portion of the population tested positive for COVID-19 but were completely asymptomatic.
When this large group was included, their calculated death rate dropped to 0.37 percent.
Another scientific study looking at antibody testing in Los Angeles county suggests that infections from COVID-19 are far more widespread. Factoring in their new findings, the COVID-19 death rate for LA county would be reduced to as low as 0.1 percent. Various studies from around the world have looked at the proportions of asymptomatic carriers of COVID-19 in different groups. The range is still broad starting at 5 percent and going as high as 80 percent. These are individuals positive for COVID-19 but are rarely counted because they have no reason to seek medical attention. As more data comes in and more of the general population is tested, we will likely find infection rates where higher, which will further dilute the overall death rate.
As the world pauses amid this pandemic, risking severe economic and social disruption, the call for forced vaccination will inevitably be sounded by certain quarters. This raises questions about what governments will do as the death rate falls closer to figures more in line with a serious annual flu.
I am not anti-vaccine. I would get the COVID-19 vaccine if I found solid evidence that it provides the benefit of viral immunity that outweighed the risk for any serious adverse reactions.
Vaccines can be a useful tool in the never-ending battle against infectious disease and, when used appropriately, can elevate the health of the public and the individual. Although vaccination programs have been lauded with single-handedly reducing the incidence of many common infectious diseases of the 20th century, most vaccine-preventable infections already had up to 90 percent reductions in death rate by the 1940s—years before any large-scale public vaccination programs began in the United States.
The widespread adoption of clean water, indoor plumbing, and better hygiene are the true medical champions of the 20th century. Be that as it may, vaccines then further contributed to the near eradication of many of these pathogenic microbes only a few decades later. However, like all medical interventions, the problems begin when you try to apply a “one-size-fits-all” model to the broad variability of the human race.
A common scenario that worries some people is that of the irresponsible individual jeopardizing the health of the masses by exercising their basic human right of body autonomy by refusing a vaccination.
It is an illogical argument because if the vaccine works then the person receiving it is protected from infection. If that person is not protected, then it supports the stance of the person refusing it because the vaccine clearly doesn’t work. This is by far the poorest argument for implementing a vaccine program because if that statement holds true then the vaccine being administered is not achieving its primary and only objective: to protect the vaccinated individual from the microbe in question. This is not a problem of individuals being selfish and not caring for their fellow citizen, rather it reflects poor workmanship on the part of the pharmaceutical company tasked with designing the vaccine. If the vaccine delivers what it promises, why would anyone care what someone else does with their body?
Herd immunity is an epidemiological concept that describes the state when a population is sufficiently immune to a disease so that the infection will no longer spread within that group. The percentage of the population which needs protection via vaccination or natural immunity will vary depending on the reproduction rate of the microbe. Measles, one of the most contagious diseases known, has a very high reproduction rate and would require immunity in 93 percent of the population. COVID-19 has a much lower reproduction rate and herd immunity could be established with only 70 percent of the population exhibiting immunity. You do not need to vaccinate the whole population to achieve a public health victory over COVID-19.
Body autonomy is the most fundamental of the human rights we are endowed with at birth and the individual (or the parent if they are a minor) chooses in all cases which bodily treatments or modifications are allowed. It is time to stop framing these discussions as pro- or anti-vaccine. Body autonomy is the issue.
Refusing vaccination is only one small facet of a broader refusal of medical treatments. Throughout medical history, you can find countless examples of past treatments that met the “standard of care” at that time and then later were found to be harmful. Based on this history, it is not unreasonable to be skeptical of any new treatments. Mandating treatments does not give you that opportunity.
Armen Nikogosian, M.D., practices functional and integrative medicine at Southwest Functional Medicine in Henderson, Nev. He is board-certified in internal medicine and a member of the Institute for Functional Medicine and the Medical Academy of Pediatric Special Needs. His practice focuses on the treatment of complex medical conditions with a special emphasis on autism spectrum disorder in children, as well as chronic gut issues and autoimmune conditions in adults.