Sunday, September 19, 2021

Memento Mori and Sukkot: The Paradox of Contemplating Death and Finding Joy

Love and marriage go together like a horse and carriage, at least according to the song that Frank Sinatra sung back in the 1950s. While love is not a given in a marriage, love and marriage are ideally compatible. As for death and joy, they do not seem to go together at all, at least at first glance. Yet that is exactly where my thought process has been as we transition from the repentance of Yom Kippur to the joy of Sukkot. It makes more sense to think about death during Rosh Hashanah and Yom Kippur, most notably with the prayer Unetaneh Tokef. This prayer is meant to be taken as a metaphor about life and death, our mortality, and meant to inspire introspection on what we are doing with our lives. 

The metaphor goes something like this. On Rosh Hashanah, G-d determines who is going to live and who is going to die. He writes those names in the corresponding Book of Life and Book of Death. Between Rosh Hashanah and the end of Yom Kippur, we have the ability to avert or minimize the decree by recompensing, repenting, and working on becoming a better version of the self. Again, I do not read Unetaneh Tokef literally, especially since it is a poem.....a powerful poem, but a poem nevertheless. It does not take negate the motifs of our G-d's sovereignty or our limits and mortality that are so prevalent in High Holiday liturgy. 

For Sukkot, the idea of contemplating death is not immediately apparent. As a matter of fact, it took me a number of Sukkot celebrations before I connected the dots. It is true that the harvest holiday of Sukkot is also referred to as "the time of our joy" (זמן שמחתנו). The association between death and joy is not obvious, and yet it shows up in Sukkot. For one, the sukkah is a temporary, flimsy structure that is open to the sky and anything else Mother Nature throws at us. Interestingly enough, the Rabbis in Talmud (Sukkot 23) debate not whether it should be flimsy, but how flimsy the sukkah needs to be. There needs to be at least some flimsiness, but at least enough sturdiness to last for the holiday. Based on these legalistic arguments, the structure ends up being one of impermanence and fragility, both literally and metaphorically. You know what else has impermanence and fragility? Our lives. The twelfth-century scholar Rashbam believed that the sukkah reinforces the idea that our wealth and comfort come from G-d. For Rashbam, the sukkah is a reminder of the fragility of life, which by extension, includes our own mortality. 

The idea of the impermanence of life is found in another Sukkot tradition: the reading of Ecclesiastes (קהלת). After the preface in the first verse, the Book (Ecclesiastes 1:2) starts out by saying  "הבל הבלים הכל הבל". This is commonly translated as "Vanity of vanity, all is vanity." I do not think "vanity" or a translation of "futility" does justice to the word הבל. The word הבל literally means "breath." Our time on this planet is short, like a breath. Using this literal translation, we see that King Solomon's grievance is not that life is meaningless or pointless, but rather that it is but a short breath. The ephemeral and temporary nature of life is the underpinning of King Solomon's existential angst that we see throughout the Book of Ecclesiastes. 

But why bring up death at all on a festival of joy? There are Jewish practices that give us hints. One is at the end of a Jewish wedding, one member of the couple (traditionally the groom) stomps a glass and screams "Mazal tov!" The breaking of the glass is to remember the destruction of the Temple, which was symbolic of the spiritual epicenter and cohesion that the Jewish people lost. Even in our happiest of moments, we are meant to temper our joy. This is a similar thought to why we read the Book of Ecclesiastes on Sukkot. One reason for this custom is that if we give into joy as an extreme, it becomes frivolous and we lose focus on the loftier reasons for existence (Avudraham; R. Azaryah Figo). 

This leads to my second explanation: life is a mixed bag. As Ecclesiastes brings up, "To every time, there is a season, and a time to every purpose under Heaven. A time to be born, a time to die...(Ecclesiastes 3:1-2)." There is a mixture of good and bad. Sometimes, they even get mixed together. What is the traditional Jewish garb for a groom on his wedding day? A kittel, which is a simple, white shroud. What is the traditional Jewish garb for Yom Kippur, the Holy of Holies? A kittel. What about the garb in which one is to be buried? Also a kittel. There is a similar sentiment of mixed feelings in the mourning of a loved one, known as shiva (שבעה). Shiva is mostly a sad occasion because a loved one is no longer with us. At the same time, it is a celebration of life: the impact they had on others, how they dedicated their lives, and the memories they created. It is in this paradox where I have seen chuckles and moments of laughter even in a shiva call. Life is that complex. To paraphrase Oscar Wilde, truth exists in paradox. 

Speaking of paradox, this leads to my third explanation: death gives life meaning. In Judaism, morning blessings include thanking G-d for giving us the ability to discern (אשר נתן לשכוי בינה להבחין בין יום ובין לילה). As I brought up on Tisha B'Av in 2020:

If we lived happily all the time, we would have nothing with which to compare happiness. It would get old really quick. Paradoxically, we need difficult moments in life so we can better appreciate the happier moments.  

These difficult moments sadly include death. What if we were immortal? We could always put off getting something done. It would diminish our desire to get things done or to pursue relationships because "there would always be another time." The limited timeframe of our lives gives life urgency. It gives life meaning. As R. Jonathan Sacks points out, "A book that never ended would not be a book. Music that went on forever would not be a symphony. All meaning takes place within a frame. Birth and death are the frame that give meaning to life."

That is the paradox: because death gives our life meaning, it also gives our life joy. This is one of the reasons why the idea of memento mori (Latin for "remember death" or alternatively, "remember you will die") is important. Instead of running away from the idea that we are going to die, memento mori teaches us to lean into it, to meditate on it. Montaigne once wrote that la préméditation de la mort est la préméditation de la libérté, or to translate, "to practice death is to practice freedom." 

If we practice memento mori on Sukkot, I think it would enhance the reasons why we rejoice on Sukkot in the first place. To quote Marcus Aurelius (Meditations 2:11), "You could leave life right now. Let that determine what you do and say and think." How much easier would it be to appreciate the harvest that Sukkot celebrates, and how much easier would it be to appreciate our material wealth, when we internalize that we cannot take it with us to our graves? How much more likely are we to enjoy the company of others under the sukkah or our loved ones when we remind ourselves that people come and go? How much more motivated are we to find meaning in the sukkah and indeed our lives when we recall that this all can end in the blink of an eye? 

That is one of the reasons I enjoy Sukkot. We are meant to find joy in spite of the tumultuous nature of life and in spite of the fragility of our own mortality. Rather than be depressed by our inevitable demise, it should inspire us to live life and give us the ability to prioritize what truly brings joy in life.  

Wednesday, September 15, 2021

10 Reasons Why Biden's Federal Vaccine Mandate Is Problematic

President Biden's patience is running thin with this pandemic. Biden wants to play hard ball, which is why last Thursday, he announced an emergency rule for businesses with over 100 employees. The rule states that either an employee is to be fully vaccinated or has to procure a negative COVID test once a week to prove they are not a threat in terms of COVID transmission. Each infraction of this rule would result in a $14,000 fine for the employer. Instead of using the carrot, Biden thinks that using the stick will persuade the remainder of the unvaccinated to get vaccinated. I have written about vaccine mandates twice this year (see here and here), and I am unconvinced that Biden's latest mandate is a good idea for ten reasons:

  1. Biden's rationale for the mandate is faulty. Biden said that the bottom line of this mandate was that "we're going to protect vaccinated workers from unvaccinated workers." Biden also claims that vaccines are safe and effective. Which is it: do vaccines work or do they not? According to CDC data, vaccination means one is 4.5 times less likely to get infected, 10 times less likely to get hospitalized, and 11 times less likely to die from the Delta variant (Scobie et al., 2021). The Right-leaning Heritage Foundation released a study analyzing the probability of COVID breakthrough cases and deaths (Dayaratna and Michel, 2021). One of their findings is that if vaccinated, you are more likely to die from a bee sting than you are to die of COVID. Another is a reminder that dying from COVID is still very low. Biden is correct to say that vaccines are safe and effective. What is nonsensical is saying that you need to force the unvaccinated to take the vaccine in order to protect the vaccinated. The vaccine is what protects the vaccinated. After all, that is why we have the vaccines. 
  2. The negative externality argument does not hold anymore. To quote my public policy textbook from graduate school, an externality is "any valued impact resulting from any action that affects someone who did not fully consent to it through participation in voluntary exchange." At the beginning of the pandemic, we did not have a way to protect ourselves from COVID. Mask usage was prevalent and counterproductive lockdowns were implemented. That was then, and this is now. We are in the stage of the pandemic in which there is readily available access [in the United States] to vaccines. If anything, access to those vaccines should be construed as a positive externality. As such, the risk to COVID becomes more individualized. If you want to risk getting COVID and do not want to get the vaccine, that choice [almost exclusively] directly affects you.
    • "Think of the children." This argument has been used in attempts to justify ill-advised policies, including banning same-sex adoptions, school closures during the pandemic, or funding universal preschool. The argument is being used again. But how deadly is COVID for children? According to CDC data released this month, there have been eight (yes, you read that right....eight!) in-hospital COVID-19-related deaths in persons between the age of 0 and 17 from August 2020 to August 2021 (Siegel et al., 2021). As for total deaths (as opposed to in-hospital), that number is 516 since the beginning of the pandemic, as of September 11, 2021 (CDC). Out of millions of children in the U.S., fewer than a thousand children have died. Even with the Delta variant, children are at a low risk to COVID. There were 1,800 children that died from H1N1, yet we did not have the same level of hysteria during the 2009 swine flu pandemic. 
    • What about the immunocompromised? The immunocompromised account for 2.7 percent of the population. A subset of the immunocompromised are unable to take the COVID vaccine. It stands to reason that the immunocompromised are going to be the most cautious for the longest, even after we reach a certain percentage of the vaccinated or after the pandemic is declared over. While we should make sure the immunocompromised receive adequate protection, it still would be the case that the immunocompromised being extra cautious is a sunk cost. 
  3. How effective will the vaccine mandate be? As I brought up a couple of months ago, those who have wanted the vaccine, by and large have gotten it. As of September 14, 75.8 percent of Americans have had at least one dose, according to CDC data. Earlier in the pandemic, there was a fair split between those who were hesitant and those who simply did not want the vaccine. At this juncture, the majority of those who have not received the vaccine are the most skeptical of the vaccine. I am skeptical as to whether a mandate would compel the unvaccinated to get vaccinated. If the less cumbersome act of wearing a mask has become such a political symbol for many of the unvaccinated, what makes you think that you can force these individuals to get a vaccine? Polling data from CNBC/Change Research from August 30 to September 2 found that 87 percent of the unvaccinated would not get a vaccinate if their employer mandated them. If these polling data are close enough to portraying an accurate picture of the unvaccinated, it means that Biden's mandate will have little effect on herd immunity. 
  4. Unintended consequences of the mandate. We can get into enforceability or cost of enforcement, a cost which remains unseen. Let's get into another point: the extent of the mandate's impact will depend upon how the unvaccinated will react. There are four main possible reactions of the unvaccinated employee: get a vaccine, fraudulently acquire a vaccine card, undergo the weekly testing, or quit your job. We do not have a crystal ball, but if the aforementioned polling data is any indication, a large majority of unvaccinated will not get vaccinated because their employer mandates it. Let us cover the two legal options since I am staunchly opposed to fraud.
    • Weekly testing. If most of the unvaccinated opt for this route, it will not only create a regulatory burden for the employer, but it could also limit the supply of COVID tests. Assuming a cost of $100 per test and at least 25 million employees would need a weekly test, this can cost millions per annum.
      • 11/4/2021 Addendum: The American Action Forum calculated what Biden's vaccination would cost. In total, the estimation is $3 billion within the first six months.
    • Unemployment. If the mandate creates such an adverse reaction in which the unvaccinated would rather leave their job than take the vaccine, this could create a ripple effect in the labor market and undermine the economic recovery. It could also put a strain on government spending since it would mean more recipients of unemployment insurance and other welfare benefits. 
  5. Ignoring the role of natural immunity. This gets into some murky territory since this topic has been hotly debated. However, there is more evidence coming in that natural immunity can provide considerable protection from COVID. Researchers at Washington University found that natural immunity could last four to eleven months (Turner et al., 2021). A recent large-scale, peer-reviewed study from Israel went as far as finding that natural immunity is thirteen times more effective than vaccine immunity (Gazit et al., 2021). Natural immunity has been shown to be effective for other diseases, but I think vaccination is a good idea because vaccination has helped greatly mitigate the spread of diseases in the past. At the same time, natural immunity contributes to overall herd immunity. Ignoring natural immunity overstates the problem, thereby diminishing the argument for Biden's vaccine mandate. 
  6. Can the federal government impose the mandate with current law? Biden intends to implement his "Emergency Test Standard" (ETS) through the Occupational Safety and Health Administration (OSHA). Under the OSHA Act of 1970, OSHA can determine "that employees are exposed to grave danger from exposure to substances or agents determined to be toxic or physical harmful or from new hazards." Let's forget that ETSs have not been used since 1983 or that six out of nine ETSs that have been implemented have been shot down by the courts either partially or completely. The wording of the Act implies that it would only cover exposure to chemicals on the job, and very well might not apply to a vaccine mandate. 
  7. Constitutionality. I will ultimately leave this to constitutional law experts, but I will say that this ruling presents a problem for separation of powers and for those who believe in representative government. Article I, Section I of the Constitution clearly states that legislation is to be created by Congress. The problem with the executive branch trying to exert too much power is not unique to the Biden Administration. It goes further back than Presidents Obama or Trump. FDR and Lincoln were also known to overreach beyond their constitutionally stated powers. The fact that congressional members on both sides did not want to enact a vaccine mandate should tell you something. In any case, I expect a lot of litigation in response to the mandate.   
  8. Biden's take on freedom. In his remarks last Thursday, Biden said that "this is not about freedom or personal choice." Well, that much is obvious. The premise behind a free society is that we get to make choices about our own lives and our own bodies as long as those choices do not directly harm others. There are multiple choices related to health that could shorten one's lifespan but many Americans do anyways. We don't ban alcohol, mandate exercise, or force people to eat five servings of fruits and vegetables even though those would be healthier life decisions. More to the point, forcing someone else to inject a vaccine they do not want cannot be justified under a doctrine of self-defense since it is unclear as to whether that individual will directly be responsible for disease transmission. None of this gets into natural immunity or herd immunity contribute to fighting disease burden. As I brought up in Point #2, the risk of not vaccinating is primarily on the individual level. If "my body, my choice" is to mean anything, a vaccine is a good litmus test. 
  9. Biden's vaccine mandate will not stop COVID. What is implicit with such policies is that if we get enough people vaccinated, we will be rid of COVID. The idea that we can get rid of COVID, i.e., zero-COVID, is a delusion. For one, the only human-borne illness we have eradicated is smallpox. Two, the rate of transmission with the Delta variant is so high (somewhere between 5 and 9) where we would need about 90 percent of the population with some form of immunity in order to reach herd immunity. Third, let's remind ourselves where the prominent variants came from. The beta variant came from South Africa, the Delta variant from India, and the Lambda variant in Peru. Getting a few more people vaccinated does not negate the fact that there are millions in the rest of the world that need to be vaccinated. Instead of thinking COVID is going away, we need to focus on harm reduction and learning to live with COVID.
  10. Biden's executive order continues to erode trust in the government. Shortly after being elected President, Biden said in December 2020 that there would be no federal vaccine mandate, saying that "I wouldn't demand that it be mandatory." In July 2021, White House Press Secretary Jen Psaki said that vaccine mandates are not the role of the federal government, but something private entities could do if they so desired (I happen to agree since businesses already impose other requirements as part of employment). At the end of July, CDC Director Rochelle Walensky said there would be no federal mandate. It did not take even two months after Walensky's promise that we would not have a mandate, and we now have a federal vaccine mandate. How can we trust the Biden administration when they say one thing and do another? Sadly, this mixed messaging from the federal government has been taking place throughout the pandemic. While the Trump administration was also responsible for mixed messaging, the Biden administration is not doing any favors in terms of being able to bring the country together. 
Conclusion: Vaccines are the single greatest tool we have at reducing the harm caused by COVID. While I agree with the importance of vaccination, Biden's vaccine mandate has problems, whether ethical, constitutional, or especially consequential. As CNN brought up in a recent article, if facts will not convince the unvaccinated, coercion certainly will not. By showing understanding the unvaccinated individuals' concerns and convincing them to get vaccinated willingly, we can bring an end to the pandemic more efficiently than Biden's vaccine mandate will.

Monday, September 6, 2021

Apples Dipped in Honey on Rosh Hashanah: Finding Goodness and Sweetness in the New Year

In many cultures, the New Year symbolizes a time of renewal, celebration, and new beginnings. The Jewish religion is no exception. Judaism has symbolism to that effect. One of the most iconic symbols of Rosh Hashanah is that of apples dipped in honey. Where does this practice originate? Why do we do it? What is its significance? 

It might be tempting to tie it back to the Tree of Knowledge in the Garden of Eden, but the Torah never identifies the type of fruit that grew from that Tree. We do not find any mention of the combination of apples and honey neither in the Torah nor in the Talmud. The practice dates back to the Geonic period, which is somewhere between the sixth and eleventh centuries. As to the why, there are multiple interpretations. However, the simplest and most common answer to give is because apples and honey are both sweet foods. We wish people a sweet, happy new year. As a matter of fact, the phrase we utter after we recite the blessing of the apple on Rosh Hashanah is the following:

יהי רצון מלפנך שתחדש עלינו שנה טובה ומתוקה.

May it be Your will to renew for us a good and sweet year.

We don't just wish for a good year, but also a sweet one. Isn't sweetness a subset of goodness? Why emphasize the sweetness? You can have something purposeful without enjoying it. You can also have something enjoyable without meaning. As Harvard professor Tal Ben-Shahar explains in his book Happier, happiness is a combination between pleasure and meaning. But why the emphasis on sweetness? Sweetness implies richness, goodness, a reward, or something pleasurable. There is something about the experience that you are truly meant to enjoy when having something sweet. I can certainly understand sweetness in the abstract. We want people to have a wonderful year. It almost sounds idyllic in theory, especially since we are combining two sweet foods during this ritual. However, if a ritual is to mean anything, if we are to have a sweet New Year in practice, we need to find ways to make the world a bit sweeter. Otherwise, the consumption of apples dipped in honey remains hollow. How do we have a sweet year? I think the beginning of that answer ironically can be found in the Passover seder.  

One of the requirements of the Passover seder is to eat bitter herbs. Another part of the Passover seder is to eat charoset, which is a paste made of fruits and nuts. Interestingly enough, apples is a common choice for charoset, which is why I bring it up. The bitter herbs represent the bitterness of the slavery that the Israelites endured (Exodus 12:8). The charoset is consumed during the seder to blunt the taste of the bitterness. As I brought up seven years ago, the consumption of the bitter herbs is mandatory, whereas the consumption of charoset is optional. If the Passover seder is to be a metaphor for life, the meaning within the "bitter herbs versus charoset" is that bitterness in life is inevitable, even though we wish for a sweet new year during Rosh Hashanah. At the same time, sweetness is optional. One of the beauties of the Passover story is that we are given freedom, even in such difficult times as the ones in which we find ourselves. But that is the first step: we have to choose the sweetness

While a paradigm shift is essential, it is not the only step. In Christianity, the end goal is salvation. In Buddhism, it is karma. Both are focused on the destination. Judaism, in contrast, is focused on the journey. If Judaism reminds us of anything, it is that spirituality is a long-term process. As Rabbi Abraham Joshua Heschel says in his book Between Man and G-d, "A Jew is asked to take a leap of action rather than a leap of thought" and that "the destiny of man is to be a partner of G-d and a mitzvah is an act in which man is present, an act of participation." We are meant to "walk after your L-rd your G-d" (Deuteronomy 13:5). What does it mean to walk after G-d? According to the Talmud (Sotah 14a), it means to imitate G-d. The examples the Talmud outlines our clothing the naked, visiting the sick, and comforting mourners. We emulate G-d in our actions. When we connect to these actions, at least based on Jewish thought, we are connecting to the sweetness that G-d has given us.  

Bringing us back to the metaphor of apples dipped into honey, we are to bring sweetness and happiness through our actions. After all, Judaism and the system of mitzvot is very much based on one's actions, as opposed to one's beliefs. We have to consistently pursue actions. It would explain why a traditional Jew says the Shema twice a day or why a traditional Jew prays for forgiveness three times a day in daily prayers. While some of these concepts seem straightforward or simple, they are hardly easy to implement. It might be easy to think of justice or kindness when you are putting on tefillin and uttering words about how we should pursue those concepts. But how difficult is it to put in practice and to do so more consistently? If good actions are applied wisdom, which is how I feel about the role of philosophy, then we should see this improvement in our actions. 

One of the things I appreciate about Chasidic thought, certainly at its founding, is that it believed in not just going through the motions. Sweetness is not a mere byproduct of meaningful work, but we are meant to find authentic joy in the process. After all, that happens to be one of the major themes of the holiday of Sukkot. As I brought up about eight Sukkots ago, happiness is not something to be acquired. It is a byproduct of one's action, as well as to what and to whom we connect. Going off my thought about Chasidic thought, I would add it is how we connect to that which is around us. Gratitude is one of many ways that we can make those stronger connections. 

While Jewish rituals and ethics provide a strong base to develop the sweetness, this concept applies beyond Jewish religious practice. Happiness is an elusive concept and can vary from person to person, much like people have different taste buds and have a different take on sweetness. However, what science has revealed, and was made famous by psychology professor Sonja Lyubomirsky in her book The How of Happiness, is that there is a significant percentage of happiness under our control. Let's take exercise as an example. Regular exercise is shown to increase dopamine and serotonin levels, which would help fight off depression. We are what we eat. This does not simply apply to symbolism found in kosher eating, but also in terms of how healthier diet can improve overall physical health. Meditation is also shown to have benefits, including lower stress, improved outlook on life, and a lengthened attention span. While they seem secular in nature, I would argue that self-care, exercise, and anything pertaining to one's health are applications of the mitzvah to "guard yourself and guard your soul carefully (Deuteronomy 4:9)." Not only do we live longer lives, but we are happier and more energetic in our pursuit towards a healthier version of the self. I would also contend that taking control over the things you can control also creates a sweetness because it creates a sense of agency, feeling of accomplishment, and a connection with living in accordance to one's values. 

I want to conclude with two points. The first point is that Jewish thought tends to emphasis the purpose and meaning aspect. With Rosh Hashanah, you get to focus on the sweetness, as well. An ideal life is not solely about living according to one's values or to have goals, but also enjoying the experience. 

The second point has to do with the nature of happiness and sweetness. It is custom to wish people a "Good and Sweet New Year." It is not an automatic process, and G-d is not a vending machine that will give you sweetness or goodness simply because you ask for it. You have to choose sweetness and make the paradigm shift to live a purpose-driven life with a more positive outlook. But it doesn't stop there. Much like anything in life, anything worthwhile takes constant effort, whether that was the Israelites from the Passover story being free or us having a sweet new year. So much of the High Holiday season is about introspection into the previous year and also looking forward. Sweetness is not going to fall on your lap. What are you willing to do differently from last year to make it truly good and sweet?

Thursday, August 26, 2021

Moral and Economic Reasons for Letting As Many Afghan Refugees As Possible into the United States

While the United States military was correct in withdrawing troops from Afghanistan this year, that still does not change the fact that Afghanistan is a bloody mess right now. Thousands are looking to leave the country. It is so bad that there were Afghan citizens swarming the airport, breaking through security to try to get on a plane. Some clung to military planes taking off and lamentably fell to their doom. Given the precarious situation in Afghanistan, an end to U.S. involvement was inevitable, as was the Taliban resurgence. The fate of thousands of Afghans, on the other hand, is not set in stone. 

President Ronald Reagan once called the United States a city on a shining hill. For many people seeking a better life, the United States has represented a land of freedom, opportunity, and a chance at a better life. As it says on the Statue of Liberty's pedestal, "Give me your poor, your huddled masses yearning to be free." Emma Lazarus' words have rung true over the decades as the United States has led the world in accepting refugees. While this has been an ideal set in the moral fabric of the United States, it has been less-than-ideal in practice. One of the reasons that President Franklin D. Roosevelt was one of the worst presidents is because he turned away refugees fleeing from Nazi persecution. More recently, President Donald Trump enacted a refugee ban as part of a litany of anti-immigrant regulations, whether it was for undocumented workers or those who "arrived here legally." 

In spite of this imperfect enactment of laws pertaining to refugees, at least we can take some solace that 81 percent of Americans are in favor of letting Afghan who helped the U.S. military throughout the War in Afghanistan into the United States (CBS-YouGov). Let's think about the moral arguments that would create such a majority opinion. For one, accepting refugees is truly an issue of a right to life, which should make pro-lifers happy. Two, it is something that has defined the American Dream since its inception, which should make those on the Right happy that we are continuing with this tradition. Not only does it help the downtrodden, but it also contributes to the diversity of the United States, which should make the Left happy. I could quote Exodus 22:20 and point out that the Bible details how the the text lays out an obligation to help out refugees, which should make the religious in the U.S. happy. We are helping those fleeing from literal tyranny to make a better life for themselves. 

The moral arguments should cover every major part of the political spectrum in the country, and yet there are some that are still against it. Some might be worried about the national security of the United States, so let's look at historical terrorism data (Nowrasteh, 2019). There have been three attacks or attempted attacks from Afghan-born individuals in the United States. Those attacks resulted in zero deaths and 30 injuries. Recent criminal data has a similar outcome. Afghan-born immigrants were incarcerated at a rate of 127 out of 100,000 individuals. As for native-born U.S. citizens? At a rate of 1,477 out of 100,000, which is to say that Afghan immigrants are 11.6 times less likely to commit crimes than native-born citizens. Furthermore, the Taliban doesn't have any ambitions beyond its own borders, which minimizes the likelihood of an attack on American soil. Also, let's keep in mind what happens on the next military endeavor (because odds are there will be one). If we abandon Afghans who helped the U.S. military during the War in Afghanistan, that tarnishes the United States' reputation. How likely would people be to help the U.S. military in future engagements knowing that translators and other supporters are hung out to dry?

Now that we have established that the threat from Afghan refugees to the American people is minimal, let's jump to the economic arguments. There are those on the Right, more specifically the anti-immigrant Right, that would like to portray refugees as an economic drain (e.g., Camarota, 2015). Some argue that greater welfare benefits are more likely to attract migrants. Earlier this month, political pundit Tucker Carlson blamed the housing crisis on refugees. He should be blaming land use regulations, but I digress. It might be politically convenient to blame refugees for being an economic burden, but refugees are in fact an economic boon. 

Let's start with the fact that refugees typically do not compete for the same jobs as native-born citizens (Mayda, 2017), a trend we see also see with immigrants. There is economic evidence showing that six years after arriving to their new country, refugees work at a higher rate than native citizens. This study also shows that the break-even point in terms of cost is around nine years. By the time the typical refugee has been in the United States for 20 years, that individual has paid $128,689 in taxes, which is $21,000 more paid in taxes than they received in benefits (Evans and Fitzgerald, 2017). Analysis from Western European data comes to a similar conclusion (D'Albis et al., 2018). Using a specific case study, Vietnamese refugees were able to become contributing members of society after so many fled Vietnam in the 1970s (Alperin and Batalova, 2018). You can read more from the Brookings Institution on the economic argument for accepting refugees (Bahar and Dooley, 2020).

This is not to say that taking in a large influx of refugees is not a huge undertaking because it is. At the same time, what I can say is this. It does not matter whether a migrant is leaving their country willingly (i.e., immigrant) or unwillingly (i.e., refugee). Much like with immigrants, refugees are a net positive contribution to the economy, especially in the long-term. Not only would it be good for the U.S. economy if we were to accept more refugees, it would be the morally right thing to do. It is my hope that the U.S. government expands the Special Immigrant Visa [SIV] program and raises the refugee cap to help alleviate the burgeoning humanitarian crisis in Afghanistan. 

Friday, August 20, 2021

It Is About Time the United States Withdraws Its Troops From Afghanistan

On August 15, the Taliban took over the Afghan capital of Kabul and the Afghan President fled. A day later, President Biden stood by his decision that he made on April 14 to withdraw troops from Afghanistan (here is a timeline for the Afghanistan withdrawal for more details on the events leading up to now). Since then, the news cycle has been going on nonstop about Afghanistan.  

The Right has been merciless in blaming Biden for a messy withdrawal. Biden's exit strategy is worth criticizing, especially with regards to evacuating American personnel, leaving military materiel behind and in the hands of the Taliban, and helping the Afghans that assisted the U.S. military. At the same time, the Afghanistan debacle started long Biden chose to withdraw troops from Afghanistan. Congress authorized the War in 2001 and President Bush led the charge on nation-building in Afghanistan. One could argue that Obama had inadequate resolve to fight in Afghanistan. We can blame Trump for entering peace talks with the Taliban or how he went about it. If you go through the Afghanistan Papers, which are assessments generated by a federal government project, there were also high-ranking officials who realized that the Afghanistan War was unwinnable while portraying the war with a rosy, Pollyannish view. There has been no shortage of imperfect actors in this war. 

That being said, criticizing Biden for how the troops were withdrawn does not mean the troops should not have been withdrawn. My criticism of the Afghanistan War dates back to 2009. U.S. involvement did not make sense in the 2000s, and it makes even less sense now. Afghanistan remains an exceptionally corrupt nation (Freedom House). The U.S. military still has not defeated the Taliban or reformed Afghan politics in a way where there is a democratic and stable government. What has been the cost of getting involved in another country's civil conflict? In terms of lives lost, there have been 65,000 Afghani soldiers, about 2,500 U.S. service members, over 3,800 U.S. contractors, and 47,245 civilians killed. The United States will probably have $2 trillion in war debts by 2030, which will creep up to $6 trillion by 2050 because of interest (Peltier, 2020). 

I am not going to hash out the entire history of the War in Afghanistan here, but I will assert the opinion that the war has been mismanaged. If you want a expert analysis on the matter, go with the the Special Inspector General for Afghanistan Reconstruction [SIGAR], which is the government's oversight authority for the country's reconstruction. In its August 2021 report, SIGAR detailed how the U.S. government "continuously struggled to develop and implement a coherent strategy for what it hoped to achieve." 

To continue quoting SIGAR: "The U.S. government consistently underestimated the amount of time required to rebuild Afghanistan, and created unrealistic timelines and expectations that prioritized spending quickly. These choices increased corruption and reduced the effectiveness of programs." Again, those are not my words, although I do concur. That is the conclusion of the oversight agency meant to monitor and evaluate how the U.S. military was performing in Afghanistan. In other words, the U.S. military had no long-term strategy on its military involvement in Afghanistan and had no exit strategy

Since the best military in the world is withdrawing, there is bound to be at least some effect on Afghanistan's internal affairs. At the same time, this was a civil war long before the U.S. entered Afghanistan for what was initially "a constrained counterterrorism operation in retaliation for the 9/11 attacks." The U.S. military went into Afghanistan to stop Al-Qaeda. As the think-tank Brookings Institution points out in its recent analysis, Al-Qaeda has a fraction of the power it had in 2001. At this point, terrorist groups from the Middle East and Africa are more of a threat to national security than Al-Qaeda, which diminishes the national security argument for staying in Afghanistan. 

Some situations are truly hopeless, much like Sisyphus pushing that boulder up the hill. Afghanistan is a country plagued with tribal bickering, parochialism, corruption, lack of sound institutions, and a lack of willpower for actual reform. Alexander the Great, Genghis Khan, and the Soviets had issues when they invaded Afghanistan. Given the history of volatility in that part of the world, not to mention the geopolitical, ethnic, and cultural complexities, it was inevitable that there would have been havoc and chaos when U.S. troops entered Afghanistan. However, the United States has been attempting nation-building for twenty years in Afghanistan without significant reform. As frustrating as it might be to put in so much effort so little reward, it is about time that the United States cuts its losses and withdraws from Afghanistan.

Thursday, August 12, 2021

We Do Not Need Mask Mandates to Fight the Delta Variant

We were making such progress with the pandemic in the United States. We got through the COVID peak in the winter. Since the vaccine rollout began in December, 71.3 percent of adults have received at least one dose as of August 11. Restrictions were getting lifted across the country. It looked like we were seeing the end of the tunnel with this pandemic. Then the Delta variant, a strain of COVID that is about twice as contagious as the Alpha variant (i.e., R0≈7), came along. In response to this variant, multiple cities have reinstated mask mandates, including Los Angeles, Phoenix, and Washington, D.C. 

There has been a partisan divide throughout this pandemic. Generally speaking, Democrats have taken the pandemic more seriously and have been more scared of coronavirus. Republicans, on the other hand, have not taken it as serious and are less afraid. Independents are somewhere in between. This trend has borne out by survey data. Republicans show a lower rate of vaccinations than other demographics (Kaiser Family Foundation). This divide is not confined to the vaccines. To quote Reason Magazine contributor Robby Soave, "In practice, people who don't want to get the vaccine are unlikely to follow the other, more annoying mitigation strategies. On the contrary, the places that are most likely to reintroduce the mask mandates and see widespread compliance are places where vaccination rates are high." According to a Morning Consult survey from August 4, both the unvaccinated and Republicans are less likely to wear masks going forward than the vaccinated and/or Democrats. Although the pandemic has been greatly politicized, we should not view it in those terms. The question is whether these mandates are going to help or if it is an exercise in futility. 

Before the Delta variant arrived, the question about mask efficacy has been in question. In the medical journal JAMA, they wrote in March 2020 that "face masks should not be worn by healthy individuals to protect themselves from acquiring respiratory infection because there is no evidence to suggest that face masks worn by healthy individuals are effective in preventing people from becoming ill (Desai and Mehrotra, 2020)." I looked at the question of face mask effectiveness twice last year (see here and here). At that time, I found inconsistent evidence, but was also mildly supportive of a temporary, indoor face mask mandate because a) they work under certain conditions (e.g., high compliance rate, more effective indoors and in larger crowds), b) they come with a lower cost (especially compared to lockdowns), c) surgical and N95 masks work much better than cloth masks, and d) there was an overriding public health concern. Looking at World Health Organization recommendations, I concluded that, at best, face masks would be but part of a more comprehensive strategy since their efficacy was lower than such a measure as social distancing. In December 2020, the WHO stated in its interim mask guidance (p. 8) that "there is only limited and inconsistent scientific evidence to support the effectiveness of masking healthy people."  That was the prominent WHO about a year into the pandemic, and that was the best they could say about masking healthy people. The American Institute for Economic Research released a piece on mask efficacy evidence that I found to be a good read. Needless to say, how I view the masks are that their efficiency is modest at best, and inconsistent and negligible at worst. 

In addition to asking whether the masks are effective, there is also a question about whether the mandates work. Lockdowns provide a good example and proxy of voluntary versus mandated behavior. Lockdowns were advocated for not based on evidence (because none existed at the time), but on modeling. The modeling made generous assumptions about the benefits of lockdowns while giving most, if not all, the credit, to lockdowns. The evidence is coming in with regards to lockdowns, and what we have been seeing is that lockdowns are ineffective. There are multiple reasons, but one of the big reasons was that people were social distancing without the lockdowns. People did not need a mandate. By and large, they voluntarily kept their distance. Do we see a similar phenomenon with masks? Were most people already masking before the mandates? Would people have worn masks regardless of the mandates? A recent study from the International Monetary Fund fails to make the distinction, which is why I ask these questions (Hansen and Mano, 2021). Were the mask mandates a primary cause in saving lives or were they simply incidental and correlational? 

We can look at multiple countries that implemented mask mandates and the number of cases still surged, especially last winter. I could also point out that Sweden has not had a mask mandate and its current COVID problem is all but nonexistent. I can show some earlier analysis from the Heritage Foundation, but I want to show a recent ecological study from the University of Louisville (Guerra and Guerra, 2021). The researchers found that although 80 percent of states mandated masks, the mandates "did not predict lower growth rates when community spread was low [minima] or high [maxima]." The conclusion thus inferred was that the mandates were unlikely to have affected COVID-19 case growth.


What makes all this discussion about how they have fared thus far is a case of "that was then, this is now." Two major changes have taken place in recent months. These changes do not make the previous discussion about masks pointless, but it does change the context. One such change is that the prominent strain of COVID [in the United States], the Delta variant, is significantly more contagious. You could make an argument that masks could be more effective against Delta. It is soon to tell since we do not have data to back up the assertion. The closest we have is previous research and inferences we can make. On the other hand, as I would argue, the rate of transmission is high enough that even if you go with the generous assumption of masks reducing transmission from 30 to 50 percent, there will still be high transmission in absolute terms. The second change is that the vaccination campaign is well under way. I discussed vaccine mandates a couple of weeks ago, and you can read an elaboration of the aforementioned changes here. What I will say is that while the idea of a more contagious disease sounds scary, it is not as simple or as catastrophic as "cases are surging" sounds.

Sir Andrew Pollard, who heads the Oxford Vaccine Group, said that while vaccinations slow the spread, they do not eliminate transmission. However, the odds of catching it as a vaccinated individual (i.e., a breakthrough case) is low. As the Kaiser Family Foundation points out in its research of state-level data earlier this month, the odds of a breakthrough case are less than one percent. More to the point, hospitalizations and deaths are really low for the vaccinated. Pollard also said that even if the vaccine-induced antibodies waned, odds are that our immune systems would remember enough to offer a degree of protection for decades. So why does transmission matter if actual harm has decreased? As infectious diseases expert Professor Paul Hunter brings up, we shouldn't frighten ourselves with high [confirmed case] numbers that do not translate into disease burden. 

Hospitalizations and deaths are much better indicators of disease burden than cases. What have we seen since the vaccines have taken hold? In most jurisdictions, there has not been a corresponding, comparable rise in hospitalizations and deaths. The areas getting heavily hit are those with low vaccination rates (although, to be fair, the places in the Southern U.S. are also dealing with hotter summer weather, which means they are indoors more often than the rest of the year). Looking at the American Hospital Associations Bed Occupancy Projection Tool, most parts of the U.S. are not above 70 percent. For context, the CDC calculated in 2015 that average bed occupancy was 65.5 percent. You can go through the data on hospitalizations and deaths yourself. When you do look at the numbers, I hope you see what I see, which is that the disease burden is not there to justify the mask mandates.

To summarize, our focus should not be on renewed mask mandates. Why? For one, mask mandates, as opposed to general mask-wearing, are shown to have been negligible at best. It has hardly been the silver bullet that proponents make it out to be. Two, the unvaccinated are less likely to wear masks than the vaccinated. Three, those who have been pushing for the mask mandates are the ones most likely to assume that we can get rid of COVID. Historically, we have only eradicated smallpox and rinderpest. A mask mandate distracts us from being able to accept that COVID is most likely to be endemic, i.e., it's not going anywhere. If endemicity is the future, then at best, masks would only delay the inevitable. Finally, one of the most prevailing features of those entering the hospitals for COVID are that they are not vaccinated. Fauci was right that this pandemic has become a pandemic of the unvaccinated. That being the case, mask mandates make little sense if the unvaccinated are the drivers of COVID at this stage. Vaccines are safe and effective. They have been shown to be especially effective against severe COVID cases and COVID deaths. Instead of spurious mask mandates or the CDC using mixed messaging about vaccines and face masks, what needs to happen is a solid vaccine campaign with unambiguous messaging so we can get our lives to as close to "pre-pandemic normal" as possible. 

Friday, August 6, 2021

The Swedish COVID Approach: A Case Study Pandemic Control Freaks and Lockdown Proponents Prefer to Ignore

Last year, Sweden was the target of derision on the Left, particularly those who were gung-ho about more pandemic restrictions. What did Sweden do that was so terrible? On the one hand, Sweden did recommend masks in certain scenarios (e.g., public transit), banned large gatherings, closed upper-secondary schools, and imposed travel bans. On the other hand, it didn't implement lockdowns, curfews, or mask mandates. This approach has been seen so lax by the pandemic control freaks that Sweden has been called a disastera catastrophea failure, an example of "how not to handle COVID", and has been accused of killing its own people

There was a model coming out of Sweden, one that was based on the infamous Imperial College model that got the United Kingdom to go into lockdown mode, that predicted that 96,000 Swedes would die by June 2020 if Sweden would not implement lockdowns, mask mandates, or other stringent measures (Gardner et al., 2020). Much like I asked last August, I would like to see how well Sweden has fared, even in spite of its seemingly lax approach.

Let's start with number of deaths. How close was Sweden to the predicted 96,000 deaths? According to the Swedish Health Ministry (Folkhälsomyndigheten), the number of dead in Sweden as of August 6, 2021 is 14,657. It has been about a year-and-a-half since the pandemic started, and Sweden has had less than a sixth of what the doom-and-gloom crowd predicted. Additionally, 9,771 of those deaths (or 66.7%) were of those who were 80 or older. The next argument I can anticipate is "well, maybe that is so, but it would have been better with lockdowns." Is that so? I took a look at the academic literature on lockdowns in June, and the data-driven evidence is showing that lockdowns were ineffective at its goal of saving lives. Not only that, it is likely that lockdowns have actually increased excess deaths.

Speaking of excess deaths, Sweden had a much lower excess death rate than many of its counterparts that locked down, including Spain and Belgium (Reuters; Eurostat). Deaths per 100,000 play out a similar finding (Johns Hopkins), mainly that other countries that locked down (e.g., Italy, France, Spain) fared worse than Sweden. Before mentioning Norway or Finland, it is worth mentioning that the Scandinavian counterparts ranked lower than Sweden in terms of restriction stringency on Oxford's COVID-19 Stringency Index during much of the pandemic.


How has the laxer approach working out for Sweden? Whether we look at Sweden's deaths (avildna), cases (sjukdomsfall), or intensive care admissions (nya intensivvårdade), what we see from the statistics from the Folkhälsomyndigheten [below] is that the pandemic seems to be subsiding in Sweden. While Sweden is looking at a denouement, other countries are looking to impose another round of restrictions. 

It is not that Sweden did nothing. What Sweden did was its best to truly follow the science, as opposed to being needlessly stringent under the guise of "following the science." In the meantime, those who want to continuously impose restrictions ignore the likes of Italy, Spain, or Peru, the latter of whom has the highest per capita death rate in spite of having locked down hard and early. While the Swedish case study is not definitive proof unto itself that excessive restrictions do not work, it adds to the growing evidence base that a less onerous and more laissez-faire approach rooted in science was the better way to handle the pandemic.