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Flawed Fiat: Challenging Adrian Gore (Part 1)

Part #1: An open letter to Discovery founder and CEO Adrian Gore

Dear Adrian

You’ve mandated thousands of people get a specific medical treatment. That demands a bulletproof justification. I’d like to challenge you on that. I argue that your “six-point rationale” is dangerously flawed.

Many will follow your ruling by reason of your formal role as leader of Discovery. Many will follow you because of the high esteem they justifiably hold you in.

In a series of pieces, I will press you on many of your premises. My goal is healthy debate. This is important for the precedent it can set and the impact your vaccine mandate will have on lives.

Your first premise: “People are dying. We need to stop it.”

We or me?

Why “we”? Why a for-profit business? Why a mandate? And why your employees?  

We have long accepted that medical treatment is for the individual to manage themselves. For children, a parent or guardian has a duty, too. Doctors have an indispensable advisory role. This seems uncontroversial. Nobody I know challenged it before Covid mania struck.

The principle here is “informed consent”. Here’s a strong discussion and explanation of this from the SA Orthopaedic Journal. I’ll leave it there, as I trust you agree it is self-evident that this is the right way to manage medical treatment – even if we disagree on its application.

Why would a corporation suddenly need to force a medical intervention on their employees?

The relationship is not familial. It is not one of authority. The company and the employee are contractually bound. One provides labour, the other money. The connection is limited to the contents of the contract. It is governed by contract law and labour law. And overarched by the Constitution. I reckon we can look to the likes of international treaty for authority as well. Consider the United Nations International Covenant on Civil and Political Rights (1966).

Neither party is superior to the other. Discovery may not demand that an accountant perform sales duties. It has no right to force a call centre agent to work 43 hours a week instead of an agreed 40. Just the same, the accountant or agent has no standing to knock on your door, payslip in hand, and demand one rand more than his agreed remuneration.

Which people?

Your first word is problematic. Strictly you’re entirely correct. People are dying. But there is an inference here, I submit, that vast numbers of people are dying across the board. You wouldn’t have written that sentence if you were addressing very few deaths in a small segment of society.

Substantial numbers of people are dying. Each one is a matter if great emotion for the relevant nearest and dearest. That is of some relevance when making policy. But a thoroughly actuarial approach has to supersede that.

Further, we have a limited capacity to address these deaths. And every effort we make to do this has a direct cost, an indirect cost and an opportunity cost.

For the purpose of appropriately crafting the tone, I argue that talking broadly about “people” should be avoided in the context of Covid. This virus is of vanishingly little danger to children. It is of some danger to groups like healthy 30 year-olds. With an average age of death from Covid above 82, it is a clear and present danger to that group. Presumably none of your staff fall into the 82-plus category.

The upshot is that Covid’s impact on quality-adjusted years of life lost is massively smaller than it might be if it killed people evenly across age groups. And individual responses to the virus ought to be informed by these meaningfully different risks.

Also, why only Discovery’s South Africa-based people?

I’m making a highly nuanced point on “people”. Pedantic, even. But that is what we ought to do for a matter of this gravity. Especially in a milieu where tone and narrative have such potent force.

Why Covid?

You announce, “Every life lost is a life too many, and every effort to curb further loss must be taken.” That sounds noble. However, the fundamental claim is unsustainable. It is not the case that all and any of us must do everything we can to prevent the loss of every life. Rather, some people have some duties to work to prevent the loss of some lives, within a cost-benefit scenario.

A reductio ad absurdum is instructive here. Using your framing, government could – in fact, must – mandate emergency medical staff be stationed green-side at every bowls game. I must boost my neighbour’s expected life span by forcing him to jog with me.

Each of us makes decisions about how to risk our lives every time we get into a car, play tennis or go skydiving as a birthday thrill. I understand part of the reasoning for vaccine mandates is that vaccination against Covid has an impact on the risk calculation for other people. Later I will address this.

You provide no framework for where it might sensibly end. What precise and complete criteria justify the corporate mandating of a medical treatment? What I draw from your first premise is, “it is very bad and we should step in”. We need brighter lines than that. Better defined and with more robust limits.

Covid is a nasty virus. We now know its toll. No need to discuss that here. But why Covid specifically? In England Covid is now 24th on the list of leading causes of death. It falls outside the leading causes of death in the table below compiled from official sources. For fullness, England has far higher rates of vaccination than we do and a superior health system. The comparison is imperfect.

If you want to wield every effort to save as many lives as possible, why the decision to target Covid in preference to every other potential cause of death? Is there more bang for buck elsewhere?

The burden of proving that is not on me or any Discovery employee who doesn’t want the vaccine – for whatever reason. It is on you. I challenge you to show us. You have done your actuarial calculation on Covid. We need it for all the other major causes of illness and death.    

  

Force versus trust

Why the strict mandate? Trust is the golden rule in public health. There is good exploration of that here – Trust in Public Health Is Essential Amid the COVID-19 Pandemic – by the Journal of Hospital Medicine.

Similarly, Harvard Medical School Professor Martin Kulldorff argues in his Twelve Forgotten Principles of Public Health that this area should be bedded in trust, not demands. As the expert in infectious disease outbreaks and vaccine safety puts it, “Public health is about trust. To gain the trust of the public, public health officials and the media must be honest and trust the public. Shaming and fear should never be used in a pandemic.” I’m sure Kulldorff would add corporates to public health officials and the media where they make health policies. I’d extend “shaming and fear” to include threats of losing your job.

Why won’t you trust our staff? Those who have had Covid already have as much if not more protection against the virus as those who have been vaccinated. And vaccinated or not, anyone infected can transmit the virus. I’ll return to the details of this paragraph in later editions. I find it a particularly vexing part of the science.

I submit that you have a duty to fully consider less dictatorial methods. It is unclear to me if you have done this. At a minimum, I suggest you owe it to your staff to explain why you haven’t taken inspiration from the Great Barrington Declaration, which advocates targeted measures using education and recommendations, rather than force.

Heavy burden

This is unambiguously your burden. “He who alleges must prove”. The status quo is not to mandate vaccines. You want to alter that. And in this case, you are impacting (I’d say infringing) a number of rights in the Bill of Rights in our Constitution.

Privacy: we have a right not to disclose our medical history. Freedom of movement: presumably staff will be banned from your premises (admittedly private property) without a vaccine card. The right to earn a living. Will you fire anyone who doesn’t take the vaccine? I suspect you’ll be infringing religious freedom in some instances. Based on the iconic S v Makwanyane Constitutional Court decision of 1995 (the “death penalty case”), I’d not be surprised if a court found the right to dignity is infringed by demanding a medical treatment on pain of losing your job.

I expect a lawyer may find additional Constitutional and other legal challenges.

These rights may be legitimately limited. But it is a weighty burden for each one. And your mandate limits many of these entrenched rights. You do deal with this in premise 6. So I’ll leave it here for now.

Next: Faulty Fiat #2

In my next instalment I’ll tackle the second part of your rationale: “Our data is unequivocal”. Data is very rarely unequivocal. On Covid, vaccines and vaccine mandates, I will put to you that it is not just equivocal but that it stacks up against your decision.

I’ll note here the fact that your letter does not provide sources for your data. This tarnishes your argument’s credibility. What sort of authority produced which number? How reliable are they? Was it a drug manufacturer’s claim or a finding in a peer-reviewed study in a respected journal by scientists with good track records and demonstrable impartiality? How did they obtain these figures? What was the sample? You haven’t granted us the ability to evaluate these things.

I challenge you to provide us with your sources.

Recommended reading

I’ll close #1 with a suggestion. Here is a robust work opposing vaccine mandates for many reasons. Author Abir Ballan is a public health expert with a background in psychology, as well as a member of the executive committee of PANDA.

If you are mandating thousands of people get a specific medical treatment, your argument should be bulletproof. On my analysis, yours has meaningful faults that deserve fuller consideration before the rule takes effect on many lives.

Adrian, I would hugely appreciate your engagement on this. Despite my strong conviction one way, I endeavour to be open-minded and ready to change my mind if persuaded. Despite your decision, and I imagine an equally potent yet polar conviction to mine, I do hope you’ll do the same.  

Regards,

Ian Macleod

Ian Macleod

Ian Macleod

Ian Macleod studied business science at the University of Cape Town, and journalism at Rhodes University. He completed his MBA at the University of Pretoria’s Gordon Institute of Business Science (GIBS) in 2017. Ian's career has spanned from feature writing for magazines to consulting at a big four professional services firm. Currently he divides his time between two consulting roles, one in a quasi-academic capacity and the other to investment firms in the novel field of narrative economics.

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