Coronavirus

Time To Triage (Out!) The Anti-Vaxxers Who Get COVID

In Canada's Western province of Alberta, hospital beds are running out and forcing officials to "triage" to decide who does and doesn't get care. The same formula should not apply to those who have chosen not to get the COVID vaccine.

photo of two nurses inside an ambulance

"We're sacrificing the health and indeed the lives of children,"

MatNap/Unsplash
Ranjani Iyer Mohanty

-OpEd-

CALGARY — The province of Alberta in western Canada has a reputation for being outdoorsy, somewhat conservative, and laid back. Well, it's not laid back anymore. Over the past week, both medical administrators and the media have been warning that due to steeply rising numbers of COVID-19 cases and rapidly filling hospitals, medical workers may soon have to apply the triage policy to determine who is allocated medical care …and who is not.

In reality, triaging already began several weeks ago — and to the detriment of the vaccinated and children.

A common definition of triage is "a practice invoked when acute care cannot be provided for lack of resources. The process rations care towards those who are most in need of immediate care, and who benefit most from it"


Alberta has a framework for this process titled Critical Care Triage during Pandemic or Disaster, documented for the first time earlier this year. It says that "the triage protocols create an objective process to guide health care professionals in making the difficult determination of how to allocate resources to critically ill adult and pediatric patients when there are not enough critical care resources for everyone."

The objective of the framework is to ensure that "a fair and equitable process is applied to all people of Alberta." The main criterion for allocating critical care is the 'capacity to benefit,' which is a way of saying: "prioritizing the admission of patients who have a substantially better chance of surviving after receiving critical care."

A fair and equitable process

There are several challenges with this approach. The first is the lumping together in the document of two very different situations. The term 'disaster' implies something that is a natural, sudden calamity, where we are all equally caught off-guard. This pandemic, instead, has been more than two years in the making, highly publicized and analyzed — and for the past six months, highly effective vaccines have been easily accessible.

Second is the phrase "when there are not enough critical care resources for everyone." And why are there not enough critical care resources now for everyone? The answer is simple: a section of the population (adults with no medical reasons) consciously and knowingly decided not to get vaccinated, despite being presented with every opportunity, and are now catching COVID in large numbers.

Third, the document claims to offer a fair and equitable process. Only it doesn't. We are now rationing care towards those with COVID, which means we are now rationing care largely towards the unvaccinated. This is appropriate and necessary when it involves children and adults who for medical reasons cannot be vaccinated. But it is unacceptable when it includes adults who have purposefully refused to be vaccinated.

Hundreds Protest COVID-19 Mandates At Freedom Rally In Edmonton

Artur Widak/zumapress

90% in hospital are unvaccinated or partially vaccinated

Some 90% of the people in hospitals now with COVID are unvaccinated or only partially vaccinated. The adults among them have declined the chance to get vaccinated, various reasons including distrust of the government, distrust of medical science, and not wanting a foreign substance in their body.

They should not occupy hospital resources.

Fair enough; I can respect someone standing up for their principles. But using the same logic, when they catch the virus, they should stay at home. They should stay far away from government-run hospitals, where medical staff will be injecting various drugs into their bodies and performing various invasive procedures in an attempt to treat them and keep them alive. They should not occupy hospital resources. But because they are, the medical system is already triaging and that too, in favor of the unvaccinated.

In addition, by postponing surgeries, the medical system has further prioritized the care of the unvaccinated over the care of others – who may need a hysterectomy due to cervical cancer, as the Calgary Herald reported, or who may need surgery due to lung cancer, who may be waiting for a knee or hip replacement and suffering from severe pain and reduced mobility in the meantime.

When surgery 'postponement' is a euphemism

These surgeries are being canceled so as to create space in ICUs for the unvaccinated. Even children's surgeries are being postponed, the CBC reports and some staff from the Alberta Children's Hospital have been deployed elsewhere. Of course, often the term 'postponed' is euphemistic. If the patient happens to die due to the postponement, call it 'canceled.' While we know the numbers who have died of COVID, we don't know the numbers who have died and will die due to postponement of their treatment.

We're sacrificing the health and indeed the lives of children, the vaccinated, and those who genuinely cannot be vaccinated in order to treat those who have consciously and callously refused to be vaccinated. We are giving up our hospital care for them.

Lastly, triaging solely on the basis of 'capacity to benefit' is simplistic, narrow-minded, and unfair. We also need to triage on the basis of whether patients have taken the trouble to get themselves fully vaccinated. So two criteria are needed to allocate hospital care: 1. Capacity to benefit; 2. Full vaccination. While the first reflects the patient's physical ability to survive, the second is indicative of perhaps even more important things: their healthy fear of a serious illness, their mental desire to survive, their respect for medical science, and their concern for the rest of society.


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Ranjani Iyer Mohanty is a commentator and academic editor. Her articles have also appeared in the New York Times, the Wall Street Journal, the Atlantic, and the Globe and Mail.

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Society

Debt Trap: Why South Korean Economics Explains Squid Game

Crunching the numbers of South Korea's personal and household debt offers a glimpse into what drives the win-or-die plot of the Netflix hit produced in the Asian country.

In the Netflix series, losers of the game face death

Yip Wing Sum

-Analysis-

SEOUL — The South Korean series Squid Game has become the most viewed series on Netflix, watched by over 111 million viewers and counting. It has also generated a wave of debate online and off about its provocative message about contemporary life.

The plot follows the story of a desperate man in debt, who receives a mysterious invitation to play a game in which the contestants gamble their lives on six childhood games, with the winner awarded a prize of 45.6 billion won ($38 million)... while the losers face death.


It's a plot that many have noted is not quite as surreal as it sounds, a reflection of the reality of Korean society today mired in personal debt.

Seoul housing prices top London and New York

In the polished streets of downtown Seoul, one sees endless cards and coupons advertising loans scattered on the ground. Since the outbreak of the pandemic, as the demand for loans in South Korea has exploded, lax lending policies have led to a rapid increase in personal debt.

According to the South Korean Central Bank's "Monetary Credit Policy Report," household debt reached 105% of GDP in the first quarter of this year, equivalent to approximately $1.5 trillion at the end of March, with a major share tied up in home mortgages.

Average home loans are equivalent to 270% of annual income.

One reason behind the debts is the soaring housing prices. In Seoul, home to nearly half of the country's population, housing prices are now among the highest in the world. The price to income ratio (PIR), which weighs the average price of a home to the average annual household income, is 12.04 in Seoul, compared to 8.4 in San Francisco, 8.2 in London and 5.4 in New York.

According to the Korea Real Estate Commission, 42.1% of all home purchases in January 2021 were by young Koreans in their 20s and 30s. For those in their 30s, the average amount borrowed is equivalent to 270% of their annual income.

Playing the stock market

At the same time, the South Korean stock market is booming. The increased demand to buy stocks has led to an increase in other loans such as credit. The ratio for Korean shareholders conducting credit financing, i.e. borrowing from securities companies to secure stock holdings, had reached 21.4 trillion won ($17.7 billion), further increasing the indebtedness of households.

A 30-year-old Seoul office worker who bought stocks through various forms of borrowing was interviewed by Reuters this year, and said he was "very foolish not to take advantage of the rebound."

In addition to his 100 million won ($84,000) overdraft account, he also took out a 100 million won loan against his house in Seoul, and a 50 million won stock pledge. All of these demands on the stock market have further exacerbated the problem of household debt.

42.1% of all home purchases in January 2021 were by young Koreans in their 20s and 30s

Simon Shin/SOPA Images/ZUMA

Game of survival

In response to the accumulating financial risks, the Bank of Korea has restricted the release of loans and has announced its first interest rate hike in three years at the end of August.

But experts believe that even if banks cut loans or raise interest rates, those who need money will look for other ways to borrow, often turning to more costly institutions and mechanisms.

This all risks leading to what one can call a "debt trap," one loan piling on top of another. That brings us back to the plot of Squid Game, "Either you live or I do." South Korean society has turned into a game of survival.

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