By Rabbi Yair Hoffman for 5tjt.com
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The current state of COVID-19 in America is that it is killing 3000 people every day. What follows is an analysis of the policy that has been adopted by the CDC as to who should be vaccinated first. In this author’s opinion, and in the opinions of numerous doctors and expert statisticians that this author has consulted with, the CDC policy is morally and halachically bankrupt. If one carefully examines the mission statement of the CDC – one will see that the raison d’etre of the CDC is to maximize the saving of life. Lehavdil, the parameters of halacha are also to maximize the saving of life.
NOT WHAT IS HAPPENING
But that is not what is happening here – with the priority of the vaccination system that has been implemented. Young, healthy people with antibodies are being given the vaccine – even before the elderly and those most at risk. In the local area, two caretakers of an elderly woman have been given the vaccine – long before the woman that they are taking care of. They wanted her to have it, but the state did not let.
THE BACKGROUND TO THE RECOMMENDATIONS
On December 3rd, the CDC made recommendations to the three governments throughout the nation – the federal government, the state governments and the local governments about who should be vaccinated first. These were called Phase 1A recipients. These recommendations were based on those made by the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts.
The three thoughts this author would like to share are as follows:
- The recommendations are wrong.
- At the current rate of deaths in this country, the recommendations are killing an extra 500 people per day. They will kill many thousands, if not tens of thousands of people
- There is still time to change them.
WE SHOULD ONLY FOCUS ON SAVING LIFE
The criterion as to who should be vaccinated first should be made solely with one factor in mind – to maximize the saving of life. This means if option A will save 4200 lives a week and the option that the CDC has chosen will save 700 lives then the policy is responsible for the death of 3500 people a week – which translates to 182,000 people per year. Those most at risk for dying and the elderly – should receive the vaccine first – this should be the only criterion.
The CDC website states that their recommendations were made with these 3 goals in mind:
- Decrease death and serious disease as much as possible.
- Preserve functioning of society.
- Reduce the extra burden COVID-19 is having on people already facing disparities.
The problem is that goal #2, and goal #3 undermine goal number one. The scandal that has happened in Brooklyn should be a call to the real scandal that is happening. It should be a clarion call to all doctors, presidents, clergymen and everyone that values life to change the criterion.
WHO IS GETTING IT NOW
Currently, healthcare personnel and residents of long-term care facilities are offered the first doses of COVID-19 vaccines (Phase 1a). Healthcare personnel are less at-risk for dying of COVID-19. According to those with a background in statistics, this decision will cause many thousands of deaths each week. True, the healthcare workers are heroes and they will be discussed later in this article. But, once again, those most at risk for dying should receive the vaccine first. That is it.
THE RECENT RECOMMENDATIONS
On December 22nd, the CDC made recommendations as to who should be included in Phases 1b and 1c.
1b will include frontline essential workers such as:
- fire fighters
- police officers
- corrections officers
- food and agricultural workers
- United States Postal Service workers
- manufacturing workers
- grocery store workers
- public transit workers
- those who work in the educational sector (teachers, support staff, and daycare workers.)
Really? What madness has entered the minds of the people making such decisions? The emperor has no clothes. Who are they to place value on one life versus the other? Trauma centers are designed to triage. Who made this decision – and why is this not the scandal of the century? Has the entire world gone stark raving mad??
WHERE IS THE MEDIA? WHERE ARE THE DOCTORS THAT ARE TRAINED IN STATISTICS?
Yes, true, in the1b phase, the CDC recommendations include people aged 75 years and older because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 75 years and older who are also residents of long-term care facilities should be offered vaccination in Phase 1a.
In Phase 1c, the CDC includes people aged 65—74 years “because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 65—74 years who are also residents of long-term care facilities should be offered vaccination in Phase 1a.”
In 1c, the CDC includes people aged 16—64 years with underlying medical conditions which increase the risk of serious, life-threatening complications from COVID-19.
Again, an error – this group should have been included in 1a.
Who else is in 1C? They are other essential workers, such as
- people who work in transportation and logistics,
- food service,
- housing construction and finance,
- information technology,
- communications,
- energy,
- law,
- media,
- public safety
- public health.
This is sheer madness, and actually a deeply immoral policy. We have thrown out all the logic of triaging and have adopted “politically-correct” notions in who shall live or who shall die. If ever there was a time for President Trump to step in and stop this insanity he should do so now. It will be his greatest legacy. In addition to all this – even those with antibodies, lots of them, are getting the vaccine – while others who are so at risk are not.
THE STATISTICIANS SPEAK
There are approximately 30 million essential workers. There are 540 daily deaths in the 25-65 range – we are assuming that they comprise 18 percent of these death and that they are no more likely than other members of that age range to be infected.
The CDC publishes data on the distribution of nationwide deaths by age as of a recent date in December. See https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
That produced the following distribution of deaths by age range:
All Ages
- 0% Under 1 year
- 0% 1-4 years
- 0% 5-14 years
- 0% 15-24 years
- 1% 25-34 years
- 2% 35-44 years
- 5% 45-54 years
- 12% 55-64 years
- 21% 65-74 years
- 27% 75-84 years
- 32% 85 years and over
Keep in mind that this is the percentage contribution of deaths regardless of whether people had underlying conditions. COVID deaths are currently in the 3,000 per day neighborhood nationwide. If we distribute those 3,000 deaths according to the above percentages, we get the following:
- Under 1 year 32
- 1-4 years 19
- 5-14 years 51
- 15-24 years 81
- 25-34 years 99
- 35-44 years 48
- 45-54 years 23
- 55-64 years 54
- 65-74 years 40
- 75-84 years 76
- 85 years and over 78
Total daily deaths 3,000.00
We see that ages 25-64 are contributing about 580 deaths per day while the 65-74 range are contributing 640 deaths per day.
There is an AARP article lays out some numbers for the respective groups in the CDC prioritization:
https://www.aarp.org/health/conditions-treatments/info-2020/covid-vaccine-pr
iority-groups.html
It says that there are about 30 million “frontline essential workers” and about 28 million Americans in the 65-74 range. The US population by age indicates that the population from 25-64 is approximately 170 million (Wikipedia).
Age men women total % of US % male % female male/female ratio
0-14 31,255,995 29,919,938 61,175,933 18.73% 51.09% 48.91% 1.04
15-24 22,213,952 21,137,826 43,351,778 13.27% 51.24% 48.76% 1.05
25-54 64,528,673 64,334,499 128,863,172 39.45% 50.08% 49.91% 1.00
55-64 20,357,880 21,821,976 42,179,856 12.91% 48.26% 51.74% 0.93
65+ 22,678,235 28,376,817 51,055,052 15.63% 44.42% 55.58% 0.80
all 161,034,735 165,591,056 326,625,791 100.00% 49.30% 50.70% 0.97
Assuming that the 30 million frontline essential workers are largely in the age 25-64 range, they represent about 18% percent of the total population in that range and would only be contributing about 100 deaths per day.
There are a variety of nuances that would arguably change the precise numbers – including overlap in the populations, different risk profiles of subpopulations. According to this, prioritizing frontline essential workers in front of age 64-75 would appear to be prioritizing a population segment contributing roughly 100 deaths a day over a segment contributing over 600 deaths per day.
THEY WON’T HELP
The argument has been made that healthcare workers should receive it first because otherwise no one will be there to help those who are sick. This is actually, not likely to betrue. Our healthcare workers are true heroes. As someone who witnessed them firsthand in the hospital, I questioned then and most did not have it. They are the real heroes of COVID-19 and would do it anyway. We are under-estimating the nature and character of our nurses and healthcare workers. And by doing so, we have adopted a policy that will kill untold tens of thousands.
DECLARATION OF INDEPENDENCE
The CDC must not forget the words of the Declaration of Independence: We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. Let’s go back to that first of the three – Life. Life comes before all. The CDC in this murderous, politically correct policy is depriving Americans of their inalienable rights – the right to live. This policy must be changed. We are causing the deaths of 500 Americans each day.
THE HALACHA
The concept of healing the one that is most at risk is found in the Pri Magadim of Rav Yoseph Teumim OC 328 in his Mishbetezes Halacha #1. In terms of halacha, the entire idea of placing the young before the old is incorrect. This is explicit in Rav Moshe Feinstein zt”l’s Igros Moshe (CM Vol. II #75:7). It is also in Rav Shlomo Zalman Auerbach zt”l’s Minchas Shlomo (MT 2-3 Siman 86) as well as the Even Bochen Migdal Oz #85 of the Yaavetz.
MORAL DUTY
It is this author’s view that it is our moral duty to point out this moral and ethical failure of the CDC and get it changed via Governor Cuomo – as soon as possible. The Governor can choose to implement or ignore the words of the CDC. Doctors trained in statistics, clergymen, public policy politicians who can consult statisticians – where are you? We should be lobbying Governor Cuomo now.
The author can be reached at [email protected].
The hypocrisy of this author is extraordinary, for months he was busy promoting the CDC and how we have to follow them and their doctors and advisors blindly because they’re the experts and it’s a chiuv to follow their advice, now when he feels he knows better and his numbers are correct then they’re the one killing people and we should actually go convince the CDC that Rabbi Hoffman’s way of running the health system in this country is the correct one, this is just mind-boggling. RH RESPONDS: That’s all fine, but you have not addressed the issue that per person – the older population dies at 600 percent of that of the health care workers, nor have you addressed the Pri MaGaDim. Also, you have confused hypocrisy with thinking independently and rationally. Your definition is you either drink all Kool Aid or avoid Kool Aid. Our priorities differ from that of the CDC. Saving the life of Grandma and Grandpa is our priority too – if they die at 6 times the rate
Rabbi, you are NOT a medical professional and you haven’t spent one minute in a hospital treating Covid victims. Thanks for spreading more doubt and distress. Medical personnel are in immediate proximity to dozens of Covid sufferers every day! They need to be protected! Protected medical personnel can save Hundreds of lives. Why is it written that it is more important to save the life of a mother than the life of her newborn? Time to get off the soapbox and back to the bima.RH RESPONDS: That’s all fine, but you have not addressed the issue that per person – the older population dies at 600 percent of that of the health care workers, nor have you addressed the Pri MaGaDim.
There are excellent points in this article, however the situation with healthcare workers is not so simple. Yes there are still some who are afraid to work or to intubate or do things in a high risk situation. Every time a family member of a nurse gets sick with covid, this pulls the nurse for 10 days from helping patients. We can allow them to go back to work and handle the load if they get the vaccine.RH RESPONDS: They have PPEs. This was factored in and the rate of taking ill. Still per person – the older population dies at 600 percent of that of the health care workers, znd you have to look at things as if they were family members. Do you let Grandma and Grandpa die so that the young and healthy not get sick? This negatesthe Pri MaGaDim.
If you are fighting a war, you give your soldiers the best weapons and the best gear so they can continue fighting and keep everyone else safe. Then you can make sure the most vulnerable are safest and furthest from the fighting. The healthcare and frontline workers are keeping the world running, and even if they don’t die, just getting sick can cripple hospital and food service and delivery systems.
The PPE is STILL not plentiful to this day, and woefully inadequate for non hospital workers. The death rate will worsen if the people protecting and treating them get sicker.
You can keep responding to these messages and repeating yourself like a broken record that old people die at %600 of young people but old people are more likely to get it from the asymptomatic doctors and nurses who constantly work with them then from anywhere else so yes by giving the young medical personnel the vaccine first you’re also saving the older people
People in low risk occupations can socially distance and remain relatively safer . For example, a type 2 diabetic who’s at high risk for serious disease , but working remotely from home, has the option of protecting himself . Phase 1c sounds reasonable for that person .
Does the Pri MaGaDim address the issue of short-term versus long-term thinking? By this I mean if the emphasis is on giving the vaccines to the elderly, might more health care workers become sick because they didn’t receive the vaccine? Less health care workers potentially means more people will die from COVID and other issues because there aren’t enough healthy health care workers available to treat them?
Put another way, does the Pri MaGaDim measure the fact that potentially risking 10 lives today (giving vaccines to health care workers ahead of the elderly) might mean saving 100 lives tomorrow (more health care workers available to treat the sick)? Or are the lives at risk now more important halachically than many more lives potentially at risk tomorrow?
Rabbi, WADR, stay in your lane.
R’ Hoffman, please rethink this.
You did not address very significant issues such as risk of further mutation and what that means to risk of life. You also completely ignored the extent continued spread of COVID contributes to loss of life.
It is arguably much more critical to vaccinate those interacting with others than the elderly or at-risk because they result in far more cases, including by the at-risk population getting it. The more spread the more people that will die and the greater risk of mutation.
The people coming up with this distribution approach have numerous viewpoints that are not going to be fully expressed in what you end up reading and they are trying to do what the think makes most sense and will help reduce the loss of life as well.
Saying this is a halachic issue is premised on a conclusion that the policy for distribution results in more deaths of those at risk, whereas if you challenge the notion raised here and argue instead this approach actually reduces the number of deaths (e.g. by being more effective at preventing further mutation), there is no halachic issue.
Rabbi Hoffman keeps citing “political correctness”. Whether you agree with the CDC’s strategy or not, what does any of this have to do with “political correctness”?
First of is the most obvious stupidity of the CDC in vaccinating people with antibodies. Of the 83+ million people that have tested positive, a very relative few have ever even claimed to have gotten the virus twice giving you a “vaccine” efficacy rate of over 99.999% percent while the vaccines claim only 95%! What a waste of resources.
This article seems to ignore that the health care workers are not just in danger of getting the virus, but because they deal with vulnerable people constantly at close range they can also transmit it to many. In nursing homes the main danger to the patients is from the workers and by vaccinating them you protect everyone. Once they have been vaccinated the need to vaccinate the patients falls.
The main problem with the CDC guidelines is its overly broad definition of “essential workers”.
If the states would do their job properly of giving the vaccine at a quick pace much of these arguments would be mute as soon every one would get get the vaccine. The unwillingness to do this quickly is the problem. In New York a clinic obtained 2300 doses that the State wasn’t using and started to vaccinate people; Governor Cuomo instead of saying “Thank you”, said that he intends to prosecute them.
Every loss is tragic. But if we lose healthcare workers, that leads to even more death of the very people we’re trying to protect. When we fly, the crew always reminds us about the oxygen masks that might drop. With that, the “azharah” to take care of your own mask before that of your children. It may seem “noble” to save your children before yourself, but if you lose consciousness in those few seconds, you’re both likely to die.
“This means if option A will save 4200 lives a week and the option that the CDC has chosen will save 700 lives then the policy is responsible for the death of 3500 people a week – which translates to 182,000 people per year.”
When I read this ridiculous statement I knew that whatever follows is suspect as well.
Even if the premise of your example were to be true in reality, how does it translate to 182,000 per year? Why not claim 1,820,000 per decade? 18,200,000 per century?
Why not? Because we know that at a certain point the very people that you claim should be getting the vaccine now will eventually be getting it soon. How soon? Mere weeks from now. So the claim of the yearly rate is specious, at best.
So why make that preposterous claim of an additional 182,000 deaths per year? Simply to overhype the faulty premises laid out in the article.
Those highly vulnerable people that the article is focused on are actually getting the vaccine imminently (and many have already received it).
Fortunately, both TX & FL have announced that they will NOT be following CDC guidelines, & will vaccinate according to vulnerability; i.e. over 65 before “essential” workers.
“Saving lives” is rarely as simple as you might think and this is why there are 3 different, competing objectives.
Yes, we want to save lives…but we have to keep the healthcare system operational.
Yes, we want to save lives …but we don’t just look at mortality, we also look at morbidity, i.e., it’s not just deaths but sickness.
Yes, we want to save lives….but if we lose critical industries we can lose more lives in the long run.
PAR care & the other heimishe urgent cares could.ve had half brooklyn vaccinated by now , instead the gov is using resources to keep it under lock & key
the same with the covid testing sites half a block long & the line barely moves , i see it every day on fort hamilton pkwy.
10 national gaurd men to give out a 100 food boxes in patterson nj , and gibbers knocks 1500 w / 10 bucherim
Who can develop a priority system that would meet all concerns. The latest CDC recomendations represent the best thinking of our public health sector, including physicians and nurses. The author has some decent points, all wrapped up in a gulash of wild statements, which he repeats in his comments on other readers’ comments. We need our first responders, just as we need all people, including the elderly (of which my years have brought me to). Who will care for the supposedly 600% more vulnerable if we do not have first responders healthy and able to tend to the vulnerable of all ages. As for statements about who already has antibodies, the author apparently outshines medical scientists in his claims. This is a very irresponsible article. Ok, Rabbi, repeat your nonsense loud enough to confuse an already difficult situation.
Your numbers seem to be all wrong in this section – it does not fit with the rest of your numbers at all
Other than that I agree with you.
“According to those with a background in statistics, this decision will cause many thousands of deaths each week.”
It would be helpful if you indicated who these statisticians are and where they make this statement.