Infectious diseases figure prominently as (counter)examples in debates on how to conceptualize “disease.” But crucial epidemiological distinctions are often not heeded in the debate, and pathological and clinical perspectives focusing on individual patients are favored at the expense of perspectives from epidemiology focusing on populations. In clarifying epidemiological concepts, this paper highlights the distinct contributions infectious disease epidemiology can make to the conception of “disease,” and the fact that this is at least tacitly recognized by medical personnel and philosophers. Crucially, (...) infectious disease epidemiology can help elucidate how carrying and transmitting infectious, communicable entities is a disease, even if the carriers themselves are not directly affected by symptoms detrimental to them. (shrink)

If scientists violate principles and practices of routine science to quickly develop interventions against catastrophic threats, they are engaged in what I call fast science. The magnitude, imminence, and plausibility of a threat justify engaging in and acting on fast science. Yet, that justification is incomplete. I defend two principles to assess fast science, which say: fast science should satisfy as much as possible the reliability-enhancing features of routine science, and the fast science developing an intervention against a threat should (...) not depend on the same problematic assumptions as the fast science which estimates the magnitude, imminence, and plausibility of the threat. (shrink)

The value-free ideal in science has been criticised as both unattainable and undesirable. We argue that it can be defended as a practical principle guiding scientific research even if the unattainability and undesirability of a value-free end-state are granted. If a goal is unattainable, then one can separate the desirability of accomplishing the goal from the desirability of pursuing it. We articulate a novel value-free ideal, which holds that scientists should act as if science should be value-free, and we argue (...) that even if a purely value-free science is undesirable, this value-free ideal is desirable to pursue. (shrink)

We analyse insufficient epistemic pluralism and associated problems in science-based policy advice during the COVID-19 pandemic drawing on specific arguments in Paul Feyerabend’s philosophy. Our goal is twofold: to deepen our understanding of the epistemic shortcomings in science-based policy during the pandemic, and to assess the merits and problems of Feyerabend’s arguments for epistemic pluralism as well as their relevance for policy-making. We discuss opportunities and challenges of integrating a plurality of viewpoints from within and outside science into policy advice (...) thus contributing to discussions about normative issues concerning evidence and expertise in policy-making. (shrink)

Lockdowns and related policies of behavioral and economic restriction introduced in response to the COVID-19 pandemic are criticized, drawing on three sets of ideas and arguments that are organized in accordance with the likely degree of controversy associated with their guiding assumptions. The first set of arguments makes use of cost–benefit reasoning within a broadly utilitarian framework, emphasizing uncertainty, the role of worst-case scenarios, and the need to consider at least the medium term as well as immediate effects. The second (...) draws on assumptions about the political value of basic liberties. The third draws on ideas about the roles of different stages within human life. (shrink)

Take a question like the safety and effectiveness of COVID-19 vaccines. Whether an ordinary citizen or a public official can acquire the correct answer to this question depends on the functioning of the epistemic basic structure of their society. The epistemic basic structure of a society consists of “the institutions that have a crucial role in the distribution of knowledge, that is, in the production and dissemination of knowledge, and in ensuring that people have the capability to assimilate what is (...) disseminated by providing them with the necessary educational background and intellectual skills”. It includes institutions of science and education, the media, search engines, libraries, museums, think tanks, and various government agencies. (shrink)

Diagnostic testing can be used for many purposes, including testing to facilitate the clinical care of individual patients, testing as an inclusion criterion for clinical trial participation, and both passive and active surveillance testing of the general population in order to facilitate public health outcomes, such as the containment or mitigation of an infectious disease. As such, diagnostic testing presents us with ethical questions that are, in part, already addressed in the literature on clinical care as well as clinical research (...) (such as the rights of patients to refuse testing or treatment in the clinical setting or the rights of participants in randomized controlled trials to withdraw from the trial at any time). However, diagnostic testing, for the purpose of disease surveillance also raises ethical issues that we do not encounter in these settings, and thus have not been much discussed. In this paper we will be concerned with the similarities and differences between the ethical considerations in these three domains: clinical care, clinical research, and public health, as they relate to diagnostic testing specifically. Via an examination of the COVID-19 case we will show how an appeal to the concept of diagnostic justice helps us to make sense of the (at times competing) ethical considerations in these three domains. (shrink)

Models not only represent but may also influence their targets in important ways. While models’ abilities to influence outcomes has been studied in the context of economic models, often under the label ‘performativity’, we argue that this phenomenon also pertains to epidemiological models, such as those used for forecasting the trajectory of the Covid-19 pandemic. After identifying three ways in which a model by the Covid-19 Response Team at Imperial College London may have influenced scientific advice, policy, and individual responses, (...) we consider the implications of epidemiological models’ performative capacities. We argue, first, that performativity may impair models’ ability to successfully predict the course of an epidemic; but second, that it may provide an additional sense in which these models can be successful, namely by changing the course of an epidemic. (shrink)

In response to the spread of COVID-19, governments across the world have, with very few exceptions, enacted sweeping restrictive lockdown policies that impede citizens’ freedom to move, work, and assemble. This paper critically responds to the central arguments for restrictive lockdown legislation. We build our critique on the following assumption: public policy that enjoys virtually unanimous support worldwide should be justified by uncontroversial moral principles. We argue that that the virtually unanimous support in favor of restrictive lockdowns is not adequately (...) justified by the arguments given in favor of them. Importantly, this is not to say that states ought not impose restrictive lockdown measures, but rather that the extent of the acceptance of these measures is not proportionate to the strength of the arguments for lockdowns. -/- We begin by exploring the case for restrictive lockdowns. We first argue that several of the principles that are used to justify the lockdowns yield unexpectedly revisionary implications for other political problems that many would be unwilling to accept. We then outline what we consider the strongest argument for a lockdown—namely, that its net welfare benefits are great enough to defeat the moral presumption against restricting citizens’ civil liberties to move, work, and assemble. However, we give a number of reasons for doubting that the lockdown’s net welfare benefits are, in fact, sufficiently high to defeat the presumption against it. (shrink)

As many Western countries emerged from initial periods of lockdown in spring 2020, they had brought COVID-19 infection rates down significantly. This was followed, however, with more drastic second and third waves of viral spread, which many of these same countries are struggling to bring under control, even with the implementation of further periods of lockdown. Could this have been prevented by policymakers? We revisit two strategies that were focus of much discussion during the early stages of the pandemic, and (...) which were implemented in several Western countries, albeit in a weakened form. These strategies both proceed by targeting certain segments of the population, while allowing others to go about their lives unhindered. The first suggests selectively isolating those that would most likely suffer severe adverse effects if infected – in particular the elderly. The second involves identifying and quarantining those who are likely to be infected through a contact tracing app that would centrally store users’ information. We suggest that both strategies showed promise in preventing the need for further lockdowns, albeit in a significantly more stringent form than anything that was implemented in Western countries. We then proceed to an ethical evaluation of these more stringent policies. We contend that selective isolation strategies face severe ethical problems due to its discriminatory nature, while the ethical issues with a more aggressive contact tracing regime can be mitigated. This analysis has implications for how to respond effectively and ethically to future pandemics, and perhaps contains lessons on how to successfully emerge from our current predicament. (shrink)

Drawing on the SAGE minutes and other documents, I consider the wider lessons for norms of scientific advising that can be learned from the UK’s initial response to coronavirus in the period January-March 2020, when an initial strategy that planned to avoid total suppression of transmission was abruptly replaced by an aggressive suppression strategy. I introduce a distinction between “normatively light advice”, in which no specific policy option is recommended, and “normatively heavy advice” that does make an explicit recommendation. I (...) argue that, although scientific advisers should avoid normatively heavy advice in normal times in order to facilitate democratic accountability, this norm can be permissibly overridden in situations of grave emergency. SAGE’s major mistake in early 2020 was not that of endorsing a particular strategy, nor that of being insufficiently precautionary, but that of relying too heavily on a specific set of “reasonable worst-case” planning assumptions. I formulate some proposals that assign a more circumscribed role to “worst-case” thinking in emergency planning. In an epilogue, I consider what the implications of my proposals would have been for the UK’s response to the “second wave” of late 2020. (shrink)

Scientific models can be performative: they can causally affect the phenomena they are intended to represent. The existing literature offers two responses. The appraisal view emphasizes that performativity can sometimes be a good-making model attribute, e.g., when predictions steer the public’s behavior in desirable ways. The mitigation view seeks to endogenize agents’ behavioral response to model-issued forecasts to get rid of performativity instead. This paper argues that neither approach is fully compelling: the appraisal view encounters severe concerns about moral values (...) illegitimately encroaching on how modelers construct and use models, while the mitigation view fails to acknowledge that endogenization is itself a choice that involves substantive value-judgments relating to the desirability of certain social outcomes. (shrink)

A wide range of non-pharmaceutical interventions (NPIs) have been introduced to stop or slow down the COVID-19 pandemic. Examples include school closures, environmental cleaning and disinfection, mask mandates, restrictions on freedom of assembly and lockdowns. These NPIs depend on coercion for their effectiveness, either directly or indirectly. A widely held view is that coercive policies need to be publicly justified—justified to each citizen—to be legitimate. Standardly, this is thought to entail that there is a scientific consensus on the factual propositions (...) that are used to support the policies. In this paper, we argue that such a consensus has been lacking on the factual propositions justifying most NPIs. Consequently, they would on the standard view be illegitimate. This is regrettable since there are good reasons for granting the state the legitimate authority to enact NPIs under conditions of uncertainty. The upshot of our argument is that it is impossible to have both the standard interpretation of the permissibility of empirical claims in public justification and an effective pandemic response. We provide an alternative view that allows the state sufficient room for action while precluding the possibility of it acting without empirical support. (shrink)

Philosophers have recently questioned the methodological status of agent-based modeling. Meanwhile, this methodology has been central to various studies of the COVID-19 pandemic. Few agent-based COVID-19 models are accessible to philosophers for inspection or experimentation. We make available a package for modeling the COVID-19 pandemic and similar pandemics and give an impression of what can be achieved with it. In particular, it is shown that by coupling an agent-based model to a standard optimizer we are able to identify strategies for (...) implementing non-pharmacological interventions that flexibly lower or raise social activity, depending on how the outbreak develops, while balancing various desiderata that cannot be fully satisfied together. The simulation outcomes to be presented testify to the power of agent-based modeling and thereby help to push back against the recent philosophical critique of this methodology. (shrink)