The vicious circle of precaution

By Ezio Di Nucci.

The precautionary principle has been implicitly utilized and explicitly invoked in March of 2020 when many governments introduced restrictions and lockdowns to contain COVID-19. ‘Implicitly utilized’ because the preliminary evidence and modelling those restrictions were based on was a good example of the kinds of problems the precautionary principle is meant for – think of climate change. And it was also ‘explicitly invoked’, for example by Denmark’s Prime Minister in implementing a lockdown against the advice of her own health authorities.

A year later, the precautionary principle is now again explicitly invoked by many European governments in deciding to pause the AstraZeneca vaccine because of blood clots reports. This time the explicit invocation is harder to trace back to implicit utilization, given that there is no evidence – not even preliminary evidence – that there is any increased prevalence of blood clots among those vaccinated with AstraZeneca (or indeed any other COVID-19 vaccine) than in the population at large.

We shouldn’t be too quick to conclude, though, that there isn’t anything behind the explicit invocation of precaution this time around, as maybe the risk that those precautionary decisions are based on isn’t the prevalence of blood clots but a different kind of side-effect, namely vaccine hesitancy and reduced uptake of a particular vaccine – or indeed COVID-19 vaccines more in general – as a result of such reports, even without increased prevalence or causality.

The irony of this particular way of ‘rescuing’ the precautionary principle for the case of the decision to suspend the AstraZeneca vaccine is obviously that, if vaccine hesitancy was the worry in the first place, individual countries sporadically deciding to pause the vaccine after anecdotal reports (and again against the advice of the relevant health authorities, EMA in this case) without a coherent or coordinated joint response, will hardly reassure folk.

There is, then, both coherence and incoherence in the decision-making described above, and it is helpful to keep the coherence separate from the incoherence, because in fact it will turn out that the former is possibly even more problematic than the latter – an analytic philosopher’s worst nightmare!

Incoherence because last time (lockdowns in March 2020), the explicit invoking of the precautionary principle matched its implicit utilization; while this time (vaccine policy in March 2021), the explicit invoking of the precautionary principle doesn’t actually match its implicit utilization. And then it’s just a theoretical issue whether in this new case we should talk about the precautionary principle being just improperly invoked or actually improperly deployed (I would personally tend towards the former hypothesis).

It is the coherence, though, that is maybe more interesting here, especially when we consider that last year’s appeals to caution were always accompanied by ‘we follow the science’ statements while this year’s cautionary appeals are explicitly not following the science; and it is in fact those countries like the UK that are not pausing the AstraZeneca vaccine which are ‘following the science’.

This is important for two reasons: risk-tolerance and democracy. Firstly, a society with a substantially lowered risk-tolerance might turn out to be more rather than less dangerous, as we will see in a moment.

Secondly, some people were worried that last year’s ‘follow-the-science’ precautionary restrictions might have set a dangerous precedent for emergency executive action which bypasses standard democratic procedure.

As with lowered risk-tolerance, people were worried about this in terms of our post-covid future, but they might have again been overly optimistic: the vicious circle of precaution means that while last year’s caution was working against COVID-19, already this year it is working in its favour by slowing down (and possibly also depressing) vaccination rates. And ‘ignore-the-science’ by decree is even scarier than ‘follow-the-science’ by decree.


Author: Ezio Di Nucci

Affiliation: University of Copenhagen

Competing interests: None

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