Herd Immunity: History, Concepts, and Ethical Rationale.

Public health emergencies are fraught by epistemic uncertainty, which raises policy issues of how to handle that uncertainty and devise sustainable public health responses. Among such responses, a herd immunity policy might be an option. Particularly before the development of vaccines, the current COVID-19 pandemic has highlighted the polarized nature of the political debate concerning the ethical feasibility of herd immunity strategies. This article provides a conceptual framework tailored to uncover the ethical rationale behind such strategies. Clarity on this issue is important in order to facilitate the terms of the political debate when tackling future health emergencies.

The road from evidence to policies and the erosion of the standards of democratic scrutiny in the COVID-19 pandemic.

The COVID-19 pandemic poses extraordinary public health challenges. In order to respond to such challenges, most democracies have relied on so-called 'evidence-based' policies, which supposedly devolve to science the burden of their justification. However, the biomedical sciences can only provide a theory-laden evidential basis, while reliable statistical data for policy support is often scarce. Therefore, scientific evidence alone cannot legitimise COVID-19 public health policies, which are ultimately based on political decisions. Given this inevitable input on policy-making, the risk of arbitrariness is ubiquitous and democratic scrutiny becomes essential to counter it. During the COVID-19 pandemic, the standards of scientific and democratic scrutiny have been, as a matter of fact, substantially lowered. This erosion potentially damages democracy.