by [anonymous]
1 min read18th Jan 201521 comments

17

Source.

It's illegal to work around food when showing symptoms of contagious diseases. Why not the same for everyone else? Each person who gets a cold infects one other person on average. We could probably cut infection rates and the frequency of colds in half if sick people didn't come in to work.

And if we want better biosecurity, why not also require people to be able to reschedule flights if a doctor certifies they have a contagious disease?

Due to the 'externalities', the case seems very compelling.

Moving my commentary to a separate comment, so as to disambiguate votes on my commentary and the original argument.

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The difference is that food workers are what is known as superspreaders.

If you go around sneezing in a restaurant kitchen you will infect hundreds of costumers . Whereas if you go around sneezing in your office you will at worst infect a few dozen coworkers.

You reminded me of the time I reprimanded a postal employee because he had found that envelopes opened faster if he blew into them. I didn't manage to convince him that with such a routine he could easily infect the entire country.

[-][anonymous]9y130

The measures proposed in the comment are essentially imposing a quarantine, that is barring some people from coming into contact with some other people, including limits on their travel. It is a logical extension of food rules.

The argument is quite well received by the very reasonable facebook rationalists crowd. However many rationalists were quite clearly squicked out by the idea of quarantine when applied to lethal diseases ( http://lesswrong.com/lw/l3u/link_the_coming_plague/ ), yet talking about the minor inconvenience of colds suddenly everyone is a utilitarian and is willing to suspend certain supposedly sacred rights.

Hypothetically make the disease in question incurable and lethal, and instead of quarantine being even more obvious an answer since it has higher externialities, it becomes even less acceptable to propose.

Something funny is going on with people's moral reasoning here and I suspect it isn't peculiar to rationalists, but reflective of something in wider culture. Consider the difference in the acceptability of proposing quarantines when it came to Sars and Ebola.

[-][anonymous]9y180

The situations are hardly comparable. The original poster is talking about giving people the option to isolate themselves in situations where it is not socially acceptable today, quarantine tends to mean forced separation. This is very important qualitative difference.

Something funny is going on with people's moral reasoning here

Based on my general experience, I would say that most people engage in what I would call "Miss America Moral Reasoning," i.e. their main priority is to figure out what position will be most impressive to the (perceived) judges.

Do rationalists and/or wannabe rationalists behave in this way? Probably a lot do, but it's rather hard to assess.

When someone has an incurable and lethal respiratory illness, I think we do require them to stay in quarantine and this is broadly accepted. The reason this doesn't apply to HIV and other such diseases is that they are barely contagious.

[-][anonymous]9y110

Re magnitude-dependent utilitarian contradiction: Perhaps the difference is the number of cases. If you only limit the freedom of only a couple of poeple (those who suffer from rare diseases) the risk of stigmata and exclusion seems intuitively high. In the other case it would be more of an collective effort, because pretty much everyone has to deal with colds on a regular basis.

Alternately people don't think THEY will get ebola so they don't subconsciously appreciate the benefits of a quarantine, but have plenty of recommendations of Bob in Accounting getting them sick.

My guess on why this is well-received is that the immediately obvious consequences are positive. You don't have to go to work and you're allowed to reschedule flights when you're sick. Most people have had to work while sick, which is miserable, and a lot of people have been sick on trips, which pretty much ruins them. I don't think the reasoning extends much beyond that.

But when you talk about indefinitely quarantining people with incurable diseases, that feels like persecution of a minority group for something outside of their control, which everyone knows is Bad™.

Also, the phrasing of the quoted comment doesn't sound like a mandate.

...why not also require people to be able to reschedule flights if a doctor certifies they have a contagious disease?

I predict you'd get a different response if the proposition was to forbid people from flying while showing any symptoms of being sick and fining people for sneezing on an airplane.

Well I wasn't proposing a strict quarantine or limits on travel. Merely preventing people from coming into close contact with colleagues at work where the risk of contagion is highest, and requiring them to have the option to reschedule their (expensive) travel. People are already familiar and comfortable with regulations in workplaces and aviation.

If I were proposing a thoroughgoing quarantine, I expect people wouldn't be nearly as enthusiastic.

The argument is quite well received by the very reasonable facebook rationalists crowd. However many rationalists were quite clearly squicked out by the idea of quarantine when applied to lethal diseases ( http://lesswrong.com/lw/l3u/link_the_coming_plague/ ), yet talking about the minor inconvenience of colds suddenly everyone is a utilitarian and is willing to suspend certain supposedly sacred rights.

Are you sure the same individuals are doing those? Muhammad Wang fallacy, and all that.

Something funny is going on with people's moral reasoning here and I suspect it isn't peculiar to rationalists, but reflective of something in wider culture.

Maybe it is peculiar to rationalists, or I should say, "rationalists": people who think they're rationalists. Quarantining people with colds and not quarantining people returning from places with Ebola have this in common: it is the opposite of the practice seen in the wider world. Therefore, if you take this view, and assemble clever arguments for it, you must be being more rational.

As I'm sure you have considered, issues relating to racism and homophobia come into play.

Why? Is it rational to let them influence the issue in any way? In your personal value system, is a relatively heightened chance of dying from an infectious disease preferable to being thought of as racist or homophobic? How high does it have to get until that's no longer the case?

Moloch is at work here. Pretend that all open American racists advocate quarantining U.S. Ebola victims, and I'm not a racist but I do believe in quarantining. My opinion on quarantining will have almost no impact on U.S. policy, but will cause people to increase their estimate of my being a racist so it's in my self-interest to either oppose quarantining or to keep silent on the issue since I don't want to be perceived as racist. If all non-racist do this than supporting quarantining is strong evidence you are a racist.

You have left out another difference: whether the person is known to be infected.

Many people reserve the word "quarantine" for those exposed, but not known to be infected; and use "isolation" for those exhibiting symptoms. They are expected to appreciate the medical care, although that is not relevant in the case of the common cold. No one has objected to the isolation of people exhibiting symptoms of Ebola after exposure.

The response to SARS quarantines seemed to me pretty similar to the response to Ebola quarantines.

Related to what James Miller said, it seems analogous to the experimental finding that white American liberals are more likely to sacrifice whites (relative to blacks, at least) in the famous trolley thought experiment.

European countries are way more lenient with workers who do not show up for health reasons. How does the data compare there, are workers more productive on average and sick less often?

Also, what is the unintended side effect of this? Do we open up an evolutionary niche for something even more horrible? Wouldn't it be better to require sick people to wear a face mask like it is usual in some Asian countries?

Typically with the evolution of pathogens, we see a trade-off between the ability of a pathogen to spread ("virulence") and the ability of the pathogen to keep the host alive (although there's definitely a lot of variation depending on the life history of the pathogen and the behavior of the host). Overall pathogen fitness (for between-host dynamics - it gets more complicated if the pathogen is competing with other pathogens within the host) is based on (virulence) x (number of other hosts that infected host contacts). So increasing host lifespan and increasing virulence both increase pathogen fitness (but, again, usually increasing one decreases the other). This means that we often see pathogens falling into two syndromes:

a) Fast spreaders ("raiders") - because they spread rapidly, there is less selection for them to keep their host in good condition (and so it's better to sacrifice host health to increase spread rate). Alternately, because their host becomes ill rapidly, there is selection for them to be good at spreading. Example would be Ebola.

b) slow spreaders ("farmers") - because they do not spread rapidly, there is selection for them to keep their host in good condition. Alternately, because their host is in good condition for a long time, there is less selection for them to be good at spreading. Extreme versions of this are pathogens that are largely/entirely transmitted vertically (mothers pass pathogen to offspring). Because the host's fitness is a part/all of the pathogen's fitness, there is strong selection for the pathogen to keep the host alive (and even to boost host fitness). A super interesting example of this can be found in the arthropod bacteria http://en.wikipedia.org/wiki/Wolbachia, where some Wolbachia species have evolved into mutualistic relationships with hosts. (But because Wolbachia is only passed from mothers to children, many species change the sex ratio of offspring of infected individuals to be all female. Biology is awesome!)

Decreasing the number of people the host is in contact with is effectively decreasing virulence rate. Because the host (sick person) isn't going to be in contact with too many potential hosts (other people), there's a fairly low upper bound on how fit a super virulent/damaging pathogen can be - it's much more effective for the pathogen to maintain host health as much as possible. Typically we expect this to lead to decreased health impacts on the host. Additionally, this would give hosts a longer time to get access to treatment.

tl;dr Decreasing contact rate is likely to lead to evolution of less virulent/harmful pathogens

Food workers have the potential to infect many more others, so that part is clear. Though, as far as I know, having common cold and flu-like illnesses does not make it illegal to "work around food". What are your sources of information?

Just because it would be good for society if people stayed home when they were sick, doesn't mean legislating that would actually have that effect without any drawbacks. Something between the two states seems to be in order.

I've been watching various colds and winter ailments move through my workplace. While I've been doing my part by trying to convince my co-workers that they ought to stay home if they're sick, people still come in when they're sick maybe half the time. At other places I know of, where workers don't get dedicated use-it-or-lose-it sick time, matters are much worse. I wonder if legislating sick time would have a strong effect.

Actually, it looks like this is happening (http://www.natlawreview.com/article/voters-four-jurisdictions-pass-sick-leave-ballot-initiatives). Should be a couple of papers for some enterprising economist or sociologist comparing productivity per worker in states where this happens compared to states where it doesn't.