The USA is doing it. Europe is doing it. Why is the UK not doing it? Has the UK ‘s decision making in the Covid war become too timid so that it has become an outlier not a leader?
VACCINE PASSPORTS – TOO AUTHORITARIAN OR REALLY ESSENTIAL?
Presidents Biden and Macron have had no hesitation in the use of vaccine passports, favouring the vaccinated over the unvaccinated as to what places they can visit and what activities they can engage in, in the name of protecting society. Also, or primarily, this approach is designed to encourage those who refuse to get the anti-covid jabs to take the plunge. It is discrimination. In the USA and in Europe there remains considerable objection to these infringements on equality, but Governments have weighed risk versus benefit and decided on where the balance lies. In France, a non-vaccinated person cannot enter a café without the State health pass evidencing double vaccination. In the USA, a person cannot work for the Federal Government without equivalent evidence. Other European nations such as Italy have similar rules.
Apart from in the area of international travel, where vaccine passports distinguish the restrictions applicable to travellers coming or returning to England, the UK has been slow to adopt the concept more widely. While still available in the armoury of weapons to combat Covid, the vaccine passport has been kept back from the front line. In the UK the debate over its fairness, and its damage to equality and personal freedoms, being openly discriminatory, remains an active debate and is perhaps a welcome restraint on UK Government being too authoritarian. That individual freedom is not easily crushed in the UK is encouraging, relative perhaps to other countries.
However, despite the great success of vaccination among the UK adult population (90% take up), 5 million adults remain unvaccinated, the vast majority through choice: how many have made this decision due to social media misinformation or scare mongering is unknown. How many because of thought through values is unknown. Whatever their reason, this huge unvaccinated minority poses the biggest obstacle to controlling the disease. They themselves are the most at risk of catching serious disease, of infecting others, of being hospitalised, of being in intensive care and of dying from infection. National statistics show that in the first 6 months of 2021 of those dying with Covid, 99% were not vaccinated, and the average age of the vaccinated deaths was 84. They are the biggest factor which could lead to the NHS being overwhelmed: that overwhelming has always been and remains the real justification of lockdowns. While not precisely quantifiable, it is generally accepted that the damage caused by the lockdown is huge – economically, socially, in physical and mental health, including especial damage to the more deprived and children. The lockdown is inconsistent with having to live with Covid, which it seems is generally considered the only long- term answer. Vaccine provides the sole pathway to that end.
In circumstances where vaccine is the key weapon against Covid and the unvaccinated people are the main obstacle to society controlling Covid, is there not a strong argument that the balance of risks and benefits is to adopt the vaccine passport idea more actively? Given the level of contact with the elderly, vulnerable and sick, is it not reasonable to require health and care workers to be vaccinated? Is it however less tolerable to require the same of an office worker? Maybe UKGOV is being too soft, or is it in fact the strongest defender of individual freedom? If it continues with keeping the passport in the locker, justifying a lockdown in the future, when it has refused to use the weapons at its disposal, will perhaps be unconvincing.
VACCINATING THE YOUNG
The USA and Europe have been doing it, and why has not the UK? The “it” in this case is vaccinating 12–15-year-old children. The UK was slowest to approve vaccinating 16–18-year-olds, and its reluctance to vaccinate children means it slipped down the league table of volume of vaccination of the whole population, while leading on adults’ vaccinations. But league tables are not the point. The USA and European Governments decided some time ago that the risks of vaccinating these age groups were outweighed by the benefits. Without scientific analysis and medical approval or at least not disapproval, it was untenable for UKGOV to adopt a similar approach as those others.Only in September did the UK’s JCVI, the independent body advising on vaccination programmes, feel it had enough evidence to opine on the issue. Its conclusion was that it could not recommend vaccinating 12–15-year-olds as it could not say that the simple medical benefits of vaccine against non-vaccine clearly outweighed the risks. The benefits to them were marginal in their view – not surprising as the risk of such a child arriving in intensive care due to Covid is apparently two in a million! As near zero as barely matters.
The Chief Medical Officers of the UK nations, after taking account of the JCVI view and the potential damage to children’s health of disruption in education, have now recommended vaccination of this age group. It has to be remembered that the known health risk of vaccination is a child developing Myocarditis, a cardiac condition, but only mildly, with a risk factor of between 3 and 17 in a million, quite close to zero too! So, their recommendation seems reasonable in the circumstances. There should of course also be benefits in reducing infection among these children’s contacts. Now UKGOV has approved that programme and it has begun. Too slow some may say. Have UK experts been too slow to advise? Is the JCVI not aggressive enough?
Was it not reasonable for the UK to take a prudent approach before recommending vaccination of a group who barely suffer from Covid? Perhaps Europe and the USA have been more pragmatic, putting society generally before the rights of children, a perfectly tenable approach. Or is the UK rightly more restrained when it comes to an individual child’s rights?
VISITING OR RETURNING TO THE UK
The need to have expensive Covid tests before boarding a plane to the UK, and after arriving there, is undoubtedly a serious deterrent to visiting the UK. It is also a serious deterrent to Brits going abroad for fear of being stranded there if tested positive, saddled with a seriously high bill for self-isolation. This deterrent does major damage to the travel industry. Europe has been much quicker to relax these rules for those who can prove they have had a double jab of an approved vaccine. The UK’s highly cautious approach may indicate an overly cautious health team, justifying the approach by the need to stop or at least identify variants sneaking into the UK unnoticed: hard for the lay person to argue with, though experts seem adept at adopting opposing positions – as ever with Covid nobody knows. However, the leap is finally being made by UKGOV, having relaxed the travel testing regime for the double vaccinated. This is entirely consistent with the principle of learning to live with the virus in reliance on highly effective vaccines and reflects a fair balance of freeing up travel for all and other benefits, such as the economy, against more controlled risks.
This approach may also encourage the unvaccinated who wish to enjoy travelling again to get their jabs, so vital as discussed above. In fact, new proposed changes to rules may toughen up travel requirements for the unvaccinated, reinforcing that encouragement. On balance again, perhaps that is not a bad thing. As has been observed before, is it possible that the slow pace of relaxation around travelling abroad, coming after the holiday season, reflects the wish to encourage staycations in the Summer, with the consequent economic benefits, as well as health caution?
