With Omicron evading the current crop of vaccines with effortless ease and the UK Government withdrawing most other virus-control measures, there is no rational justification for vaccine mandates for healthcare staff.
This Wednesday (Jan 19), the UK Government took the world by surprise — or at least the world outside the UK — by announcing plans to lift almost all of its so-called “Plan B” measures for England. They include mask mandates, social distancing measures and the vaccine passport, which had only been introduced in mid-December. The policy U-turn appears to be an act of political expediency by a government brought to its knees by an endless succession of corruption scandals.
The withdrawal of some of the restrictions could end up seriously backfiring, especially if the UK suddenly sees a fresh resurgence of case numbers in the coming weeks, as has already happened in Denmark. The UK’s embattled Prime Minister Boris Johnson may not last long enough in his job to ensure the policy reversal stays in place. Nonetheless, the move still represented the first outright rejection by the government of a major Western “liberal democracy” of the need for mandatory vaccine passports. That alone is cause for celebration.
As I argue in my upcoming book, Scanned: Why Vaccine Passports and Digital IDs Will Mean the End of Privacy and Personal Freedom, the passports “offer precious little in the way of potential good—and a huge amount in the way of potential harm.” They represent an all-out assault on civil liberties while exposing large segments of the population to unprecedented levels of discrimination and segregation. Yet they do precious little to help countries combat transmission of the virus, which is supposedly their raison d’etre. In fact, they may actually be exacerbating it by giving the recently vaccinated a false sense of security. How else to explain the fact that by the end of 2021 the EU, the region of the world with most vaccine passports per person, was once again ground zero for the COVID-19 pandemic?
Lack of “Rationality” and “Proportionality”
But one measure the UK Government hasn’t repealed is the vaccine mandate for all NHS staff. From April 1, two jabs will become obligatory for frontline NHS staff after MPs voted on the legislation last month. But opposition is rising to the mandate after a leaked document from the Department of Health and Social Care (DHSC) warned ministers that the new evidence on Omicron – showing vaccine effectiveness dropping to zero – raises serious doubts about the new law’s “rationality” and “proportionality:” More from the Guardian:
The document, drawn up by Department of Health and Social Care (DHSC) officials and seen by the Guardian, said the evidence base on which MPs voted “has changed”, creating a higher chance of objections and judicial review.
The effectiveness of only two vaccine doses against Omicron, and the lower likelihood of hospitalisations from the milder variant, are cited.
More than 70,000 NHS staff – 4.9% – could remain unvaccinated by 1 April, the document says. NHS trusts in England are preparing to start sending dismissal letters from 3 February to any member of staff who has not had their first dose by then.
Amid significant pressures on the NHS, last week groups including the Royal College of Nursing urged Sajid Javid, the health secretary, to delay the legislation, known as “vaccination as a condition of deployment” (VCOD2). An earlier VCOD1 rule applied to care workers and came into force on 11 November.
On Tuesday the Royal College of Nursing said the leaked memo should prompt ministers to call a halt to the imposition of compulsory jabs, which it called “reckless”.
“The government should now instigate a major rethink”, said Patricia Marquis, the RCN’s England director. “Mandation is not the answer and sacking valued nursing staff during a workforce crisis is reckless.”
The document prepared by DHSC officials noted that two vaccine doses provide up to 32% effectiveness against Omicron infection, which wanes to an effective zero 20 weeks later.
Elderly Care in Tatters
The Department of Health and Social Care has already pushed through a blanket vaccine mandate for care home care workers, propelling as many as 70,000 workers out of the sector. Care leaders begged the health secretary, Sajid Javid, a former investment banker, for an 11th hour reprieve, but he refused to listen. That was in mid-November. A month and a half later, the Government announced it was relaxing immigration rules in order to recruit care staff from overseas.
In early January, more than 90 care home operators declared “red alert” on staff shortages, meaning that staffing ratios had been breached. To combat rising staff shortages, Health Secretary Sajid Javid proposed establishing a “volunteer army” of retired nurses, doctors, and carers to take shifts and reduce the burden.
Vic Rayner, chief executive of the National Care Forum, warned: “The spread of Omicron across the country will bring more care homes into outbreak, put huge pressure on the already compromised staff group and mean those who need care do not get it.”
The vaccine mandate not only exacerbated the acute staffing shortages in the UK’s elderly care sector, with some 170,000 estimated vacancies; it also heaped yet more pressure on the NHS’s buckling systems, as more and more care homes were left with little choice but to refuse to take patients from hospitals.
The NHS is also facing an acute staff shortage. According to the King’s Fund, an English health charity, NHS hospitals, mental health services and community providers were reporting a shortage of nearly 84,000 full-time equivalent (FTE) staff just under a year ago. That’s the equivalent of 6% of the NHS’s total workforce.
In 2017, a House of Lords Select Committee warned that the lack of a comprehensive national long-term strategy to secure a well-trained and committed workforce to meet the needs of the the UK’s health and care system over the next 10–15 years represents “the biggest internal threat to the sustainability of the NHS”. That was three years before COVID’s arrival.
Today, many nursing staff “are going into work with only half the number of staff that are needed but with still the same number of patients to look after,” Royal College of Nursing director for England Patricia Marquis recently told ITV News. “They are being spread thinner and thinner and we are hearing of many being reduced to tears because they are not able to deliver the care to their patients”.
The Final Straw
As I write in Scanned, “it is a vicious cycle that is crippling healthcare care systems around the world. The worse the staff shortages get, the more nurses and doctors end up succumbing to mental and physical exhaustion, further exacerbating the shortages.” The vaccine mandates appear to be the final straw. A sudden wave of dismissals and resignations of unvaccinated staff is making it even harder for overstretched hospitals to treat patients of COVID-19 and other serious conditions.
In some parts of Canada, including Quebec, public health authorities in December “allowed” infected workers to return to work as hospitals grappled with thousands of staff calling in sick amid a surge in new case numbers. The province of Alberta took the much more rational step of allowing unvaccinated workers back on the job, as long as they agreed to undergo regular testing — something the UK’s NHS could do easily and at little extra cost with the roughly 70,000 workers that still refuse to get vaccinated. In fact, it should be doing it with both vaccinated and unvaccinated workers.
Fighting a pandemic with legislation that ends up producing fewer rather than more employees in the healthcare system is not just dangerous but absurd, especially given that the “no jab, no job” mandates are for a non-sterilising vaccination that does not stop infection or transmission but only reduces the risk of the recipient developing serious symptoms.
This is particularly true in the case of the Omicron variant. According to the UK Government’s latest vaccine report, published on Jan 13, cases per 100,000 are now higher in the vaccinated than in the unvaccinated. It is a similar story in Denmark where the public health authorities, which have done a pretty decent job of tracking COVID-19 case numbers as well as the emergence and spread of new variants, reported in late December that 90% of the 17,800 Danes who had contracted Omicron by December 15 had been vaccinated two or three times. Only 8.5 percent were unvaccinated. In the case of Delta or other variants, the unvaccinated accounted for 23.7 percent of case numbers.
Clearly, in the age of Omicron and with the current crop of vaccines there is no logical justification for vaccine mandates for healthcare staff, especially given that many of them already have some degree of infection-acquired immunity. This is even more the case in a country where the Government has essentially removed most other public health measures for trying to control the spread of the virus such as the mask mandate and work from home rules, as even some former staunch advocates of vaccine mandates are now conceding.
In fact, the only possible logic for continuing with the vaccine mandate is to further weaken the National Health Service, in order to create even more opportunities to outsource its services to private operators. Given this government’s track record as well as the fact that it is already forcing the NHS to pay private operators hundreds of millions of pounds just to be on standby whether or not they have to deliver (what the Government calls a “minimum income guarantee”), that possibility should be taken very seriously.