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Sensemaker: Vaccine mandates

Sensemaker: Vaccine mandates

What just happened

Long stories short

  • President Biden said he expected Vladimir Putin to “move in” to Ukraine, and that an invasion would be “disastrous” for Russia.
  • A Conservative MP who defected to Labour prompted a rethink among Tory rebels plotting to oust Boris Johnson as the UK’s prime minister.
  • Jamaica’s four-man bobsled team qualified for the Winter Olympics for the first time in 24 years.

Vaccine mandates

Vaccines work – but do vaccine mandates?

The question is timely because the evidence is overwhelming that high vaccination rates are the best route out of the pandemic.

The answer is easily obscured: the UK doesn’t have any mandates – yet – but boasts that it’ll be the first major western country to emerge from under the Covid cloud. France does have mandates, and went through Europe’s biggest Covid infection spike this month despite them. 

The last time we looked at mandates was three months ago. Since then Omicron has swept the world. Infection levels are now falling in many countries but healthcare workers in particular remain at heightened risk, which is why they’re the focus of the mandate debate. Last week the US Supreme Court upheld a mandate for the healthcare sector. This spring the UK government wants one for the NHS. Globally, the trend is towards tighter rules.

The rules.

USA. The mandate will apply to 10 million healthcare workers across all 50 states. The Supreme Court noted doctors’ and nurses’ duty to patients: “ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, do no harm.” A separate “vaccine-or-test” mandate for large businesses was overturned. 

Canada. A range of measures aimed at encouraging vaccination have been proposed in Quebec.

  • A new rule requiring proof of Covid vaccination to get into government-run stores selling alcohol and cannabis. 
  • Proof of vaccination required to enter large stores.
  • A “health contribution” added to the tax bills of people who refuse to be vaccinated.
  • None of these is strictly a mandate but they’ll all make life more difficult for the 10 per cent of Quebecois who remain un-jabbed.

France. On Sunday the French parliament passed legislation requiring vaccine passes to be shown for entry to restaurants, cafes, cinemas and other public places from.

  • Under France’s previous “passe sanitaire” rules a vaccine certificate or proof of a recent negative test was enough. Soon only evidence of double vaccination and up-to-date booster jabs will suffice. Using a fake pass, or someone else’s, can mean a €1,000 fine. 

Elsewhere. Italy and Greece have vaccine mandates in place for older adults. In Austria, vaccination will be mandatory for all adults from 1 February. 

The impact

Restrictions on where unvaccinated people can go and work do seem to boost uptake: 

  • The day after Quebec’s proposal to restrict access to bottle shops for the unvaccinated, bookings for vaccine appointments quadrupled. The threat of a financial penalty had a similar effect: 7,000 appointments were booked in the 24 hours following the announcement.  
  • Since New York State introduced a mandate for healthcare workers four months ago, vaccination rates for hospital workers have risen from 84 to 98 per cent. Staffing shortages caused by workers resigning instead of getting vaccinated were anticipated but failed to materialise. 
  • A study in The Lancet Public Health compared uptake in six countries that started requiring vaccine certificates last year with a counterfactual scenario in which certificates were not required. Daily vaccinations per capita went up – not just from the moment the measures were introduced but from the moment they were announced.

Implications for the UK

Healthcare unions are calling on the UK government to reconsider its vaccine mandate plans for healthcare workers in England and Wales. As things stand, doctors, nurses and other support staff are to be fully vaccinated by 1 April 2022. That means getting their first dose by 3 February if they are to get their second jab in time. Unless exempt, staff who remain unvaccinated after that date won’t be allowed to work with patients and are at risk of being fired. 

The Department of Health and Social Care estimates over 70,000 NHS staff are likely to be unvaccinated when the rules come into force. The medical unions are concerned that mass layoffs of unvaccinated staff would put pressure on an already short-staffed NHS and endanger patients. 

Sajid Javid, the health secretary, has told unvaccinated care workers to “get another job”. Evidence from around the world suggests he would be wise to hold his nerve and stick to current plans. 

Wealth investment, fairness, prosperity

Trump assets
Did Donald Trump lie to banks and tax officials about his finances? That has been the premise of years of prosecutorial scrutiny and New York State’s attorney general is more convinced than ever the answer is yes. On Tuesday she released a 115-page court filing on “material misstatements and omissions” in the Trump Organization’s financial statements. Letitia James’ findings add to growing evidence the company inflated the value of its assets and used those bloated numbers to secure bank loans, insurance policies and tax breaks. She says Trump claimed his Manhattan triplex was three times its actual size (and therefore three times as valuable) and swelled the value of his land holdings and golf courses based on the addition of villas and mansions that were never built. Jeffrey McConney, the Trump Organization’s controller, has been cooperating with James but his boss, Allen Weisselberg, has not been playing ball. James subpoenaed Weisselberg last year; under questioning he invoked his Fifth Amendment rights more than 500 times. Next on her list: Ivanka, Donald Jr. and Trump himself.

belonging identity, society, beliefs, countries

Pet flights
Hong Kongers are paying $25,000 per animal to fly their pets out of Hong Kong on private jets as Beijing makes life miserable in the city and Covid squeezes space on normal cargo flights. The number of animals involved is not high in absolute terms, but it’s high enough to signal a new strain of elite desperation. The FT reports that Top Stars Air, Dog Express and Pet Holidays have all been doing brisk business booking pets and their owners on private planes as the only alternative to staying put or using commercial flights that tend to be overbooked or cancelled. The only acceptable alternative, that is. Separately, Hong Kong officials have announced that more than 1,000 hamsters, rabbits and chinchillas imported for resale are to be culled for fear of spreading Covid.

New things technology, science, engineering

Reprogrammed cells
A $3 billion biotech start-up that hopes to reverse disease by reprogramming cells has won a significant vote of confidence from Hal Barron, GlaxoSmithKline’s head of R & D. Yesterday it was announced he’ll move to run the start-up, which is called Altos and aims to pioneer nothing less than the reinvention of medicine. The science Altos hopes to harness is based on work by the Nobel laureate Shimya Yamanaka and others on pluripotent stem cells and “rejuvenation programming”. Barron said it was clear from such work that “cells have the ability to rejuvenate, resetting their epigenetic clocks and erasing damage from a myriad of stressors”. Rough translation: it should be possible to reverse cell damage caused by disease, and even ageing. This is not a Marvel script, nor is today April 1st. Altos is backed by Jeff Bezos and the Russian-born web billionaire Yuri Milner. They won’t want this to be the next Theranos.  

The 100-year life health, education, living, public poliCY

4th dose doubts
Governments moving to give fourth vaccine doses may want to keep an eye on Israel. Preliminary analysis since Israel started rolling out second boosters earlier this month has found that although four jabs produce more antibodies than three, the second booster is only enough for a “partial defence” against Omicron. The WHO has told countries offering second boosters they are “unlikely to be appropriate or sustainable”, and the European Medicines Agency’s head of vaccines strategy has said he worries that fourth doses could lead to “immunity fatigue”, potentially prolonging the pandemic. The science is hazy here – questions about T-cell exhaustion remain unanswered – but there is good evidence for keeping a healthy gap between doses, like the one between yearly flu jabs. Vaccinating people who haven’t had a first jab yet should be top of the to-do list. 

covid by numbers

£5.2 billion – dollar funding gap for global vaccination efforts in 2022, according to the international vaccine alliance Gavi.

Our planet environment, natural resources, geopolitics

Perfect reef
French researchers using special diving equipment have found a pristine reef off Tahiti that appears to be unaffected by climate change. Most coral reefs have suffered from warming waters, ocean acidification and bleaching events such as one that damaged large parts of the Great Barrier Reef in 2019. This one hasn’t, according to Laetitia Hédouin of the French National Centre for Scientific Research in French Polynesia. She first saw it on a Unesco-funded dive last year to a previously unexplored spot off the Tahiti coast. Unlike most reefs, which are close to the surface, this one is between 35 and 70 metres down, limiting the time divers with basic scuba equipment can spend there. Hédouin’s team has now spent 200 hours studying it and is confident it is in virtually perfect condition. Is it safe, or is it only a matter of time before water warms up even at this depth?

Thanks for reading. Do share this around, and let us know what we’ve missed.

Ella Hill

Edited and produced by Phoebe Davis

Photographs Getty Images, Alexis Rosenfeld/Instagram

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