Iíll give you my overview first. There are no absolute truths here. The science around Covid, immunisation, epidemiology, virology. is not secure, and you would not expect it to be. Itís a new virus, the immunisation is new, Itís not like e=mc2 or Avogadroís hypothesis. So informed and intelligent arguments about what to do for the best, now that Covid is here, and is changing, will often come to competing conclusions - not necessarily opposite ones, but different.
This is an example of such an argument, and congratulations to the interviewer and the interviewee for an enlightening way to challenge each other.
After listening to Dr Steve James ultimately I have to make a binary decision as it pertains at the moment as he himself has had to make. Have the vaccine or not? I donít agree with him saying no. But I will qualify this later.
My main moral and medical argument is to accept that as social beings, living in a society where we all, everyone of us, depend on the actions of everyone else, that there sometimes comes a need to accept a common purpose and action, even if we might do so reluctantly. That being so, I have had no objection to being immunised in the first place, I feel more than personally protecting me, itís protecting my wife, my family, my friends and my community. It does so in two ways. One, if I am ill as a consequence of getting this virus, I am causing unnecessary expense and effort from the medical community and their facilities. Two, immunisation may not entirely stop transmission, but it does reduce it. Every sufficiently immunised person is a possible candidate for the virus to come to a halt, reducing the spread and urgency of medical care in any part of the still vulnerable population. And of course, I am seventy-four and I donít want to get ill or die. At some stage you have to accept the bulk of concerned professional and knowledgeable advice. And isnít that exactly why you can criticise so many governments in the face to this pandemic, their continued failure to do this?
Every year we commemorate the sacrifices of millions of our predecessors in two world wars. You can debate the worth or origin of conflict however much you like, but the fact is that history tells us people do respond in remarkable ways to times of trial. You see the same after major natural disasters, incompetent government iso often s sidelined by superhuman cooperative activity. I see Covid immunisation in much the same light.
Dr Steve James acknowledges the worth of the vaccine first of all. Heíd have been totally unbelievable in anything he subsequently said if he werenít to do that. It will have saved many tens of thousands of lives in the UK and probably even higher numbers of seriously ill people, hospital care, and long Covid.
His argument fundamentally is personal, not scientific, and deviates from most of his equally well qualified professional colleagues. And despite his explanation, I donít really understand it.
So then we come down to a very simple ethical question, is it moral to insist on a certain medical procedure to continue your employment? Well, the answer is obviously yes in this society, as many jobs require certain immunisations or restrictions on health to continue in work. Vaccine mandates pertain in many states in the US. The pertain here in NZ since November. If youíre non-immunised you do have a higher risk of passing on your infection to your patients or colleagues for the original Covid and Delta, but with Omicron, I donít think you can now state whether full or boosted immunisation does reduce transmission. I suspect it does, but nowhere near enough to reach ďherd immunityĒ.
So what has happened though is Omicron has changed the scene. I think the science of full immunisation of health professionals with non-Omicron infection was secure, and insisting on immunisation, distasteful as it would be to any right-wing political system, was correct. I think it would be very difficult to convey the subtlety of all Dr Jamesís arguements to any large and lay citizenry, and thatís a good bit of the problem, as the interviewer raised.
So as Dr James said, though he wasnít to know it at the time though it still wasnít particularly rational, his decision re immunisation has given time for the nature of the virus to change, and only now makes his decision rather more more rational. I am not sure what the UK government will do, but contrary to what Dr James thinks, I believe that by April, so many of the population will have already caught the virus and recovered, with more than just a few being seriously ill and dying, that the need for the medical profession to be immunised as a condition of employment might have receded, both on scientific and on political grounds. The April deadline was obviously decided by the English government with this thought in mind (that would be a political though, not scientific, as the government has placed so little reliance on science up to now).
I think the same will apply in New Zealand once Omicron gets through the population. Weíve yet to have any local transmission of this variant, and our total number of Covid cases is just 15,000 since the start of the pandemic, with 52 deaths, but obviously it will happen. If I were running the system, Iíd be looking at the end of February to ensure all vulnerable people and as many ordinary adults and youngsters were boosted by then. We could then stop compulsory quarantine for seven days in isolation facilities for incomers, but just home isolation, and just try to keep the lid on the too rapid spread of the virus in this almost entirely virus naive community over the next few months with home isolation, masking on public transport and in shops etc, vaccine passports (which we have here) and medical treatment and continued encouragement of immunisation. One of the issue for New Zealand has been the 900,000 Maori and Islander populations whose home circumstance are poor, and with a lot of obesity, diabetes and other underlying diseases and a low take up of vaccine, now much improved, have been highly vulnerable. Not dealing with Covid the way we have would have been frankly seriously racist. When, like in the UK, pretty nearly everyone has had the virus at least once, it will need be treated like flu, and an annual booster injection will likely be needed for a wee while. Ultimately Covid may retreat to a highly infectious but not serious upper respiratory tract infection like a souped-up common cold, just endemic and seasonally epidemic. It will still have the capacity to see off quite a few really elderly and infirm patients each year though, just like any upper respiratory tract infection can already. .