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Standing down front line health workers makes no sense

2021 was the year of the great Irish vaccine culture war. And, in a sane world, 2021 is where that great vaccine culture war would stay. We now know the facts about the Covid 19 vaccines, and what they do, and do not, do.

We know, for example, that the vaccines confer some important benefits. If you get sick, they seem to significantly reduce your chances of hospitalisation or death, or long-term side effects. There remain some on the fringes who dispute this, but the evidence in favour of that statement is overwhelming.

We also know what the vaccines do not do. They do not prevent transmission. There are some on the opposite fringes who scream that they reduce transmission, but if they do, then the evidence of Ireland’s present omicron surge is that any such effect is ultra-marginal. The bottom line is that 95% of us have taken two or three vaccine shots, and case numbers are in the hundreds of thousands. Vaccinated people are spreading and contracting covid every day.

It might fairly be said then that the vaccines are an important and useful tool if your goal is covid mitigation, and of no use at all, if your goal is covid elimination.

Which makes the decision by the HSE to stand unvaccinated health workers down from front line duties beyond mystifying:

We know several things about the present covid situation. They are as follows:

First, we know that the pressure on hospitals and the health service is not actually – at least not now – coming from a massive surge of covid patients in hospital and ICU. Although case numbers are rising, hospital numbers are fairly stable, as of today’s date.

Second, we know that a major problem in hospitals is staffing shortages due to covid. Even though Omicron is not especially serious, nurses and doctors who get it must still isolate, and take time off work. This is putting significant pressure on the delivery of services.

Third, we know that unvaccinated people are only marginally more likely – and ultra-marginally at that – to transmit covid to others than a vaccinated person. This is based on the research showing that peak viral load lasts slightly – about two days – longer in an unvaccinated person than a vaccinated person. The effect is there, but very marginally.

Fourth, we know that the quarantine requirements are identical for both vaccinated and unvaccinated staff – if you test positive, you’re out of action. The protocols for keeping infected staff away from patients apply whether a person is vaccinated or not.

That leaves only one potential justification: The notion that unvaccinated staff are more likely to have undetected covid than the vaccinated. The problem is that there is no evidence for this. In fact, it flies in the face of all the arguments for the vaccine: The vaccine is supposed to make covid more mild, and less symptomatic. In fact, it should usually be easier to detect covid in an unvaccinated person, since they are more likely to have noticeable symptoms.

In these circumstances, it seems to stretch the limits of sanity to be removing perfectly healthy workers from the front lines of the health service, whether they be in the ambulance service, the nursing service, or anything else.

In the round, what we seem to have in Ireland (and indeed, in several other countries) is vaccine policy tailored to an entirely different vaccine. It might still be possible to oppose the removal of unvaccinated staff from front line positions on ideological grounds, if the vaccine efficiently prevented transmission, but there would at least be a strong practical argument for it. As it stands, the practical argument is close to non-existent.

What we have here instead is pure culture war nonsense masquerading as health policy. The Government’s position is not really about the vaccine, but about the morality of those who take it, and those who refuse it. The policy is based on the notion that anti-vaxxers (to use the media’s preferred term) are bad and immoral, and the vaccinated are good and upstanding. This is not about medical cleansing, but about moral cleansing.

The bottom line here is there is next to no evidence that has been presented by Government that any of their coercive vaccine policies – from vaccine passports, to this – have had any impact at all on the level of covid infection in the community. When asked about it, the response of Government is to say that the policies have induced people to get vaccinated, which is as close as you will come to an admission that the policies have not worked to reduce covid levels.

But at 95% or more vaccinated, it is, at this point, foolishness to believe that those who have resisted being vaccinated to this point will have a sudden change of heart. And so, the Government has officially reached the point where it is cutting off its own nose to spite the anti-vaxxer’s faces. This is why you will never hear any senior medic in the media outlining why a policy like suspending unvaccinated medical staff makes medical sense.

We are, though, so far down the rabbit hole of the vaccine culture war that for many people in Ireland, this article may as well be talking to the wall. Indeed, there will be some on the unvaccinated side who react with horror to the factual assertion in paragraph two that the vaccines confer some benefits. The rational side of the human brain appears to have been entirely eliminated from existence, any time the word “vaccine” gets mentioned.

And so here we are, as we start 2022, fighting a war on the unvaccinated. Mainly because the war on covid has long since been lost. It is not an auspicious beginning to the new year.

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