Should ‘Refuseniks’ be forced to vaccinate
As you will probably know by now, the New Zealand Government has made COVID vaccination mandatory for doctors, pharmacists, and all other health care workers – each and every one to be fully vaccinated by December; teachers and other workers in the education sector, by January 2022. Groups representing affected workers are in favour of the mandate (Aljazeera 11 October).
- * All care home workers in England were supposed to have had their first COVID vaccination by midnight on 16 September so that they could meet the government’s deadline of 11 November to be fully vaccinated, or face being banned from entering care homes (BMJ 21 September).
- * As from 9 September, the Department of Health and Social Care (DHSC) launched a six-week consultation asking health and care workers, health care providers and patients to share their views on whether staff, unless exempt, should be required to be vaccinated. The BMA has warned that making vaccination compulsory is complex, and raises many ethical, legal and practical questions (BMJ 10 September).
- * Before New Zealand, “no jab, no job” policies had been adopted, with various provisos, by the governments of Canada, Costa Rica, Fiji, France, Greece, Hungary, Indonesia, Italy, Kazakhstan, Lebanon, Malta, Micronesia, Netherlands, Russia, Saudi Arabia, Sri Lanka, Switzerland, Turkey, Turkmenistan and the United States (Reuters 8 October).
- * Turkmenistan became the first country to make COVID vaccination mandatory for all adults on 7 July (BMJ 12 July).
It is a sad fact that our National Health Service was direly understaffed before COVID. The effect of the pandemic on staffing levels has been disastrous. Already grossly underpaid, heavily overexploited and disabused health workers, at all levels, had been abandoning the unwieldy, unaffordable and inappropriately politicised behemoth.
The NHS is the largest employer in England with nearly 1.2 million full-time equivalent (FTE) staff working in hospital and community services. The reported shortage is now 84,000 FTE staff. The projected shortage of GPs is 7,000. Unfilled vacancies increase the pressure on staff, leading to high levels of stress, absenteeism, and turnover. This has been compounded by the COVID pandemic, which has exacerbated long term issues such as chronic excessive workload, burn out and inequalities experienced by ethnic minority staff (The King’s Fund 26 February).
- * 28% of nurses and health visitors leave the NHS within the first three years of their service. There are 38,000 nursing vacancies (ibid.)
- * Care worker vacancies which are running at 120,000, would be made worse by compulsory vaccination (The Guardian 9 September).
- * 36% of UK people are vaccine hesitant – they have strong side effect fears – while a further 12% fear needles and 22% think vaccines could impact fertility (ONS 17-21 March).
- * As of February, an observational study of 19,044 multiethnic health care workers (HCWs) at University Hospitals of Leicester NHS Trusts, showed that the lowest proportions of those vaccinated were doctors (57.4%), estates and facilities staff (60.7%) and nurses and HCAs (62.5%). HCWs from ethnic minority backgrounds were significantly less likely than their white colleagues to be vaccinated. (doi.org/10.1101/2021.02.11.21251548).
Obviously, the seemingly insouciant approach of Government to vaccine hesitancy is strongly tainted by political angst – such as what will the Red Wall think?
COVID-19, the wicked witch of the common cold, has now found a comfy niche previously occupied by another vicious emanation from the cesspit of China, the endlessly mutable influenza virus. These oriental pestilences would naturally compete for sustenance in overabundant human fodder, in the compromised – the poor, the obese, the ethnic minorities with pigmented skin, the elderly and the sick.
Should one of these most recent strains of influenza prove to be sufficiently pernicious to gain a seat at this groaning table of feasts, our fragile society would be even more severely compromised – at one of the most pivotal moments in modern history.
A battle for dominance between these two well-matched, aeons-old rivals, the coronavirus and the influenza virus, could cause extreme mayhem within our super-susceptible juvenile race of hominids, their natural prey.
A recent ominous research paper, ‘Increased lethality in influenza and SARS-CoV-2 coinfection is prevented by influenza immunity but not SARS-CoV-2 immunity’ (Nature Communications 12, 5819. 5 October 2021) raises, albeit in humanised mice, the likelihood that a chance infection with both viruses could totally overcome our immune system.
Government has leaked a strong hint, a not-too-emphatic-to-alarm encouragement, that to take up the offer of one of the free flu vaccines in conjunction with the third COVID jab would be really rather wise.
Also, I am sure most of our patients would agree that their “health care workers” would be totally out of order not to be fully vaccinated.
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The incidence of COVID infections in our practice has surged over the past three weeks – not serious cases, but nasty enough to alarm: most had been fully vaccinated, some had not been taking their 4000 iu of vitamin D daily, all had been exposed to infection in crowded venues. This is the price of freedom from COVID constraints.
If you do not fancy being “struck down”, as my granny would say, PLEASE –
- * Take vitamin D 4000 iu daily. It is effective against viral respiratory infections
- * Use “First Defence” nasal spray to trap inhaled virus particles, every two hours in crowded areas. It works.
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- * Wear medical grade masks in crowded places. They will protect others from your (possibly infected) exhaled water droplets. They will not protect you from infection by inhaled free, airborne viral particles – they are far too small.
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- * Lose weight and keep fit.
- * Avoid people with “colds”
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The creator of Sherlock Holmes, Dr Arthur Conan Doyle, was an enthusiastic proponent of mandatory vaccination. In a public correspondence of 1899 with an early anti-vaxxer “hobbyist”, one Colonel Wintle, Doyle tells us that “the interests at stake are so vital that an enormous responsibility rests with the men whose notion of progress is to revert to the condition of things which existed in the dark ages before the dawn of medical science”. (PMID 24585840)
Plus ça change plus c’est la même chose.