In January, both the US and Canada made decisions regarding COVID-19 – the rest of the world should take note

Public health decisions during this pandemic have not been easy to make at either the individual or the societal level. Everywhere we turn, these decisions are met with scepticism, scorn, ridicule, politicisation and misinformation.

But two recent decisions – one by the US Supreme Court and another by a Canadian politician – seem to have struck a chord here in North America that point to, if not a defiance among political and judicial leaders, certainly a grudging acceptance about what is widely considered ‘right’ and ‘wrong’ in this third year of the COVID-19 pandemic.

The first decision in January 2022 was from the US Supreme Court that ruled that a COVID-19 vaccine mandate for healthcare workers who work at facilities that receive Medicare and Medicaid federal funding should stand. The narrow 5-4 decision read, in part, that ‘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.’ It is estimated that this Supreme Court decision will affect upwards of 10 million healthcare workers in the US, not to mention the spin-off effects of, perhaps, encouraging family members of healthcare workers to also get vaccinated.

Look, let’s be honest about where we all stand. Whether you are in the US, Canada, the UK or Timbuktu, this ruling is correct. Full stop. In fact, it is more than just correct, it is humane. That it took a US Supreme Court decision to show us what is humane and correct in a healthcare setting where we deal with vulnerable people who rely on us to protect them is astounding.

Every country that is able to do so should adopt some form of this ruling for healthcare workers in their own jurisdictions. And there should be no argument about it. Anyone who works with vulnerable people (immunocompromised patients, the elderly, school children who are too young to be vaccinated, etc) should be fully vaccinated before they are allowed to return to work.

Or they should lose their jobs. There can be no excuse for coming to work and endangering the lives of the needy and vulnerable. If you disagree, find a new job.
The other decision that was made here in North America comes to us from Canada where the Premier of Quebec, Canada’s second largest province, ruled that unvaccinated residents of Quebec will soon be forced to effectively pay what amounts to a health tax to cover the cost of the astronomical medical costs associated with unvaccinated COVID-19 patients. Of course, there will be provisions for people who have legitimate medical and/or religious exemptions or who suffer from mental illnesses that preclude them from making informed decisions.

There has been some natural aversion to this idea from both public health experts and civil rights advocates who argue that a tax such as this can have far-reaching ramifications beyond simply the balance in someone’s bank account.

What do we tell motor vehicle accident victims and heart attack/stroke patients who don’t have access to ambulances and ICU/CCU beds because they are occupied by unvaccinated COVID-19 patients? What do we tell healthcare workers who are fully vaccinated, about continuing to go to work every day to face an onslaught of unvaccinated people who may transmit the virus to them, resulting in a breakthrough infection that could cause long-term deleterious effects associated with long COVID? What do we tell surgical patients waiting for an artificial hip or a new kidney or a cataract procedure to restore their vision loss, when the operating theatres at their local hospitals have been closed and their procedures have been pushed back by six to 12 months? And what do we tell the 85-90% of those who have been fully vaccinated about the spiralling costs of managing and treating unvaccinated COVID-19 patients for which their tax dollars are used?

I understand that a vaccination is an irreversible medical intervention. I understand that autonomy over one’s own body is a fundamental right. I understand that much is not known about the long-term effects of a three-shot regimen for a novel vaccine that is barely a year old. I also understand that the needs of the many, in extreme circumstances only, should outweigh the needs of the few.

There is no single scenario that will satisfy 100% of the population in any country. That much is certain. In the absence of 100% satisfaction, certainty and consensus, there are tough choices to be made.

And someone has to make them.