Journal of the Plague Years XVI: Vaccination Authentication

Passports, please

It’s a Saturday night in the long, hot summer of 2022 and, after a raucous evening with friends, you decide to perpetuate the fun and go clubbing at that new place downtown where the beautiful people dance till dawn and the tequilas are legendary. As you arrive, despite the visceral pulsations emanating from within, you are surprised there is no queue. A genial heavy politely asks to scan your irises and then your smartphone, and next says: “All good. You’re Covid-secure. Have great evening…”. And you do.

In practise, vaccination authentication will first take old-world paper form before it goes digital – though even that is controversial in some quarters right now. But there is no way that we can return to pre-Covid “normality” without reliable authentication. The UK government, despite recent successes on the vaccine front, has suddenly gone all coy about the necessity of vaccine passports. And yet these elusive ciphers and their digital counterparts will characterise our post-Covid future.

Arguments against

Libertarians think that vaccine passports would be an unnecessary invasion of privacy – as if people had the right to inspect one’s medical records in return for providing a service. Covid-19 is not a lethal disease – not even, technically, a notifiable one, they argue. Fatalities have been overwhelmingly amongst the elderly and frail – out of 121,000 fatalities in the UK only about 7,000 have been people under 60. Moreover, the rollout of the vaccination programme will ensure that it continues to circulate at a much-diminished rate; and, while people will continue to die of the condition just as people still die of flu, it will become just another condition with which we must live.

For that matter, horrible conditions such as antibiotic-resistant tuberculosis continue to circulate but we don’t generally lose too much sleep about them. Further, the libertarians believe that once a vaccine passport system becomes entrenched, it will persist even when the pandemic has become a bad memory.

But the argument that seems to have been adopted by the political establishment is that vaccine passports would be discriminatory. The people who are most likely to go unvaccinated, either by choice or because they reside in the shadowlands of the informal economy, are precisely the most vulnerable and deprived. But then such people are probably unlikely to want to enter a nightclub or to take an overseas holiday.

The government has emphasised that vaccination is not mandatory in a free society – that is not the way we do things here is a phrase that has passed the lips of numerous ministers, not least Mr Zahawi, the vaccines supremo. Nevertheless, even those who oppose vaccine passports concede that those who refuse to be vaccinated will have disadvantaged themselves. To muddy the waters further, the Chief Medical Officer, Professor Whitty, said on Monday (22 February) that having a Covid jab could become mandatory for NHS staff. In which case, surely, care home staff would not be far behind.

In any case, a vaccine passport is no guarantee of keeping Covid at bay in an enclosed space such as a nightclub. No vaccine will be 100 percent effective, meaning that there will be a small number of people who, having been vaccinated, will contract the virus and could transmit it to others. Though, if those others have also been vaccinated then the risk of serious illness is small. Again, some people who have already had the virus will carry immunity from it, especially the under-50s. There has never been any compulsion to show proof of a flu vaccination, even though flu generally kills around 10,000 every year.

In general, those who opposed the lockdowns on principle are now those who most resent compulsory vaccine passports.

Arguments in favour

It’s clear that foreign governments and indeed airlines will require UK citizens to provide evidence of vaccination in order to travel abroad. Therefore, people will become inured to the need to demonstrate their Covid status. For pubs, clubs, restaurants, theatres, concert halls and sports stadia to get up and running it is imperative that they offer the highest degree of Covid security – and that can only be achieved by requiring customers to prove that they are unlikely to transmit the virus.

If there is no formal, government-enforced system of vaccination authentication then people will rely on ad hoc measures. Mr Zahawi even suggested that people could request a certificate of vaccination from their GP – a proposal which was roundly rejected by the medical community on the ground that it would put further bureaucratic strain on our already over-stretched local surgeries. Another problem is that such letters could easily be faked by criminals. There have already been reports of people entering the country from abroad clutching dodgy certificates.

I understand that many people who have been vaccinated in the UK have received credit-card sized cards confirming vaccination – but not all. The government has said that there will be no compulsion to carry such cards and has flirted with the idea that nightclubs, for example, might be encouraged to use lateral flow tests for the virus at the door. But this has been dismissed as impractical. Punters would have to hang around outside for at least 30 minutes before gaining admittance – all spontaneity would be lost. And the scope for error would be monumental.

As a society, we are now more-or-less unanimous that public spaces should have smoking bans – which would have seemed anathema to my parents’ generation. We are used to the idea that we require vaccinations for foreign holidays. (I had to have a yellow fever jab when I went to Kenya a couple of years ago at a cost of over £300). Expectations change.

No jab, no job

That is the policy imposed by Charlie Mullins, CEO of Pimlico Plumbers. In other words, all new employees and contractors will be required to prove that they have been vaccinated. A number of other firms intend to adopt this policy less volubly. There was an interesting conversation in early February as to whether such a policy conformed to UK employment law.

On the one hand, employers have a duty of care to their employees and must ensure a healthy and safe environment in the workplace. On the other hand, the Equality Act (2010) prevents employers from requiring employees to observe practices that offend their religious or philosophical principles. The working assumption is that the no jab, no job policy is legal – but there is a good chance that it might in due course be tested in the courts. There will always be special circumstances. If an employee suffers from an acute allergy, he or she might judge that the risks of getting a jab could be greater than the risks of not getting one. But such an employee would put his or her co-workers at risk.

The Justice Secretary, Robert Buckland MP, has suggested that a no jab, no job policy could be justified for new employees but is likely to be legally problematic for existing employees. The question remains whether an employer could fire an existing employee for refusing to be jabbed.

Implications for the aviation sector

Travel operators are clamouring for the government to facilitate the revival of air travel. So long as the government dithers about a formal vaccine passport policy the aviation sector will continue to suffer. 2020 saw a 66 percent fall in passenger kilometres travelled worldwide relative to 2019 – an entirely unprecedented slump. Losses by international airlines are estimated at $118 billion last year.

Already, carriers such as Qantas, Emirates, Etihad and American Airlines have unveiled their own plans for digital passports. United Airlines, Lufthansa, Virgin Atlantic, Swiss International and JetBlue have announced a scheme for digital health passports called CommonPass. This will record test results as well as vaccination status.

In late January, American Airlines launched its health passport technology whereby travellers can upload their test results when they book a flight. Emirates and Etihad announced that they will be using TravelPass, a system developed by IATA (also being trialled by British Airways) by means of which travellers can store and manage test results and vaccination records. IATA has been in close consultation this month on this with the UK Department for Transport. Willi Walsh, the former CEO of British Airways and then IAG will take over as IATA Director General next month. This issue will be top of his agenda.

The use of digital certificates for international travel will require standardised models, or at least mutual recognition of different countries’ certification systems. The WHO is currently devising a standard digital format, though it said this week that it will only propound on the issue in three months’ time.

Logically, the government that required travellers from red list countries to quarantine in designated hotels for ten days will require arriving passengers to prove their Covid status in due course. Apparently, the UK will table a proposal on the issue at the G-7. EU leaders agreed last night to introduce digital vaccine passports by the summer. The sooner there is an international standard on how to proceed, the better.

Digital solutions

Israel is already pioneering a green passport mobile app which allows fully vaccinated Israelis to visit gyms, swimming pools, synagogues, hotels and cultural gatherings.

People who have received the vaccine in the UK are likely to be given scannable QR codes via a special NHS app. InnovateUK, a government agency, granted £37,000 last month to a firm called Logifect to develop is vaccine authentication smartphone app, provisionally called Check Me Now. This app can interface with an individual’s NHS records – something that will require explicit political approval. It also granted £75,000 to British start-ups Mvine and iProov which are working together on digital vaccination certificates, the latter using biometric facial verification technology.

Another British start-up is EYN which is working with airlines to provide vaccination passports for people who do not have smartphones. VST Enterprises has developed a system which uses a circular barcode. The company is in discussions with SkyTeam, Malaysian Airlines and Sri Lankan Airlines. It claims that its VCode technology also has the potential to revolutionise financial transactions both online and offline.

In any case, the entire travel experience is about to change qualitatively as a result of digital technology. Contactless technology will obviate the need for human-to-human interactions in airports and even hotels. Facial recognition technology alone will permit entry to the departure zone and boarding the plane. British Airways reckons that this will dramatically increase boarding speeds while maintaining social distancing. Since the summer of last year Smart Path technology developed by a company called Sita has been in use at Beijing International Airport. Dubai International Airport uses facial and iris scanning as arriving travellers pass through an immigration smart tunnel. Delta has installed facial recognition technology in terminals in Atlanta and Detroit for certain flyers.

No doubt all this technology costs money – though the marginal cost per traveller might be insignificant. That is another reason why the golden age of cheap air travel is almost certainly over – and expect mobile phone charges to rise too as smartphones increasingly take the strain. Not to mention the increased cost of travel insurance.

Vaccine diplomacy ramps us

Meanwhile, the vaccine cold war has shifted up a gear. Earlier this month Mr Putin offered 300 million doses of the Russian Sputnik-V vaccine to the African Union as the number of Covid deaths on the continent surpassed 300,000. Sputnik-V has been approved for use in at least 30 countries. Hungary is the first EU country to start using the vaccine, even though it has not been formally approved by the EMA.

The African Union has already secured 270 million doses of vaccine from AstraZeneca, Pfizer and Johnson & Johnson under the Covax programme to which Britain has been a major contributor. Its target is to immunise 60 percent of the continent’s 1.3 billion inhabitants over the next three years.

The Covax facility, set up under the auspices of the WHO, the Coalition for Epidemic Preparedness (CEPI) and Gavi (The Vaccine Alliance), announced on 03 February that it would deliver 330 million doses of vaccine to 145 lower-income countries by early July. Rwnada, South Africa and Capo Verde will be amongst the first countries to receive such consignments. And India, Pakistan, Nigeria and Indonesia will receive 13 million doses each.

Israel is to donate 100,000 surplus doses of the Pfizer vaccine and has pledged them so far to five countries – all of which have opened diplomatic legations in Jerusalem.

On Wednesday (24 February) 600,000 doses of vaccine arrived in Ghana courtesy of Covax. By that date Ghana had recorded just 584 deaths from Covid-19, equivalent to 19 deaths per one million people, as compared to 1,787 in the UK and 1,551 in the USA. Ghana was favoured because of its supposed readiness to administer the vaccine.

The fact is that, as I have emphasised in this journal before, Covid-19 has impacted the first world much more devastatingly than the developing world. That is almost certainly because life expectancy is longer in the first world – and therefore there are more old people who are the most vulnerable to this virus. (The average age of a UK fatality is above 80). Kenya has reported just 1,839 deaths or 34 per million inhabitants. It is possible that there has been some under-reporting of the numbers in Kenya and elsewhere; but that would surely show up in the excess deaths figure – which does not appear to be the case.

True, there have been some horrendous numbers coming out of South America, not least Peru. Surely, supplies of “spare” vaccine should be prioritised to where they are most needed rather than being doled out on the say-so of Ms Ngozi Okonjo-Iweala. The groupthink mantra is currently that nobody is safe until everyone is safe. But the reality is that a world in which everyone is safe is illusory because we are never going to eliminate this disease completely.

Like the vaccine passports issue, it’s all about risk management.

Next week I’ll be taking a look at Mr Sunak’s budget and speculating on how long it will take for UK government finances to recover from the pandemic – if ever. So much has happened since Mr Sunak delivered his first budget, just three weeks into the job, on 11 March last year. Mr Sunak has had a good pandemic – at least insofar as he has maintained his footing and aura of competence even while those around him were flailing. I suspect he might surprise us next week.