The Delusional COVID Honor Code and Its Risk

We are at a critical point in our fight against COVID.   We have finally reached the point in the pandemic when, as a result of mass vaccinations and new case numbers coming down drastically, most states have fully reopened, several are scheduled for June.   Only two have set no date. 

But there's a catch.   Roughly half of the population has not been vaccinated.   And what is government's response to this catch?   Regarding mask mandates, it ignores the problem.   

The general guidance is that if you are fully vaccinated you don't have to wear a mask except in the limited situations defined by the CDC - airplanes, public transportation, etc. By deduction, that means that if you aren't fully vaccinated you should still wear a mask in all situations.   But I have not seen a sign anywhere that says, "If you are not fully vaccinated you must wear a mask to enter."

Everyone is operating on an honor system.   That is, if someone is not fully vaccinated they will wear a mask.   

Clearly in many situations, like stores, it would be impossible to police mask wearing, so one has no choice but to follow the honor system.   But at least the sign at the entrance should clearly state that if you are not vaccinated you must wear a mask to enter.   Or one could say, recognizing the risk, that everyone still must wear a mask, whether vaccinated or not. 

But even at the gym I go to, they are using the honor system.   Here it would be very easy to require people to present proof that they are vaccinated when entering the gym.

So what is the problem with an honor system?   It sounds very American.   

The problem is that many of those who have decided not to be vaccinated, for political or anti-government reasons, are the very people who were against mask mandates to begin with.   They will not now voluntarily don a mask because they haven't been vaccinated. 

And so you have half of the population that is still highly susceptible to infection by COVID most likely not wearing masks and thereby putting both themselves and those around them at risk.   For those who are vaccinated the risk may be relatively low, at least for the infection to be serious, but the risk is still there. 

We are thus risking another COVID surge.   Granted it may be limited to half the population, but that would still be bad for the economy, schools, our return to normalcy. 

At one point, there was discussion about having vaccine passports for entrance to all sorts of venues that put people in close indoor quarters - such as planes, theaters, restaurants.  That idea has been discarded because it was felt that it would impinge on people's right of freedom of movement.   But does one have a right to risk infecting another individual?  No.

Masks mandates should still be mandatory for those who are not fully vaccinated.   And in all situations where it is practical, proof of vaccination should be required before being allowed to enter without a mask.  Where it is not practical, until we reach herd immunity, everyone should still have to wear a mask. 

From a public policy perspective, perhaps such a policy would even encourage some people who weren't going to get vaccinated to get it.   That would be helpful. 

Bottom line, the government must do what it can to protect us from more damage from this pandemic. 

Vaccine Passports Should Be Required

There is much controversy over whether airlines and other close-quarter non-essential venues can require proof of vaccination for entrance.   As a public health measure, not only should companies be able to require it, the government should mandate that vaccination is a prerequisite whether to boarding a plane or going to a movie or live theater or dining-in at a restaurant.   If you are not vaccinated, you potentially endanger the life of another person and so you must pay the price. 

Such restrictions on people who are not vaccinated are not without precedent.   Many schools require that children are current with their vaccinations, barring religious or health exceptions, in order to attend school.   And in states with mask mandates, people who don't wear a mask in enclosed venues, even essential ones like grocery stores, are denied entrance.

Is this step necessary to protect the public?  Yes. Despite the fact that the US vaccination percentage was increasing at a good pace, the number of new cases per day climbed again, due probably to a combination of spring break travel and the newer variants spreading more quickly, together with people not wearing masks.   Recently the number of daily vaccinations has decreased.   It cannot be said at this point that the virus is under control. 

From a public health perspective, the virus must be brought under control.   The human cost of the pandemic in the United States has been huge.   In another month, we are likely to be at 600,000 deaths.   This virus cannot be beaten by half measures. 

The problem we face is two-fold.   One problem is that a sizable portion of the population (surveys show a range from 25 - 39%) is hesitant or has actually indicated that it will not be vaccinated.   The problem is worst among Republicans, those in rural areas, Blacks, and those aged 18-49.   The other problem is that again a sizable portion of the population (anywhere from 15% to 50%) refuses to wear masks and take other measures to reduce the potential of both transmitting or becoming infected with the virus.  While there is no data on the overlap of these two groups, it is probably more likely than not that these two population subsets are largely coterminous and therefore especially dangerous. 

If such a large percentage of the adult population does not get vaccinated and if a similar proportion refuse to wear masks in public, we will not be able to get the virus under control.   The numbers will surely go down, but there will remain a sizable risk and masks with social distancing will continue to be required of all.   A return to normalcy is not in the offing. 

Given this underlying public health and social problem, which is created not by the virus but by the attitudes of people, people who are not vaccinated should be refused entry to all non-essential enclosed spaces, such as airplanes, restaurants, and theaters. 

But the reader may ask, if everyone has to wear a mask on airplanes or in a theater, why should being vaccinated be required?  Two reasons.  First, many people are careless about how they wear their masks, not covering their nose, so they may be wearing a mask but still present a risk.   Second, at least in planes, people often take off their mask for a period of time either to eat, drink, or just because they're tired of wearing a mask; you can bet the same would happen in a dark theater.    And as a side note, we all long for a return to normalcy.  If everyone in an airplane or theater was vaccinated, we wouldn't have to wear masks.   What a relief that would be.

People may have a right not to get vaccinated or not to wear masks, but they don't have a right to thereby endanger the health and lives of others.   Thus if you insist on this personal choice, you have to accept the limitations placed on your movements for the public safety.