✏️ COVID Passports - A Critical Appraisal

By Sarayu Shankar - Year 12 Medicine Applicant

Featured from our May Newsletter - "Medicine in the News" section.

"I believe COVID Passports are being introduced to elicit confidence in people so that as restrictions begin to ease, they are given support to slowly resume normal activities again. There are many benefits and limitations to this system and when critically analysing this article, it is possible to look at how the 4 pillars of medical ethics could play a role in explaining the concept, risks and benefits of this public health system.

Beneficence refers to encouraging/promoting the actions that are in the best interests of the patient and thus doing good for the patient. When looking at COVID Passports, it would be doing good for the majority of the public because it ensures safety and gives reassurance to the public when they are out and about which in turn, allows a sense of normality to be regained. However, another contrary argument could be that some people would feel discriminated against if they don’t want to get vaccinated by choice (or for certain medical reasons) – and therefore this would not be abiding by the pillar of beneficence.

The pillar of non-maleficence looks at doing no harm. A form of harm that is often overlooked is psychological harm. People who are unvaccinated by choice or due to medical reasons may feel unnecessary emotional distress, as everyone else will be allowed access to certain privileges but those may be inaccessible to that minority. This could also lead onto the pillar of justice because when implementing such system, a balance needs to be reached between maintaining safety in public environments in a way that is not discriminatory.

The pillar of autonomy refers to allowing individuals to make their own decisions. A few individuals may not want to receive vaccinations or may not have the adequate social/economic status to conduct regular home testing and it is important to respect these factors but also encourage and provide support to those individuals in the best way possible. And furthermore, if there are restrictions imposed on people without vaccinations/unable to conduct testing (depriving them of visiting certain places/accessing amenities) then this could be argued as being unfair and not equal (linking back to the pillar of justice). Not all target populations (such as young children/adolescents) have been offered the vaccine. Therefore, whilst easing of restrictions would be applicable to those who have had their vaccinations, , it would not be the same for youngsters who could be deprived of those same experiences.

COVID passports would also be classed as another public health preventative measure. These would be used alongside other COVID-19 preventative measures such as the ‘Hands, Face, Space’ TV adverts and campaigns, social distancing measures and wearing face masks. In my opinion, I feel these have been quite impactful in controlling the levels of infections as seen from experience in the National Lockdowns and with use in current, everyday environments such as schools, shops and other public spaces.

After careful research and consideration, I feel there are 2 sides of the argument to whether COVID passports should be implemented or not. It is a beneficial idea because it means individuals can access opportunities such as work. It will make working environments safer and encourage the return back to normality. Additionally, it would mean that individuals can resume travelling to work and even abroad.

However, there are many cons to the idea of COVID passports. There are many new variants emerging such as the Kent variant, the South African variant and the new Indian ‘double mutant’ variant. It is not possible to say whether the COVID Passports would protect against getting infected by those variants. Leading on from this point, giving people access to COVID Passports would mean that people may exploit their freedom. Just because people have had the vaccine does not mean that they can’t transmit the virus; they could still be asymptomatic and pass it to others. Another issue could be discrimination. People who have had the vaccine may presume they may have the ability to do more activities than people who haven’t yet. Others may have refused to have the vaccine for medical reasons or for personal reasons and so as mentioned previously, it is important to address this. If COVID passports are paper based, then there is a risk of fraud or forgery; people may produce fake passports in order to access certain opportunities and this could in turn put the health of other people at risk. Therefore the safety element must be considered.

There are many risks and benefits to this public health measure, so I am not able to formulate a clear side to the argument. However, with more research and scientific information which will be looked into in the coming weeks, I believe a firmer conclusion can be reached."