Is it time to end faxing passports? Experts are divided on whether they are still useful

The Vax Divide: ‘We are starting to look at our fellow citizens in a way that they are not equal citizens to us …. And I think that is a very dangerous thing to do’

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McMaster University psychologist and emeritus professor David Streiner is of two thoughts about fax passports.


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He is willing to consider just about anything to convince people to get COVID shots, even charging non-vaccinated people for hospital stays.

“But the passports? They can be a good stick,” he said, “but I’m not sure how effective they are at delaying transfer.” He also worries that passports will create a “me-se” environment that could only get worse if the pandemic continues. “We’ve seen it affect families, split families apart.” Once vaccines were polarized, “every reason went out the window.”

The power of vaccines has always been in the ability to prevent serious illness, hospitalization and death in vulnerable adults. The debate was, do they reduce the risk of transmission?

According to a new and as yet peer-reviewed Canadian study, they do for a short time. But two doses are unlikely to protect against infection by Omicron. By six months after the second dose, “it decreases slightly to, like, zero,” said lead author and Toronto family doctor and epidemiologist Dr. Jeff Fuld.


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His team’s updated data show that effectiveness against infection recovers to about 60 percent after a third dose with an mRNA vaccine. Higher, yes, “but still not great,” and not as high as at Delta.

Fax passports were based on two objectives: to prevent transmission, and to help keep people out of hospitals and alive. At last the shots hold them tight. But it is becoming clearer that they are not completely stopping the transmission and infections, especially wildly infectious Omicron, which leads some to question whether passports are still relevant, and why the issue is not being fully addressed by governments.

“We have not separated in our messages what it is we are trying to achieve,” said Drs. Martha Fulford, an infectious disease specialist at McMaster Children’s Hospital. “And that’s part of the whole confusion.”


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Passports encourage vaccine intake, by making life less convenient for those who intentionally reject the shots, Kwong said. First-dose bookings quadrupled after Quebec expanded its fax certification scheme to cannabis and liquor stores.

But Kwong, a senior scientist at ICES, said that at present, fax passports serve to protect the non-vaccinated. It can be a little tricky to figure out why, exactly. But with the majority of the population having two doses, many people to be able far places with fax passports. “Given the diminished / no effectiveness of two doses, depending on when the last dose was, there is a risk that these people may have an infection, perhaps unknowingly, and pass it on to someone else in such an setting,” he said. Kwong.


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The vaccines are much more likely to develop a mild illness because of their shots. “That they may be more likely to be out and about, despite being infected,” he said. “By excluding all non-vaccinated people from these places, we keep them essentially safer from the infected people, who may be asymptomatically or pre-symptomatically infected with COVID, but may still transmit, especially if everyone has been unmasked. “

“If we drop the fax passports, the non-vaccinated will enter those spaces. At the moment, they may be living the life of a hermit, and they have managed to stay safe. But if we lose fax certificates, they are like sitting ducks. . ”


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Others believe that fax certificates can now even be harmful, “because people think they’re in a safe space – they were pre-Omicron, but not anymore,” wrote Toronto infectious disease specialist Dr. Andrew Morris in one of his COVID weekly e-mails.

“Fax certificates may prove valuable again at some point,” Morris wrote, “but the two main goals – motivating people to vaccinate and protect people by keeping spaces limited for those with a low chance of infection – are clearly no longer relevant.”

There is also a question of how many people should be excluded to prevent one transmission of SARS-CoV-2.

Quebec’s fax passport scheme will eventually require three doses to shop in government-run liquor and cannabis stores, dine indoors or enter gyms, concerts and other venues. Israel has begun rolling out fourth doses for those 60 and older. There is talk of annual shots, as in seasonal flu. Streiner, a professor in the Department of Psychiatry and Behavioral Neuroscience at McMaster, sees risk of push back. “I think we’re at this stage of producing fatigue over it: Okay, I have my two shots, my booster. All enough. Let me get on with my life.”


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Streiner is senior author, the “eminence grise” of a pre-print study that estimates in the pre-Omicron era that at least 1,000 unvaccinated people were likely to be excluded from one SARS-CoV-2 transmission event in the to prevent most species. of settings.

“In the fall, when people were talking about executing mandates, and some of my colleagues who were not vaccinated before termination, I thought to myself, what exactly is the risk reduction gained by termination? of non-vaccinated health workers, “said lead author Dr. Aaron Prosser, a psychiatric resident at McMaster. “And that just leads to a broader exploration into the real numbers behind it.”

The study looked at household settings, social gatherings (meaning more intimate contacts between friends and family), casual close contacts (“the kind of transient, fleeting contact in public areas or buildings,” Prosser said), work and study settings, and travel and transport. For comparison purposes, “Going to a restaurant is probably a mix of a social gathering and risk to public space,” he said.


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The analysis was done when infection rates in Canada and across much of the world were fairly stable. “We were in this between phases of the waves,” Prosser said. “Obviously, infection risks are increasing now. It’s a completely different situation.”

“But I think we need to think carefully about whether or not, in a pluralistic democracy, we are sure that the benefits we can extract (fax mandates and passports) outweigh the harm of creating a class of citizens who may not fully participate in society, “Prosser said.

We begin to look at our fellow citizens in a way that they are not equal citizens for us, because they have made decisions with which we disagree.

Dr. Aaron Prosser

“We are starting to look at our citizens in a way that they are not equal citizens for us, because they have made decisions that we do not agree with. And I think that’s a very dangerous thing to do. “


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New federal modeling released Friday sees an increase in daily hospital stays in the coming weeks. But there are also signs that the Omicron wave could be a peak in Ontario and Quebec, as it seems to be in Britain and the US. “It will come down as fast as it went up,” scientist Ali Mokdad of the University of Washington in Seattle told AP.

The other good news: “Vaccines protect against bad outcomes,” Kwong said. “We have to hang our hats on that.”

Canada is unvaccinated by the figures

Eligible for Canadians 5 and older who are not vaccinated (zero doses): 12%

Eligible are Canadians 5 and older in each province and territory who are not vaccinated:

Alberta: 15.8%

Saskatchewan: 14.1%

Manitoba: 12.6%

Ontario: 12.5%

BC: 11.6%

Rating: 11.6%

Quebec: 10.2%

New Brunswick: 9.7%

Yukon: 9%

Nova Scotia: 8.4%

Prince Edward Island: 7.2%

Northwest Territories: 5.6%

Newfoundland and Labrador: 2.5%

Non-vaccinated men (as of 8 January): 18.3% (of total population)

Non-vaccinated women (from 8 January): 16% (of total population)

Non-vaccinated share by eligible age group:

5-11: 60.5%

12-17: 13%

18-29: 14.3%

30-39: 12.2%

40-49: 10%

National Post, with additional files by Tom Blackwell



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