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Who’s in? Who’s out? The ethics of COVID-19 travel rules

Should countries require COVID-19 vaccination for entry while vaccines remain globally scarce?

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People wait at O. R. Tambo International Airport in Johannesburg, South Africa on Nov. 26, 2021, as many nations moved to stop air travel from the country. AP Photo/Jerome Delay

Omicron, the latest COVID-19 variant dubbed a “variant of concern” by the World Health Organization, has prompted new travel restrictions in many nations. Although little is known about omicron, scientists have expressed concern that it may be more transmissible or vaccine-resistant than previous variants.

On Nov. 26, 2021, the United States joined a growing list of nations banning travelers from countries in southern Africa, where the variant was first identified. The U.S. decision followed another recent change, which went into effect on Nov. 8, 2021, requiring non-citizens entering the U.S. by plane to be fully vaccinated, with limited exceptions. Everyone entering by plane, including citizens, must provide a negative COVID-19 test.

As bioethicists based in the U.S. and Ghana, we explore the intersection of global health and ethics in our research. In the U.S. government’s recent rules for entry, we see far-reaching consequences that should prompt policymakers to consider not just science, but ethics.

Buying time?

There are multiple arguments to support travel rules imposing bans or requiring full vaccination. U.S. policy aims to “prevent further introduction, transmission, and spread of COVID-19 into and throughout the United States,” President Joe Biden said as he introduced the vaccination requirement. He noted that the Centers for Disease Control and Prevention “has determined that the best way to slow the spread of COVID-19, including preventing infection by the delta variant, is for individuals to get vaccinated.”

Ethically, the reason to contain the spread is to protect health and save lives. It could be argued that a country’s first duty is to keep its own people safe. However, many countries manage to protect their people while building in flexibility, such as by testing and quarantining visitors in lieu of travel bans or strict vaccination requirements. France, for example, tailors requirements to infection rates. It considers the U.S. an “orange” country, meaning unvaccinated Americans must show negative COVID-19 tests and self-isolate for seven days.

One argument in favor of travel bans holds that they could slow the spread of the virus and buy time while scientists learn more. Anthony Fauci, the U.S. government’s top infectious disease advisor, reportedly told the president it would take two weeks to have definitive answers about omicron. A travel ban gives scientists more time to assess how well existing vaccines fare against new variants, and to begin reformulating vaccines if needed.

An ethical argument for vaccine requirements is that people should be held accountable for their choices, including refusing vaccination. Yet throughout much of the world, particularly poorer regions, people cannot access vaccines. On average, only 6% of people in low-income countries have received a dose of a COVID-19 vaccine, compared to 74% in rich countries.

Science in flux

Critics of travel bans and vaccine requirements point out that such controls are hardly foolproof. There is scant evidence that travel restrictions reduce disease spread, particularly if they are not timed right and paired with other prevention strategies. Meanwhile, many studies have highlighted the negative consequences of international travel restrictions, such as xenophobia and mental health concerns.

Vaccines are currently highly effective at preventing hospitalization and death from COVID-19. But vaccinated people can still be infected and transmit the virus, although they are less likely than unvaccinated people to be contagious, and less likely to get COVID-19 in the first place. Vaccines could also become less effective if undercut by new virus variants, though it is not yet clear if omicron reduces vaccine efficacy. Finally, there is uncertainty about how long vaccine protection lasts.

Banning travelers in response to omicron is intended to keep people safe. But bans could backfire if they are seen as punitive, and could make countries less likely to share information about new variants. After South Africa reported the omicron variant, its health minister said travel bans had made the country a scapegoat for a “worldwide problem,” while the foreign ministry claimed, “Excellent science should be applauded and not punished.” Targeting African countries with travel bans “attacks global solidarity,” the World Health Organization’s Africa director said in a statement.

A man and woman embrace as she talks on a cellphone in an airport.
Jolly Dave, right, makes a phone call after arriving from India and being reunited with her boyfriend, Nirmit Shelat, at Newark Liberty International Airport, Nov. 8, 2021. The couple has not been able to see one another for nine months due to pandemic travel restrictions. AP Photo/Seth Wenig

Health and justice

Travel bans and vaccine rules also raise equity concerns, given the dramatic disparity in vaccination rates across the globe. Travel restrictions disproportionately impact people from low-income nations where few vaccines are available.

It might appear that requiring vaccination for entry would not leave many people worse off, if people in poorer countries can rarely afford travel. Yet many people traveling to wealthier countries do so for jobs. Pre-pandemic, in 2019, the U.S. issued more than 900,000 work-eligible visas.

Many opponents of travel restrictions emphasize that new variants are not surprising, given how unequally vaccines have been distributed around the globe. When nations in southern Africa protested the new travel ban, they pointed to previous warnings that the delay in rolling out vaccinations there would increase the risk of new variants.

Equity concerns are intensified by wealthy nations’ partial responsibility for poorer nations’ difficulty accessing vaccines. Early in the pandemic, rich countries struck advance market agreements and secured as much as 500% of their predicted vaccine need, exacerbating global vaccine scarcity and bidding up prices.

Wealthy nations pledged 1.8 billion doses of vaccine to low-income nations through COVAX, a global initiative to equitably distribute vaccines. Yet only 14% of them have been delivered, according to The People’s Vaccine, an alliance calling for equal access to COVID-19 vaccines.

[Research into coronavirus and other news from science Subscribe to The Conversation’s new science newsletter.]

Some ethicists have argued that governments should hold off on vaccination requirements for international travelers until there is more universal access to vaccines, or allow alternatives, such as testing or vaccination upon arrival. The U.S. vaccine requirement for visitors does make humanitarian exceptions for travelers from countries where fewer than 10% of people are fully vaccinated. Still, it bars entry to people on a tourist or business visa, and citizens of many low- and middle-income nations where vaccination rates are low, but just above the bar.

Do as I say, not as I do?

The U.S. vaccination requirement also sounds hypocritical, because it does not apply to Americans. Unvaccinated citizens are allowed to reenter the country with a negative test result. Though free COVID-19 vaccines are widely available, just 58% of the U.S. population is fully vaccinated.

In addition, U.S. rules exclude unvaccinated foreigners from countries with far lower COVID-19 rates. The U.S. has about 210 confirmed cases per million people, but excludes unvaccinated people from countries including India (6 per million), Paraguay (8 per million), Cambodia (2 per million) and Zimbabwe (3 per million), although lack of testing may contribute to low case counts.

In our research, we argue global health can be protected by more equitable methods, like following the WHO’s recommendation to delay booster shots until 10% of people in every nation have received first shots; expanding vaccine manufacturing through waiving vaccine patents; and showing solidarity in the global distribution of vaccines by prioritizing countries with low ability to obtain vaccines.

Ultimately, the best way for wealthy nations to protect their own citizens is to vaccinate people across the globe. “If the variant shows up anywhere in the world, you can pretty much count on it being everywhere in the world,” as infectious disease specialist Michael Osterholm told the New York Times. Vaccinating more people reduces the chance of new variants appearing that are impervious to vaccines.

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

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Survey Shows Declining Concerns Among Americans About COVID-19

Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat"…

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Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat" to the health of the US population - a sharp decline from a high of 67% in July 2020.

(SARMDY/Shutterstock)

What's more, the Pew Research Center survey conducted from Feb. 7 to Feb. 11 showed that just 10% of Americans are concerned that they will  catch the disease and require hospitalization.

"This data represents a low ebb of public concern about the virus that reached its height in the summer and fall of 2020, when as many as two-thirds of Americans viewed COVID-19 as a major threat to public health," reads the report, which was published March 7.

According to the survey, half of the participants understand the significance of researchers and healthcare providers in understanding and treating long COVID - however 27% of participants consider this issue less important, while 22% of Americans are unaware of long COVID.

What's more, while Democrats were far more worried than Republicans in the past, that gap has narrowed significantly.

"In the pandemic’s first year, Democrats were routinely about 40 points more likely than Republicans to view the coronavirus as a major threat to the health of the U.S. population. This gap has waned as overall levels of concern have fallen," reads the report.

More via the Epoch Times;

The survey found that three in ten Democrats under 50 have received an updated COVID-19 vaccine, compared with 66 percent of Democrats ages 65 and older.

Moreover, 66 percent of Democrats ages 65 and older have received the updated COVID-19 vaccine, while only 24 percent of Republicans ages 65 and older have done so.

“This 42-point partisan gap is much wider now than at other points since the start of the outbreak. For instance, in August 2021, 93 percent of older Democrats and 78 percent of older Republicans said they had received all the shots needed to be fully vaccinated (a 15-point gap),” it noted.

COVID-19 No Longer an Emergency

The U.S. Centers for Disease Control and Prevention (CDC) recently issued its updated recommendations for the virus, which no longer require people to stay home for five days after testing positive for COVID-19.

The updated guidance recommends that people who contracted a respiratory virus stay home, and they can resume normal activities when their symptoms improve overall and their fever subsides for 24 hours without medication.

“We still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses, this includes vaccination, treatment, and staying home when we get sick,” CDC director Dr. Mandy Cohen said in a statement.

The CDC said that while the virus remains a threat, it is now less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.

Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19,” it stated.

The federal government suspended its free at-home COVID-19 test program on March 8, according to a website set up by the government, following a decrease in COVID-19-related hospitalizations.

According to the CDC, hospitalization rates for COVID-19 and influenza diseases remain “elevated” but are decreasing in some parts of the United States.

Tyler Durden Sun, 03/10/2024 - 22:45

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Rand Paul Teases Senate GOP Leader Run – Musk Says “I Would Support”

Rand Paul Teases Senate GOP Leader Run – Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump…

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Rand Paul Teases Senate GOP Leader Run - Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump into the race to become the next Senate GOP leader, and Elon Musk was quick to support the idea. Republicans must find a successor for periodically malfunctioning Mitch McConnell, who recently announced he'll step down in November, though intending to keep his Senate seat until his term ends in January 2027, when he'd be within weeks of turning 86. 

So far, the announced field consists of two quintessential establishment types: John Cornyn of Texas and John Thune of South Dakota. While John Barrasso's name had been thrown around as one of "The Three Johns" considered top contenders, the Wyoming senator on Tuesday said he'll instead seek the number two slot as party whip. 

Paul used X to tease his potential bid for the position which -- if the GOP takes back the upper chamber in November -- could graduate from Minority Leader to Majority Leader. He started by telling his 5.1 million followers he'd had lots of people asking him about his interest in running...

...then followed up with a poll in which he predictably annihilated Cornyn and Thune, taking a 96% share as of Friday night, with the other two below 2% each. 

Elon Musk was quick to back the idea of Paul as GOP leader, while daring Cornyn and Thune to follow Paul's lead by throwing their names out for consideration by the Twitter-verse X-verse. 

Paul has been a stalwart opponent of security-state mass surveillance, foreign interventionism -- to include shoveling billions of dollars into the proxy war in Ukraine -- and out-of-control spending in general. He demonstrated the latter passion on the Senate floor this week as he ridiculed the latest kick-the-can spending package:   

In February, Paul used Senate rules to force his colleagues into a grueling Super Bowl weekend of votes, as he worked to derail a $95 billion foreign aid bill. "I think we should stay here as long as it takes,” said Paul. “If it takes a week or a month, I’ll force them to stay here to discuss why they think the border of Ukraine is more important than the US border.”

Don't expect a Majority Leader Paul to ditch the filibuster -- he's been a hardy user of the legislative delay tactic. In 2013, he spoke for 13 hours to fight the nomination of John Brennan as CIA director. In 2015, he orated for 10-and-a-half-hours to oppose extension of the Patriot Act

Rand Paul amid his 10 1/2 hour filibuster in 2015

Among the general public, Paul is probably best known as Capitol Hill's chief tormentor of Dr. Anthony Fauci, who was director of the National Institute of Allergy and Infectious Disease during the Covid-19 pandemic. Paul says the evidence indicates the virus emerged from China's Wuhan Institute of Virology. He's accused Fauci and other members of the US government public health apparatus of evading questions about their funding of the Chinese lab's "gain of function" research, which takes natural viruses and morphs them into something more dangerous. Paul has pointedly said that Fauci committed perjury in congressional hearings and that he belongs in jail "without question."   

Musk is neither the only nor the first noteworthy figure to back Paul for party leader. Just hours after McConnell announced his upcoming step-down from leadership, independent 2024 presidential candidate Robert F. Kennedy, Jr voiced his support: 

In a testament to the extent to which the establishment recoils at the libertarian-minded Paul, mainstream media outlets -- which have been quick to report on other developments in the majority leader race -- pretended not to notice that Paul had signaled his interest in the job. More than 24 hours after Paul's test-the-waters tweet-fest began, not a single major outlet had brought it to the attention of their audience. 

That may be his strongest endorsement yet. 

Tyler Durden Sun, 03/10/2024 - 20:25

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While “Waiting” For Deporation, Asylum

The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several…

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several months we've pointed out that there has  been zero job creation for native-born workers since the summer of 2018...

... and that since Joe Biden was sworn into office, most of the post-pandemic job gains the administration continuously brags about have gone foreign-born (read immigrants, mostly illegal ones) workers.

And while the left might find this data almost as verboten as FBI crime statistics - as it directly supports the so-called "great replacement theory" we're not supposed to discuss - it also coincides with record numbers of illegal crossings into the United States under Biden.

In short, the Biden administration opened the floodgates, 10 million illegal immigrants poured into the country, and most of the post-pandemic "jobs recovery" went to foreign-born workers, of which illegal immigrants represent the largest chunk.

Asylum seekers from Venezuela await work permits on June 28, 2023 (via the Chicago Tribune)

'But Tyler, illegal immigrants can't possibly work in the United States whilst awaiting their asylum hearings,' one might hear from the peanut gallery. On the contrary: ever since Biden reversed a key aspect of Trump's labor policies, all illegal immigrants - even those awaiting deportation proceedings - have been given carte blanche to work while awaiting said proceedings for up to five years...

... something which even Elon Musk was shocked to learn.

Which leads us to another question: recall that the primary concern for the Biden admin for much of 2022 and 2023 was soaring prices, i.e., relentless inflation in general, and rising wages in particular, which in turn prompted even Goldman to admit two years ago that the diabolical wage-price spiral had been unleashed in the US (diabolical, because nothing absent a major economic shock, read recession or depression, can short-circuit it once it is in place).

Well, there is one other thing that can break the wage-price spiral loop: a flood of ultra-cheap illegal immigrant workers. But don't take our word for it: here is Fed Chair Jerome Powell himself during his February 60 Minutes interview:

PELLEY: Why was immigration important?

POWELL: Because, you know, immigrants come in, and they tend to work at a rate that is at or above that for non-immigrants. Immigrants who come to the country tend to be in the workforce at a slightly higher level than native Americans do. But that's largely because of the age difference. They tend to skew younger.

PELLEY: Why is immigration so important to the economy?

POWELL: Well, first of all, immigration policy is not the Fed's job. The immigration policy of the United States is really important and really much under discussion right now, and that's none of our business. We don't set immigration policy. We don't comment on it.

I will say, over time, though, the U.S. economy has benefited from immigration. And, frankly, just in the last, year a big part of the story of the labor market coming back into better balance is immigration returning to levels that were more typical of the pre-pandemic era.

PELLEY: The country needed the workers.

POWELL: It did. And so, that's what's been happening.

Translation: Immigrants work hard, and Americans are lazy. But much more importantly, since illegal immigrants will work for any pay, and since Biden's Department of Homeland Security, via its Citizenship and Immigration Services Agency, has made it so illegal immigrants can work in the US perfectly legally for up to 5 years (if not more), one can argue that the flood of illegals through the southern border has been the primary reason why inflation - or rather mostly wage inflation, that all too critical component of the wage-price spiral  - has moderated in in the past year, when the US labor market suddenly found itself flooded with millions of perfectly eligible workers, who just also happen to be illegal immigrants and thus have zero wage bargaining options.

None of this is to suggest that the relentless flood of immigrants into the US is not also driven by voting and census concerns - something Elon Musk has been pounding the table on in recent weeks, and has gone so far to call it "the biggest corruption of American democracy in the 21st century", but in retrospect, one can also argue that the only modest success the Biden admin has had in the past year - namely bringing inflation down from a torrid 9% annual rate to "only" 3% - has also been due to the millions of illegals he's imported into the country.

We would be remiss if we didn't also note that this so often carries catastrophic short-term consequences for the social fabric of the country (the Laken Riley fiasco being only the latest example), not to mention the far more dire long-term consequences for the future of the US - chief among them the trillions of dollars in debt the US will need to incur to pay for all those new illegal immigrants Democrat voters and low-paid workers. This is on top of the labor revolution that will kick in once AI leads to mass layoffs among high-paying, white-collar jobs, after which all those newly laid off native-born workers hoping to trade down to lower paying (if available) jobs will discover that hardened criminals from Honduras or Guatemala have already taken them, all thanks to Joe Biden.

Tyler Durden Sun, 03/10/2024 - 19:15

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