Medical apartheid
Ever since 1952, when Clarence Willcock took the British government to court to force the end of wartime identity cards, UK governments have repeatedly tried to bring them back, always claiming they would solve the most recent public crisis. The last effort ended in 2010 after a five-year battle. This backdrop is a key factor in the distrust that's greeting government proposals for "vaccination passports" (previously immunity passports). Yesterday, the Guardian reported that British prime minister Boris Johnson backs certificates that show whether you've been vaccinated, have had covid and recovered, or had a test. An interim report will be published on Monday; trials later this month will see attendees to football matches required to produce proof of negative lateral flow tests 24 hours before the game and on entry.
Simultaneously, England chief medical officer Chris Whitty told the Royal Society of Medicine that most experts think covid will become like the flu, a seasonal disease that must be perennially managed.
Whitty's statement is crucial because it means we cannot assume that the forthcoming proposal will be temporary. A deeply flawed measure in a crisis is dangerous; one that persists indefinitely is even more so. Particularly when, as this morning, culture secretary Oliver Dowden tries to apply spin: "This is not about a vaccine passport, this is about looking at ways of proving that you are covid secure." Rebranding as "covid certificates" changes nothing.
Privacy advocates and human rights NGOs saw this coming. In December, Privacy International warned that a data grab in the guise of immunity passports will undermine trust and confidence while they're most needed. "Until everyone has access to an effective vaccine, any system requiring a passport for entry or service will be unfair." We are a long, long way from that universal access and likely to remain so; today's vaccines will have to be updated, perhaps as soon as September. There is substantial, but not enough, parliamentary opposition.
A grassroots Labour discussion Wednesday night showed this will become yet another highly polarized debate. Opponents and proponents combine issues of freedom, safety, medical efficacy, and public health in unpredictable ways. Many wanted safety - "You have no civil liberties if you are dead," one person said; others foresaw segregation, discrimination, and exclusion; still others cited British norms in opposing making compulsory either vaccinations or carrying any sort of "papers" (including phone apps).
Aside from some specific use cases - international travel, a narrow range of jobs - vaccination passports in daily life are a bad idea medically, logistically, economically, ethically, and functionally. Proponents' concerns can be met in better - and fairer - ways.
The Independent SAGE advisory group, especially Susan Michie, has warned repeatedly that vaccination passports are not a good solution for solution life. The added pressure to accept vaccination will increase distrust, she has repeatedly said, particularly among victims of structural racism.
Instead of trying to identify which people are safe, she argues that the government should be guiding employers, businesses, schools, shops, and entertainment venues to make their premises safer - see for example the CDC's advice on ventilation and list of tools. Doing so would not only help prevent the spread of covid and keep *everyone* safe but also help prevent the spread of flu and other pathogens. Vaccination passports won't do any of that. "It again puts the burden on individuals instead of spaces," she said last night in the Labour discussion. More important, high-risk individuals and those who can't be vaccinated will be better protected by safer spaces than by documentation.
In the same discussion, Big Brother Watch's Silkie Carlo predicted that it won't make sense to have vaccination passports and then use them in only a few places. "It will be a huge infrastructure with checkpoints everywhere," she predicted, calling it "one of the civil liberties threats of all time" and "medical apartheid" and imagining two segregated lines of entry to every venue. While her vision is dramatic, parts of it don't go far enough: imagine when this all merges with systems already in place to bar access to "bad people". Carlo may sound unduly paranoid, but it's also true that for decades successive British governments at every decision point have chosen the surveillance path.
We have good reason to be suspicious of this government's motives. Throughout the last year, Johnson has been looking for a magic bullet that will fix everything. First it was contact tracing apps (failed through irrelevance), then test and trace (failing in the absence of "and isolate and support"), now vaccinations. Other than vaccinations, which have gone well because the rollout was given to the NHS, these failed high-tech approaches have handed vast sums of public money to private contractors. If by "vaccination certificates" the government means the cards the NHS gives fully-vaccinated individuals listing the shots they've had, the dates, and the manufacturer and lot number, well fine. Those are useful for those rare situations where proof is really needed and for our own information in case of future issues, it's simple, and not particularly expensive. If the government means a biometric database system that, as Michie says, individualizes the risk while relieving venues of responsibility, just no.
Illustrations: The Swiss Cheese Respiratory Virus Defence, created by virologist Ian McKay.
Wendy M. Grossman is the 2013 winner of the Enigma Award. Her Web site has an extensive archive of her books, articles, and music, and an archive of earlier columns in this series. Stories about the border wars between cyberspace and real life are posted occasionally during the week at the net.wars Pinboard - or follow on Twitter.