The state will rely on the honorary system for coronavirus protection, without there being any evidence that anyone meets the new requirements for underlying conditions.
(Rick Egan | The Salt Lake Tribune) Julyn Shepherd fills syringes for Utah County residents to get their COVID-19 vaccinations at a former Shopko store in Spanish Fork, Wednesday, January 27, 2021.
Instead, the state relies on the system of honor. It’s an attempt to get shots in the arms as quickly as possible, but it will almost certainly result in abuse, as people find that there are relatively few obstacles that prevent them from jumping forward in the queue.
“It is possible for people to lie if they have one of these underlying health conditions,” Gov. Spencer Cox admitted at a news conference Thursday in which he pleaded with Utahns to play by the rules.
The requirement of paperwork as proof of eligibility would not only significantly delay the process of getting vaccines into the arms of these people, Hudachko said, but it would also place an “unnecessary burden on health workers who would be responsible” be for the provision of such documentation. “
This shift to wider access to vaccines is approaching as the death toll from Utah due to the coronavirus 2000 approaches. But the seven-day average for the rate of positive coronavirus tests has fallen, below the traditional measure of the state – which was still above 10% last week – and the new method which turned around 6% last week. The number of Utahns fully vaccinated with two doses was 225,000 in the middle of the week, and the total is likely to be the highest 250,000 over the weekend.
What happens elsewhere?
As states have larger groups of residents eligible for vaccinations, they have taken different approaches to whether they need paperwork to vaccinate people in a priority group.
While it remains to be seen how well the honorary system will be implemented here, Margaret Battin, a professor of philosophy at the University of Utah, said she wonders if the community influence of The Church of Jesus Christ of Latter-day Saints the success of the policy.
“The teachings of the church … I think it will tend to discourage behaviors like keeping in line,” said Battin, who is also a deputy professor. in the U.’s program for medical ethics and humanities within the Department of Internal Medicine. “Everyone who ‘does the right thing’ and ‘chooses the right’, that kind of moral teaching may play a role in the behavior of many people in this state that may not be so true in a more heterogeneous state like New York. . ‘
Hudachko said the decision was based primarily on feedback from vaccine and health care providers that paperwork needed would be ‘significant bottlenecks’. He said he had not yet been able to make comparisons on which approach was more effective, noting that several states had not yet begun vaccinating people with underlying health conditions.
Who gets the vaccine next?
Utahns 16 and older with certain serious and chronic health conditions can now receive COVID-19 vaccine. Here is a list of the qualifying health conditions, according to the Utah Department of Health:
Recipients of solid organ transplants.
• Certain cancers.
• People who have been immune-boosted (with a weakened immune system) by blood, bone marrow or organ transplants; HIV; long-term use of corticosteroids, or the use of other long-term immunosuppressive drugs.
• Severe kidney disease or dialysis, or with stage 4 or 5 chronic kidney disease.
• Uncontrolled diabetes.
• Severe obesity (body mass index older than 40).
• Chronic liver disease, including chronic hepatitis B or C.
• Chronic heart disease (not including hypertension).
• Severe chronic respiratory disease (except asthma).
• Neurological conditions affecting respiratory function, including Down syndrome, multiple sclerosis, Parkinson’s disease, cerebral palsy, quadriplegia or hemiplegia.
• Stroke and dementia (Alzheimer’s, vascular, frontotemporal).
• Asplenia, including splenectomy or a dysfunction of the spleen, including sickle cell disease.
While the honor system presents its own problems, Jim Tabery, an associate professor of philosophy at the United States, said he thinks the deployment of the vaccine as planned ‘is the’ ethically appropriate way to go ‘.
“Obviously, when you think of something like that, your mind naturally goes to the kind of vaccines or the freezers,” he said. ‘There may be something out there, but the question is: what system are you going to create that will eliminate them? And would that actually be a better system? ‘
He said people with disabilities should be asked to prove they have an underlying health condition, and it could also be a terrible intrusion for people with disabilities, and it could also cause problems accessing the vaccine. For example, people in colored communities of color do not have access to a health care provider to get evidence of their condition, or struggle to get work done to get an appointment.
‘If you’re dealing with someone [in that situation] “who has diabetes and you say, ‘To get the vaccine, we also need confirmation that you have diabetes’, you are in fact asking them to see a doctor they do not have access to,” he said. said. “And it’s likely to guarantee that someone will not have access to a vaccine.”
Up to this point, it has been ‘relatively easy’ for vaccine providers to qualify in Utah, Hudachko noted.
Nevertheless, Salt Lake County Health Department spokesman Nicholas Rupp said there were a few cases where people tried to cheat the system and were turned away at a vaccination site.
“Fortunately, this is not a widespread problem,” he said. “We have misunderstood more and more people to be eligible, but even those are not widespread.”
The province did not take a stand on the use of an honorary system, but Rupp said the health department would follow the instructions of the state and the governor and encourage people to be honest, so vaccination first go for those with the greatest risk of being serious. disease.”
(Rick Egan | The Salt Lake Tribune) A social waiting area for Utah County residents to get their COVID-19 vaccinations at a former Shopko store in Spanish Fork, on Wednesday, January 27, 2021.
In Thursday’s announcement that the vaccines would be available immediately to people with underlying conditions, rather than the date previously planned for March 1, Cox noted that those who now qualify are at greatest risk for hospitalization and death due to COVID -19.
And he encouraged Utahns not to make appointments.
“There are so many more vaccines coming soon, but we are prioritizing these individuals – again based on age and these underlying conditions – because they have the greatest risk of hospitalization or death,” he said. “So if you jump ahead in the queue, it means that there is someone else who will not get the vaccine as soon as possible, and it is quite possible that they may end up in the hospital, or worse, that they will die. “
Those who follow the rules “can sleep well at night knowing that you have not cheated the system, that you are willing to give it to those who need it most”, he added.
As the state opens up vaccination to more people, Tabery said the most ethical thing that those who are not yet eligible can wait their turn.
There are legitimate questions about equity within the deployment of vaccines, he noted. But if an employee in a grocery store says he or she had to be admitted to the latest vaccination round, the way to deal with it is to contact the state leaders to voice the matter – not to correct someone.
If someone were to get into a situation where they happened to be in the hospital or the pharmacy, and the pharmacist or nurse said, ‘Hey, we have an extra dose. It will go to waste if you do not use it, ‘then it would be wrong not to take it,’ he said.
It is likely that many people will do these ethical calculations during this phase of state implementation, but Battin has indicated that social stigma and disapproval of people who cross the line will be the primary defense against that behavior.
Tabery said he expects there will be times when people will cut the vaccine line and that the news, when identified, will make the news.
But he is confident that most Utahns will ‘play by these rules’.
“I think there is a kind of underlying common mentality in the state of Utah that serves it well in such situations,” he said. ‘And so I’m sure there will be lines. I’m sorry they found themselves in a situation where they felt they had to or could do it. But I think they are definitely going to be the exception – not the rule. ”