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For ERS, Covid-19 vaccine opens up challenges and opportunities

A healthcare worker of the free influenza vaccination programme holds a flu vaccine inside a tram, as the global spread of the the coronavirus disease (COVID-19) continues, in Vienna, Austria, October 1, 2020. REUTERS/Lisi Niesner/File Photo

Ahead of the Covid-19 vaccination campaign, the Director of Public Health, Dr Sohail Bhatti, is weighing up the logistical challenges that could arise if Elderly Residential Services residents, staff and visitors were to decline the vaccine.

Whether or not residents, staff and visitors take the vaccine once it is available will be a matter of “freedom of choice”, he said.

But the take-up – in particular for resident and staff – may have implications on how ERS manages its sites in the months ahead.

Dr Bhatti is confident there will be a high uptake in ERS after 92% of residents have had their flu jabs.

He considers vaccination of the eldest in the local community and their carers against Covid-19 as crucial.

To reflect this, over 80s and ERS staff will be the first to be offered a Covid-19 vaccine developed by Pfizer and BioNtech and due to be available in Gibraltar this January.

Dr Bhatti told the Chronicle he expects that the majority of residents and staff will take up the Covid-19 vaccine.

But, he added, if ERS staff decline a vaccine this could pose challenges and could even put into question whether they are safe to work in ERS sites.

“That is a very good rhetorical question that we will need to have a discussion with those people refusing, [and the question] is then how can you be considered to be safe to work with those individuals?” Dr Bhatti said.

Dr Bhatti added that it is a conundrum but that most who are in the field of health care do not wish to do any harm.

“I know the question I would ask if you were looking after my father or mother is, are you safe? If you could conceivably then give them a disease that could kill them, I might have a view on that.”

“It is something we are debating at the moment in health and ERS, how to make it happen.”

“Almost certainly... there’s a question mark here.”

“A person may have a very good reason for not having the vaccine. But I think the duty of care is such that you would not wish to harm the people you are looking after because you are a caring professional. We will need to work that through. Obviously, there are HR issues.”

This comes as ERS is set to reopen, with strict restrictions to avoid any spread of the virus.

As the roll out of a Covid-19 vaccine soon approaches, Dr Bhatti consistently encouraged the public take up the opportunity to get vaccinated.

He stressed that even the eldest in society, the immunosuppressed and cancer patients can have the Covid-19 vaccine.

He reminded people that the vaccine does not contain coronavirus, but rather a molecule that will allow for immunity.

If residents, or their families on their behalf, decline the vaccine this could pose issues for ERS.

Dr Bhatti said it would be difficult to care for someone who has not been vaccinated and is at-risk in ERS.

“That may have an impact on how many visitors are allowed in,” Dr Bhatti said.

“Everyone wants to visit their relative in ERS. The best way to enable that to happen is that you are not bringing the infection in and if we have a cohort of people dotted around ERS that aren’t immune that obviously throws some logistical challenges.”

“I think these are really difficult issues.”

“I’m not in favour of coercing anyone. I think this is a freedom of choice decision, but what people have to be assured of is when you have had the vaccine, then you can say that the likelihood is that you are protected for life from that particular variant [although] the virus can mutate.”

Dr Bhatti added a Covid-19 vaccination may offer potential for further relaxation of visiting restriction in the coming weeks and months, although no decision has been taken on this yet.

“I wouldn’t be surprised if administratively that gave you better access to your relatives,” Dr Bhatti said.

“We are just about to introduce visiting into ERS in the next few days, but that will be severely limited in terms of how often you can visit, who can visit, whereas if you had the vaccine I suspect that some of the restrictions we’ve placed may be loosened.”

The issue, however, is plagued with complexity. Even if someone is vaccinated against Covid-19, that does not rule out that they could be carrying the virus anyway.

“This is worth repeating, the thing to keep in mind is the vaccine will protect you from infection but it won’t, as far as we know because the research hasn’t been done, it doesn’t stop you from hosting the virus to spread it from someone else,” Dr Bhatti said.

“We need to do that research, that research hasn’t been done.”

Until this research is done there would still be restrictions on ERS, he said.