by Toby Young
The thing I’ve missed the most during England’s three consecutive lockdowns is going to see QPR with my son Charlie. The last time we went to a game was on February 24th 2020. It now looks fairly probable (60:40) that fans will be readmitted to stadiums in August, although there are still a lot of unknowns, such as whether clubs will have to put a cap on the number of fans they admit, whether away fans will be admitted, whether fans will be shut out again if there’s a winter resurgence of the virus, and so on. One way to mitigate these risks, according to an open letter sent to the Government by various sporting bodies last week, including the Premier League and the English Football League, is to make admission to stadiums and other sporting venues contingent on the production of a ‘Covid Status Certificate’ (CSC) and the Department of Digital, Culture, Media and Sport (DCMS) has set up a ‘taskforce’ to evaluate this proposal. It is expected to make a recommendation shortly, although it may fudge it and recommend that the decision is left to individual clubs, with those that reject vaccine passports being told to limit stadium capacity to 25% – or something. I’m not in favour, obviously.
The strongest objection to making access to any service or activity contingent on producing evidence that you don’t have an infectious disease is that it’s an inversion of the Common Law principle that everything should be permitted unless the law specifically prohibits it. It’s more in keeping with the Napoleonic Code, i.e., you are only free to do that which the law explicitly permits. As a freeborn Englishman, I prefer the Common Law tradition to the Continental one and that was one of the reasons I supported Brexit.
Incidentally, I think the Common Law principle is consistent with allowing sporting clubs/businesses to decide for themselves what hoops to make customers jump through and if the Government’s position is to leave the matter to them to decide I’ll have no objection. Provided, that is, they don’t penalise them for rejecting a certification scheme.
One difficulty the Government would get into if it did insist on making access to sporting venues contingent on producing a CSC is that it would be discriminatory. I don’t just mean it would discriminate against those people who haven’t been vaccinated or who can’t otherwise demonstrate they are unlikely to be infectious, but, by extension, against those groups who are more vaccine hesitant or cannot afford alternative forms of Covid certification.
We know from research studies that vaccine hesitancy is higher among black, Pakistani and Bangladeshi populations in the UK compared to people from a white ethnic background. (See this article in the BMJ for chapter and verse.) Of course, there are alternative ways of demonstrating you’re un-infectious for those that are vaccine hesitant, such as getting a PCR test, but these are either inconvenient to get for free or expensive. The most inexpensive commercially available PCR test costs £120 at Boots and an unvaccinated football fan would have to get it redone before every fixture. For those who’ve had COVID-19, there’s the option of getting a commercial antibody test, but the NHS doesn’t make them available for free at present unless you work in primary care, social care or education. If you want to get one commercially, they are expensive as well. I have had COVID-19 and got an Abbott blood test that shows I have antibodies and it cost about £170.
So, if the Government does insist on a CSC scheme for sporting venues it would be introducing a measure that, in effect if not intention, discriminates against BAME populations and the less well-off. Surely, those groups face enough hurdles when it comes to fully participating in British sport without the Government creating more? The Equalities and Human Rights Commission has even suggested that such a scheme could be unlawful.
Another consideration is that we don’t yet know about all the adverse effects of the Covid vaccines, but the fact that the AstraZeneca vaccine has been linked with cerebral venous thrombosis and other coagulation disorders, and the Government has now recommended that those under 30 should not take the AZ vaccine and may go on to recommend that people under 40 should not take it either, should give the DCMS pause for thought. (Incidentally, this also means the Government would be discriminating against young people if it insists on a CSC scheme.)
This goes to the ethics of introducing vaccine passports more widely. Should the Government make access to any services or activities contingent on producing a CSC, given that that will inevitably mean the uptake of the Covid vaccines is far greater, when there is still some uncertainty about the adverse effects of those vaccines? It is one thing for the Government to buy vast quantities of the vaccines and encourage people to have the jab, but quite another for the Government to create powerful incentives for people to get vaccinated. If, for instance, the AZ vaccine does turn out to have significant adverse effects – as the Swine Flu vaccine Pandemrix did – the fact that the Government had put a CSC scheme in place would be hard to forgive. Public trust in politicians is low enough as it is, but it would fall off a cliff after that. I accept that the risk is quite small, but the consequences of that risk materialising would be catastrophic.
There are also practical considerations. Is the Government confident that NHSX will be able to develop an app in time for the start of the 2021-22 football season – or the Euros – that would make a CSC scheme workable? Given NHSX’s track record, I would say it’s more likely than not that an NHS app that facilitates a CSC scheme will not be ready by August or indeed at any time before the end of the year. But in the absence of a working app, how will sports fans demonstrate to the stewards at the gates that they’re un-infectious? If the Government insists on a CSC scheme that is contingent on NHSX getting its act together, the risk is that sporting venues will have to remain closed to fans for the rest of this year and probably for some part of the next. It would defeat the object of the exercise in other words. (If sporting venues had to rely on a more cumbersome form of proof, that could create bottlenecks outside stadiums where social distancing isn’t possible.)
There’s also a risk that when the NHSX app does come on stream it will be ‘leaky’, i.e., vulnerable to being hacked by identity thieves, as our in-house technology correspondent pointed out last week. Should the Government force a scheme on sports clubs that might well lead to massive data breaches?
You might think all these risks are acceptable because the risk of allowing sporting venues to reopen in full absent a CSC scheme would be greater. But if you’re talking about an increased risk of Covid transmission, there isn’t much evidence of that.
- A systematic review of five studies found that “a low proportion of reported global SARS-CoV-2 infections occurred outdoors (<10%)”.
- A rapid review of 14 sources of evidence “found very few examples of outdoor transmission of COVID-19 in everyday life among c. 25,000 cases considered, suggesting a very low risk”. There are some caveats, however. And the study was funded by a sporting organisation.
- A recent Italian study concludes that “the probability of airborne transmission due to respiratory aerosol is very low in outdoor conditions”.
- Official figures in Ireland show that, of the “232,164 cases of COVID-19 recorded in the state up to March 24th this year, 262 were as a result of outdoor transmission, representing 0.1% of the total”.
- The Chief Medical Officer Chris Whitty said last year, “The evidence is very clear that outdoor spaces are safer than indoors”. And the BBC science journalist concluded: “All the evidence points to the vast majority of Covid infections happening indoors.”
- A paper by the PHE Transmission Group notes: “Evidence continues to suggest that the vast majority of transmission happens in indoor spaces; recent reviews considering data from several countries found very little evidence of outdoor transmission for SARS-CoV-2, influenza or other respiratory viruses.”
- Prof Mark Woolhouse, a member of SAGE, told MPs: “There were no outbreaks linked to public beaches. There’s never been a COVID-19 outbreak linked to a beach, ever, anywhere in the world, to the best of my knowledge.”
- There was a study claiming that the Sturgis Biker Rally in South Dakota caused 266,796 cases. However, that event isn’t particularly relevant since it involved both indoor and outdoor gatherings. And in any case, the study has been heavily criticised.
- This study from early cases in China found only one outbreak (of two cases) out of a sample of 7,324 infections that could be traced to an outdoor setting.
- The Cheltenham Festival on March 10th-13th of last year, which drew crowds of around 250,000 people, has entered folklore as a “superspreader event”, but in fact the evidence that it led to a spike in infections in the locality is threadbare. As the Racing Post pointed out in April 2020, Gloucestershire was one of the parts of the UK least affected by Covid: “HSJ statistics for reported COVID-19 positive deaths in England per 100,000 people put Gloucestershire comfortably in the bottom half of a table headed by The Black Country and West Birmingham. … Gloucestershire actually has a lower number of confirmed COVID-19 cases than surrounding counties – the south west itself is very low and within that Gloucestershire is below average.”
- At the time, the Chief Scientific Officer Sir Patrick Vallance said that the chances of contracting the disease by attending large outdoor sports gatherings were slim.
- And if, as both the CMO and the SCO maintained, the risk of outdoor transmission was low last year, it is even lower now that >95% of the over-65s have received at least one vaccine, as have >90% of the extremely clinically vulnerable. And by August, when the next football season begins, it’s likely that >90% of the adult population will be vaccinated. (Scientists at UCL maintain that the UK has already achieved herd immunity.)
You might argue that the vaccines aren’t 100% effective, but that, surely, is an argument for not introducing a CSC scheme rather than insisting on one? In a recent modelling exercise for SAGE, a team from the London School of Hygiene and Tropical Medicine assumed the AZ vaccine would reduce transmission by just 31% (although subsequent observational studies have put it much higher). But if that assumption is correct, there’s little point in insisting on a CSC scheme since anyone who is allowed into a stadium because they’ve received the AZ vaccine will not, in virtue of that fact alone, be likely to be un-infectious – and, indeed, the existence of the CSC scheme might lull some attendees into a false sense of security. If, by contrast, the Covid vaccines are highly efficacious, as we have good reason to believe, there would also be little point in introducing a CSC scheme since >90% of those most vulnerable to COVID-19 in the stadium would be vaccinated and therefore protected from the disease.
In short, an evidence-based cost-benefit analysis indicates that the social and other risks associated with introducing a CSC scheme would be greater than the public health risk of not introducing one.
There’s one more argument – and that seemed to be the one hinted at in last week’s letter to the Prime Minister from the Premier League et al. This argument goes that even though there’s no public health reason for introducing vaccine passports, the majority of the population wrongly believe that there is and, therefore, to induce fans back into stadiums, as well as persuade matchday staff and the wider public that reopening them is safe, football clubs will have to insist that no one can be admitted unless they’ve got the digital equivalent of a St Christopher’s pendant.
I’m not convinced by that, obviously. Surely, the best way to alleviate the public’s irrational fear of COVID-19 is not to pander to it, but to tell people the truth about the negligible risk of outdoor transmission, particularly after the vast majority have been vaccinated?
Having said all this, I’m not naive enough to believe the Government will be guided by logic and reason when it comes to a decision about vaccine passports. Consequently, if it is going to insist on some crackpot scheme – and that seems almost inevitable – could it at least be as modest as possible? How about limiting it to indoor sporting venues, or just those parts of the country where ICU occupancy is above the five-year average for the month? In those areas, a CSC scheme could be introduced and, for sporting fixtures where fans are likely to travel from those areas, a CSC scheme could be put in place for away fans only. But any such schemes should be strictly time-limited and be scrapped once the risk of infections, hospitalisations and deaths falls to an acceptable level, e.g. the level associated with seasonal influenza.
In addition, would it be too much to ask the Government to monitor the risk of allowing sporting venues to reopen in other parts of the world without an accompanying CSC scheme, such as in Texas and Florida? If the data indicates that such reopening has not caused any significant spike in infections, could the Government then review any CSC scheme it has put in place?
But why wait? Why not just look at the data from the NFL Super Bowl, which took place in Florida on February 7th, at the height of the ‘second wave’? 25,000 fans were admitted, along with 12,000 staff, and even though only a third of fans had been vaccinated at the time, health officials have only found three people who were infected as a result of attending the game. Three in 37,000. Why don’t the clubs tell that to the fans if they’re worried they’ll be too paranoid to come to games if they’re not asked to show vaccine passports at the gate? I reckon most of us will happily take those odds. Three in 37,000 sounds a lot like QPR’s win rate for the last few seasons.
Will Jones, Noah Carl and Glen Bishop contributed arguments and data to this piece, but, needless to say, any mistakes are my own.