Many will have heard of Typhoid Mary, but fewer will know her full story – or her real name. That was Mary Mallon, an Irish-born cook who worked for affluent families in the New York City area in the early years of the 20th century. She was employed by eight households, seven of whom contracted typhoid, a nasty bacterial infection that can be deadly. Whenever an outbreak began, she would usually leave without giving a forwarding address, not believing she could be spreading infection because she was never ill herself. The idea that people could carry a disease without displaying any symptoms was a novelty to the medical science of the era. So it took a lot of detective work and a long time before she was identified as what we might now call an asymptomatic super-spreader.
When she was finally tracked down in 1907, she was arrested as a threat to public health, forced into an ambulance by five policemen and sentenced to an enforced quarantine. Doctors discovered massive amounts of typhoid bacteria in her gall bladder. She rejected the suggestion that the infected organ should be removed, the one operation that might have cured her. It was a risky procedure and Mary could not be convinced that she was a carrier.
The authorities of the day were divided about the ethics of imprisoning her. She was released after three years on condition that she would not work as a cook again and take reasonable steps to avoid infecting others with typhoid. She broke that pledge by taking employment, under false identities, in a number of kitchens in restaurants and hotels and, lastly, a hospital. It is thought she infected more than 100 people, but it can’t be said precisely how many deaths she caused. Estimates range between three and 50. Rearrested in 1915, she was placed back in enforced quarantine on a small island in New York’s East River. And that was where she spent the rest of a miserable life until she died 23 years later.
I begin with the story of Typhoid Mary because it is a vivid example of an individual’s liberty coming into conflict with the safety of society when that individual poses a deadly threat to public health. How you react to her story may reveal your preferences when it comes to the argument over vaccine passports. If you think that it was appalling to force this woman into involuntary isolation, then I suspect you react negatively to the idea of placing restrictions on people who have refused to be fully vaccinated against Covid. If your sympathies are with the authorities who locked her up for the protection of the public, then I surmise that you will not quarrel with requiring people to get jabbed if they want to go to places and engage in activities where others will be present.
Some governments have already made their minds up and are legislating for vaccine passports. One of the strictest versions has just gone through France’s legislature. It requires proof of vaccination or a recent negative Covid test to access a wide spectrum of venues. From early August, those who do not possess a pass sanitaire will be excluded from trains, planes, workplaces, restaurants, museums, cinemas and swimming pools. Protesters crying “Liberty!” have been on the streets. Emmanuel Macron responded: “What is your freedom worth if you say to me, ‘I don’t want to be vaccinated’, but tomorrow you infect your father, your mother or myself?”
There’s the debate in a nutshell. One interpretation of liberty, which is solely focused on the rights of the individual, versus another, which pays respects to the rights of others not to have a disease inflicted on them by an unvaccinated carrier. To date, 13 European governments have already introduced, or will soon do so, a “green pass” of some kind. In every case, the plans have been followed by protests.
Britain is different. The opposition to the idea got angry before the government produced anything resembling either an argument for passports or a plan to introduce them. After initially ruling them out, ministers have hesitantly, haphazardly and rather stealthily crept towards embracing them. On “freedom day”, Boris Johnson announced that people would need to prove their vaccination status to get into nightclubs from September. Shortly afterwards, Nadhim Zahawi, the vaccines minister, suggested that requirement would be expanded to cover a broader range of venues, including sports fixtures, music festivals and big exhibitions. Those going to this autumn’s Conservative party conference, not an event noted for its youthfulness, will be required to prove their Covid status.
Ministerial announcements have generated swirls of suspicion about their motives because the government has never consistently articulated its case. Does it believe in passports as an effective tool for preventing infection and allowing as much opening up as possible? Or are ministers using them as a coercive stick to push more people to get themselves vaccinated? Dominic Raab, the foreign secretary, suggested that it was the latter when he remarked: “It is a little bit of coaxing and cajoling.”
Ministers have also exposed themselves to accusations that they are being sly. The NHS app was recently given an unannounced tweak to include a domestic Covid passport section. Trying to introduce them by stealth hands opponents more ammunition to complain that the whole idea is sinister.
On some of the most tricky issues around passports, the government is subcontracting decisions to others. On Friday, Grant Shapps, the transport secretary, said he supported companies that oblige staff to get vaccinated in order to return to the workplace. It was “a good idea”, but not one that the government was going to turn into legislation. The strident opposition of a sizable chunk of Tory MPs means the government will struggle to get any passport law through parliament without Labour support. Absent any law, what employers demand of their employees could vary wildly. The “no jab, no job” rule being implemented by some businesses, with the encouragement of government, has yet to be tested, as it surely will be, in employment courts.
One reason for the unsteadiness of the government’s approach is that ministers are divided among themselves. Another is the opposition of the noisy libertarian right and the rightwing media, which exert a strong gravitational pull on Mr Johnson. The libertarians contend that vaccine passports will fundamentally compromise the freedom of the individual. They do raise ethical issues, which require a proper discussion, but the libertarians are wrong to suggest that the idea is so unthinkable it should not even be a subject of debate. As the challenges and concerns of societies change, so there is a constant adjustment of the boundary between individual freedoms and the responsibilites of the individual to the community in which they live. It used to be the case that you could drive without a seatbelt and while drunk. It used to be the case that you could smoke cigarettes in the office and the pub. When these harmful activities were first made illegal, there was ferocious opposition from libertarians on the grounds that prohibition was an unconscionable assault on individual freedom. No one now seriously argues that you ought to be free to risk the lives of others by drink-driving or puffing toxic fumes into a shared environment. Libertarian opposition to vaccine passports demands a fundamental right to endanger others. They want the freedom of John to refuse a vaccine to trump Joanna’s freedom to travel, work or enjoy her leisure time in safety.
As for Labour, its MPs are divided and its position unclear. Sir Keir Starmer has said that the issue is “really difficult” while remarking that “the British instinct” will be against passports, though polling actually suggests majority public support for them. Trade union leaders are hotly opposed to “no jab, no job” rules in the workplace. Many union members might take a different view about being obliged to work alongside vaccine refuseniks.
Sceptics ask good questions. What rules will apply for those who can’t be vaccinated for health reasons? Will policing be effective and consistent? How vulnerable will passports be to cheating? There are legitimate anxieties, which the government has yet to answer.
The wrong way to try to introduce vaccine passports is in the incoherent and stealthy fashion recently displayed by ministers. The right way is to clearly articulate their case and demonstrate that the effort is worth the reward because they will make it safer to reopen and save lives.