# Designer viruses as vaccines: yea or nay?

• COVID
Mike S.
By what notion (legal or moral) do you make this EMPHATIC statement ?
It is truly absurd.
Erm, because she DID make that call? She isn't doing nursing now, but the Vaccine Police have not taken her away. And the rest of us are free to think about whether there is a way to negotiate.

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Erm, because she DID make that call?
I owe you an apology I think. I read your comment to mean it was her call whether she, as a nurse, needed to be vaccinated. This is prevailing antivax idiocy.
I also am amazed that she would suddenly realize that as a nurse, certain public health requirements would be obtain. Also I do think your assessment that it is incumbent upon us to go to the societal expense of developing an FDA proven innoculation sceme so that she can be a nurse is more than a little silly. Maybe we could do homeopathy...

russ_watters
Mike S.
"A little silly" describes most things religious; yet the failure to take them into account has the gravest consequences. Russia failed to protect a right to be Catholic in 2002 and look where we are now. Think of religion as a Frank Herbert style "Bureau of Sabotage", that throws monkey wrenches into the plans of all those too eager to scan every face and dictate every diet. If someone, for any reason (even if we think they made it up) declares a deep-seated religious objection to a vaccine, and proves it by substantial career sacrifice, we have to look for every viable alternative. (I understand getting heart patients and 90-year-olds sick is not "viable") So I think we should be looking into methods of serological certification of COVID exposure, and even controlled circumstances for doing that exposure deliberately. That differs from the original headlined "designer virus as vaccine" only in degree: how much risk of transmission are we willing to put up with from these intentional exposures, and do we try to select, culture, or modify the Omicron virus to make it less dangerous before carrying them out?

DaveE and BillTre
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To me, these ideas seem way too intrusive to happen. Serological certification would require getting blood from everyone involved, which many would object to. It would also be expensive in labor and money.
Tracking of who is certified and/or exposed would be a big bureaucratic mess.
What about those were already exposed but not in a well tracked manner?

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If someone, for any reason (even if we think they made it up) declares a deep-seated religious objection to a vaccine, and proves it by substantial career sacrifice, we have to look for every viable alternative.
1st amendment to the US constitution
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

If this person wishes to avoid vaccination, she should not become a nurse. If she doesn't like high places, she should not become a window washer. We are under no obligation, as a government, to provide special redress to ameliorate religious inconvenience for particular devotees. In fact that would be unconstitutional

BillTre
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If someone, for any reason (even if we think they made it up) declares a deep-seated religious objection to a vaccine, and proves it by substantial career sacrifice, we have to look for every viable alternative.
That's fine if the alternatives aren't vastly more expensive or complicated to implement. I don't think most here would disagree with someone taking an alternative route to the same goal if implementing that alternative route is relatively easy and doesn't put others at undo risk. But when it costs more money and generates a big headache to implement then we run into the issue of deciding where to draw the line. Why waste time, resources, and money that doesn't need to be wasted?

The real issue here doesn't even have anything to do with religion. The overwhelming, vast majority of those who object to vaccines are not doing so because of religion, despite what they may claim. They are doing so because they have a skewed understanding of medicine and the government and are often parroting things they've heard in 'echo chambers' online or through their preferred news media. They are claiming religious exemptions simply because it's an easy-to-use reason to not get vaccinated, either through legal means, as in how many states have religious exemptions, or social means, as in it's hard to tell someone their religion doesn't say anything about vaccines without many people seeing you as violating their religious freedoms.

An actual example of accommodating religion would be the inclusion of Kosher/Halal MRE's and fresh meals in the military (source and source). I expect these to be roughly the same cost as other meals and MRE's and to provide similar nutrition, but alas I can't guarantee it without what would probably be an exhaustive search effort on my part.

Dietary restrictions are a long standing tradition in certain religions, vaccine and other medical restrictions are, to my knowledge, not. At least in most western religions. I certainly never heard my grandad preach against anything having to do with modern medicine during my younger years of going to his Church of Christ, nor did I hear it at my childhood Baptist church, or in the protestant church I briefly attended in the military.

With respect, you're suggestion doesn't even accommodate religion. It accommodates misinformation, fear, and arrogance.

Laroxe, DaveE, hutchphd and 1 other person
Mike S.
It accommodates misinformation, fear, and arrogance.
Is that a bad thing? You don't make peace with your friends, and you don't guarantee rights to people who do what you want them to. Universities, rehab clinics, public housing ... most of the infrastructure that makes a society work is meant to provide for those who don't know what they should or aren't able to act on it.

Checking titers hardly seems like a fringe idea. Sometime between alpha and delta I asked the doctor about a shingles shot and she had me get a vial of blood taken instead. She said since the titer was high I could put it off a while and perhaps have better immunity later on. So I'm not thinking of the titer checking as some kind of fringe science! If we can ask refuseniks why Covid is different than polio, they can surely ask us why Covid is different from chicken pox!

BillTre
Gold Member
Checking titers hardly seems like a fringe idea.
The problem with this is that no one knows what the correlates of protection actually are. That is difficult research that will take a long time to do, if it's really possible to know. Also, some "titers", like T-cells, for example, are difficult (expensive) to do. However, this is important research to do as it is how better alternate vaccines must be tested once you have an effective vaccine deployed; it is unethical to give a potentially inferior version and allow severe disease to be your effectivity metric in clinical trials.

Yes, a simple test to see if someone has effective immunity would be great. But it's science fiction at this point and will remain so for a long time.

Finally, I suspect that many who are vaccine resistant wouldn't want to be tested anyway. I don't think that would really address the compliance problem.

BTW, most of what you read in the popular press about measuring antibodies (B-cells, really) to judge vaccine effectiveness or duration is so simplified as to be meaningless crap. Your B-cell response is supposed to wane over time, with other parts of your immune system also providing durable immunity from severe disease.

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If we can ask refuseniks why Covid is different than polio, they can surely ask us why Covid is different from chicken pox!
Yes they can. But that does not mean, for instance, that practitioners of homeopathic medicine should be funded by Medicare. Even if the individual involved really really really believes it works.
As a society, according to our founding documents, we should make decisions to "promote the general welfare" and do so according to legal process. This does not mean that all requests have equal merit. They are due equal consideration on the merit, and an adjudication is made. That is how government works best for the most people most of the time. It is a practical issue, not intrinsically a moral one.

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Drakkith and BillTre
Mike S.
Yes, a simple test to see if someone has effective immunity would be great. But it's science fiction at this point
I feel as if you're almost making an anti-vaxxer argument here. I mean not really, but close. But neutralizing antibodies do correlate strongly with COVID severity. While T cells are important, they tell a bit of an odd story, with at least this report that the cytotoxic T cells are targeting a nucleoprotein that isn't part of the vaccine.

To be sure, the vaccine isn't perfect and that's one reason why I acknowledge this woman. The stats I've seen lately seem to be trending around 50% protection from Omicron infection. (Protection from severe disease may be better, but that doesn't defend innocent bystanders) So a titer doesn't have to be a Delphic oracle to offer bystanders as much protection as a vaccine card, and it does have real meaning. Moreover, well ... we don't have to offer people an absolute guarantee against Covid exposure, because we done gone fouled that up already. If an approach like titers is reasonably likely to be reasonably effective, then instead of going to painful extremes trying to break the anti-vaxxers' spirit, we should tolerate the risk unless and until we see a disaster unfold, and in the meanwhile be doing something a little more productive like trying to spot the strain that comes out of white-tailed deer before it kills us all all over again. Which we're NOT going to do - we've laid off the contact tracers, ended the mask requirements, tied the governors' hands, and boldly whistled our way into the Exclusion Zone pretending nothing bad is ever going to happen with this disease again, knowing full well that isn't true. Is it really such a virtue also to lord it over this lady, while we do all that also, just in order to ensure that our public health people will be hated even more the next time they have to tell us things have hit the fan?

DaveE
Gold Member
I feel as if you're almost making an anti-vaxxer argument here. I mean not really, but close. But neutralizing antibodies do correlate strongly with COVID severity. While T cells are important, they tell a bit of an odd story, with at least this report that the cytotoxic T cells are targeting a nucleoprotein that isn't part of the vaccine.

To be sure, the vaccine isn't perfect and that's one reason why I acknowledge this woman. The stats I've seen lately seem to be trending around 50% protection from Omicron infection. (Protection from severe disease may be better, but that doesn't defend innocent bystanders) So a titer doesn't have to be a Delphic oracle to offer bystanders as much protection as a vaccine card, and it does have real meaning. Moreover, well ... we don't have to offer people an absolute guarantee against Covid exposure, because we done gone fouled that up already. If an approach like titers is reasonably likely to be reasonably effective, then instead of going to painful extremes trying to break the anti-vaxxers' spirit, we should tolerate the risk unless and until we see a disaster unfold, and in the meanwhile be doing something a little more productive like trying to spot the strain that comes out of white-tailed deer before it kills us all all over again. Which we're NOT going to do - we've laid off the contact tracers, ended the mask requirements, tied the governors' hands, and boldly whistled our way into the Exclusion Zone pretending nothing bad is ever going to happen with this disease again, knowing full well that isn't true. Is it really such a virtue also to lord it over this lady, while we do all that also, just in order to ensure that our public health people will be hated even more the next time they have to tell us things have hit the fan?
Wow, you read a lot into my reply that I don't think I said.

The general point of my comment was that we don't know how to do what you want yet. That is all.
Perhaps we should just agree to disagree on that point. Virology is a rather complex subject with many disagreements, which is a good thing, I think (as long as we aren't getting our information from Nurses and Cardiologists on YouTube or prime time news broadcasts ).

I feel as if you're almost making an anti-vaxxer argument here. I mean not really, but close.
I feel as if you're almost insulting my intelligence. I mean not really, but close.

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Is that a bad thing? You don't make peace with your friends, and you don't guarantee rights to people who do what you want them to.
And you don't build a second bridge to an island just because some people mistakenly believe they are going to fall off the existing bridge.

To be sure, the vaccine isn't perfect and that's one reason why I acknowledge this woman.
No vaccine is ever perfect. And if the efficacy of the vaccine was something like 5% then this woman might have a reasonable leg to stand on. But the whole point of the vaccine is to prevent someone from contracting the disease and to reduce the severity and risk of transmission if they still happen to contract it. So a 50% efficacy is still REALLY good compared to just contracting the disease itself.

(Protection from severe disease may be better, but that doesn't defend innocent bystanders)
It does if the reduced severity comes from a reduced viral load, which suggests reduced viral shedding and thus reduced risk of transmission.

If an approach like titers is reasonably likely to be reasonably effective,
But we don't know if it's reasonably likely. That's one of the main issues here. If we don't know how long natural Covid-19 immunity lasts, and the only known reliable way to keep up an immunity is through vaccinations, then having mandatory vaccination requirements for doctors and nurses is reasonable in my opinion.

then instead of going to painful extremes trying to break the anti-vaxxers' spirit, we should tolerate the risk unless and until we see a disaster unfold
This has nothing to do with breaking anyone's spirit.

Is it really such a virtue also to lord it over this lady, while we do all that also, just in order to ensure that our public health people will be hated even more the next time they have to tell us things have hit the fan?
Stop exaggerating. No one's lording anything over this lady. I doubt anyone is toilet papering her house or spamming posts on her social media because she chose not to pursue a career that required a vaccine. Children aren't throwing rotten eggs down from their windows at her while holding their vaccination cards out. She doesn't have a big red AV sewn into her clothing for all to see.

russ_watters, hutchphd, DaveE and 1 other person
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Is it really such a virtue also to lord it over this lady, while we do all that also, just in order to ensure that our public health people will be hated even more the next time they have to tell us things have hit the fan?
I have to ask: what in heck you are talking about ?
The fact that our public health people are hated by some speaks to the rationality of the haters who wish to shoot the messenger. You can't fix stupid.

BillTre
Mike S.
No one's lording anything over this lady. I doubt anyone is toilet papering her house or spamming posts on her social media because she chose not to pursue a career that required a vaccine. Children aren't throwing rotten eggs down from their windows at her while holding their vaccination cards out. She doesn't have a big red AV sewn into her clothing for all to see.
This quote seems absurd to me. She put in a lot of work learning material useful in nursing, at a time when vaccines weren't required. Then she's told it's their way or the highway - for a vaccine that offers no great assurance you won't be infected and spread the virus anyway. Now you don't have to argue with me that her reasons for rejecting the vaccine are wrong. But if you want to try to convince me that getting a house toilet papered or some nasty Twitter posts is worse than having to take another year of school for something else, well, you guys can ride *that* bandwagon without my help.

Let's put it this way: if our efforts are toward *stopping Covid transmission*, and they should be, then we should not interpose any false intermediates between our actions and that goal. It is like idolatry for epidemiologists! If we can make a reasonable assurance that someone is not infectious to the vulnerable people they tend to at the hospital, *by any means* -- preferably by reasonable inferences involving serum titers, or otherwise up to and including them exposing themselves to live Omicron virus under isolation if that's what it genuinely takes to prove they aren't more likely to pass it on to patients later -- then that is good enough. When we fail to see that as a society, it suggests that the agenda of stopping Covid has been replaced -- as it *usually* is -- by an agenda of mindless bureaucratic conformity.

DaveE and BillTre
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She put in a lot of work learning material useful in nursing, at a time when vaccines weren't required.
This seems disingenuous to me.
I would be surprised if there were not some vaccines that were already required before covid.
If not required they would be highly recommended.
The obvious reason would be to prevent disease spread to and from the patient population.
These could easily include (especially where working with newborns or compromised patients):
• Tetanus
• Diphtheria
• Pertussis (Tdap)
• Measles
• Mumps
• Rubella
• Hepatitis B
Anyone entering such a scientifically based field without knowing this is on a fool's errand.

Vaccination is not a
false intermediates between our actions and that goal.
in the control of most contagious diseases.
This is just wrong overstatement in the attempt to make your point.

You have a major unproven assumption, that testing can catch outbreaks before it can spread.
How's that worked out?

Your proposal amounts to: making more work for others, to enable a poorly informed few, to potentially endanger many.

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pinball1970, DaveE, hutchphd and 1 other person
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This quote seems absurd to me. She put in a lot of work learning material useful in nursing, at a time when vaccines weren't required.
I don't know if vaccines are required, but this link from the American Nurses Association shows that vaccination is strongly encouraged at a minimum. To go into a career path while disagreeing with a major tenant of that career path suggests that she did not think things through well enough before spending years of her own time and potentially a large amount of her own money.
Then she's told it's their way or the highway - for a vaccine that offers no great assurance you won't be infected and spread the virus anyway.
A 50% effectiveness for a vaccine designed for a different variant is pretty good assurance in my opinion. And the 80-90% effectiveness for the original variant is about standard for a vaccine.

But if you want to try to convince me that getting a house toilet papered or some nasty Twitter posts is worse than having to take another year of school for something else, well, you guys can ride *that* bandwagon without my help.
Having to take another year of school because you CHOOSE not to take a certain career path is absolutely not an example of having something lorded over you. I made no comment on whether any of my examples were worse than having to take another year of school.

Let's put it this way: if our efforts are toward *stopping Covid transmission*, and they should be, then we should not interpose any false intermediates between our actions and that goal. It is like idolatry for epidemiologists! If we can make a reasonable assurance that someone is not infectious to the vulnerable people they tend to at the hospital, *by any means* -- preferably by reasonable inferences involving serum titers, or otherwise up to and including them exposing themselves to live Omicron virus under isolation if that's what it genuinely takes to prove they aren't more likely to pass it on to patients later -- then that is good enough.
Not allowing non-vaccinated nurses to work in a Covid infested hospital IS part of our best efforts at stopping Covid transmission. That's literally why the vaccination requirement exists.

Your argument here is that we circumvent this requirement as long as we don't put others at undo risk. Which in itself is fine. But like several people have pointed out, there are other factors to consider. The effectiveness of your proposed method is unknown, the time, money, and effort spent to implement it is unknown but unlikely to be negligible, there are issues with how this affects the day-to-day workplace during future outbreaks, and there are ethical issues to consider regarding letting people into a healthcare field when they openly don't fully support what that field considers to be reasonable measures to treat and prevent disease.

No one here is saying your idea is crap, is terrible, is the worst thing ever, that you're stupid for thinking of it, or anything like that. In fact I think it's very nearly reasonable. If we understood immunity a bit better and if testing was cheaper, easier, and more accurate then I think we could justifiably relax vaccine requirements in some fields for those who have already had the disease (assuming effective immunity lasts a significant amount of time of course).

hutchphd, DaveE and BillTre
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There was more but the link would not let me edit. Anyway I was surprised at the numbers and the fact the Government had gone back on it. Potentially that's 120,000 unvaccinated NHS staff.
So that involves staff working with immunocompromised patients? Premature babies? ICU staff.
That situation seems to make the original OP suggestion more palatable in terms of ethics.(tongue in cheek)

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Mike S.
The effectiveness of your proposed method is unknown, the time, money, and effort spent to implement it is unknown but unlikely to be negligible, there are issues with how this affects the day-to-day workplace during future outbreaks

There are unknowns here, yes. But the vaccine also has unknowns. The flip side of all the unknowns is that there is research value. Yes, that sounds ugly when we speak of patients, but they're already in this global science experiment, and it's not like the Covid vaccine we have is a magic bullet that stops all transmission, and we could find out whether infection and serology has results worse or even possibly better than giving a vaccine and assuming it worked.

Similarly the flip side of "day to day workplace" issues if people don't all do exactly the same thing as they're told, is that you solve many of these other day to day workplace issues that come up when they don't.

and there are ethical issues to consider regarding letting people into a healthcare field when they openly don't fully support what that field considers to be reasonable measures to treat and prevent disease.

That sounds far too close to loyalty testing to me. It is one thing to require that they recommend vaccines to patients in accordance with professional medical practice, but to go over their behavior looking for signs of personal beliefs that are deemed subversive ... that's a very different can of worms. Keep in mind what a large proportion of our million American deaths could have been avoided if we had remained a more open society with more respect for freedom of expression -- a society where people would feel free to tell you exactly who in your workplace had Covid when, like they do in China -- and a society where movie cameras would roll footage in the emergency wards and ICUs where people were dying, so that nobody would get silly anti-vaccine notions in the first place! Our society beat people away from the vaccine and public health measures with cudgels, out of bureaucratic inertia and worries over "ethics", and now it tries to beat people back to the vaccine with more cudgels, as if that isn't going to go wrong also.

BillTre
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Our society beat people away from the vaccine and public health measures with cudgels, out of bureaucratic inertia and worries over "ethics", and now it tries to beat people back to the vaccine with more cudgels, as if that isn't going to go wrong also.
You are entitled to your opinion. My opinion is that this is delusional and I haven't a clue what you are talking about. Sorry.

/

BillTre
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and it's not like the Covid vaccine we have is a magic bullet that stops all transmission
It is the closest thing to a magic bullet that we have and it was very effective vs the variant it was designed for.
and we could find out whether infection and serology has results worse or even possibly better than giving a vaccine and assuming it worked.
This is already under investigation. The problem is that it takes time. Time which gives the virus the chance to spread and mutate.
That sounds far too close to loyalty testing to me. It is one thing to require that they recommend vaccines to patients in accordance with professional medical practice, but to go over their behavior looking for signs of personal beliefs that are deemed subversive ... that's a very different can of worms.
Doctor: "I recommend you get vaccinated."
Patient: "I've heard a lot of stuff about the vaccine that makes me worry. Are you vaccinated?"
Doctor: "No."
Patient: "..."
It's not about loyalty. It's about practicing what you preach and keeping patients and staff safe.

Keep in mind what a large proportion of our million American deaths could have been avoided if we had remained a more open society with more respect for freedom of expression -- a society where people would feel free to tell you exactly who in your workplace had Covid when, like they do in China -- and a society where movie cameras would roll footage in the emergency wards and ICUs where people were dying, so that nobody would get silly anti-vaccine notions in the first place!
I have no idea what you're getting at. Our society is far more open with far more freedom of expression than China.
Our society beat people away from the vaccine and public health measures with cudgels, out of bureaucratic inertia and worries over "ethics", and now it tries to beat people back to the vaccine with more cudgels, as if that isn't going to go wrong also.
Again, I don't know what you're getting at. Misinformation and how easy it spreads and is believed is the main reason a large number of people haven't had the vaccine or didn't get it as quickly as they otherwise would have. Bureaucratic inertia and worries over ethics had little to do with it in my opinion.

pinball1970, DaveE and BillTre
Mike S.
I have no idea what you're getting at. Our society is far more open with far more freedom of expression than China.

And yet, people at work can't tell you who had COVID in the office.

Freedom of expression has many dimensions and a society that does poorly in some ways does well in others. For another example, think of how vital Russia's involvement in Libgen and Sci-Hub have been, despite some of that country's other policies.

Mike S.
Doctor: "I recommend you get vaccinated."
Patient: "I've heard a lot of stuff about the vaccine that makes me worry. Are you vaccinated?"
Doctor: "No."

Suppose the doctor (or nurse) is one of the rare people who actually had a bad reaction to a vaccine - maybe an allergy, perhaps even a case of Guillain-Barre. Would you say that doctor should be fired also?

I'll say one thing - as a patient, I'd be a lot less taken aback by a nurse claiming a religious objection to a vaccine, perhaps because fetal cells were used in the research or something, than hearing somebody was at the brink of death from a potentially disabling disease.

Gold Member
Suppose the doctor (or nurse) is one of the rare people who actually had a bad reaction to a vaccine - maybe an allergy, perhaps even a case of Guillain-Barre. Would you say that doctor should be fired also?

I'll say one thing - as a patient, I'd be a lot less taken aback by a nurse claiming a religious objection to a vaccine, perhaps because fetal cells were used in the research or something, than hearing somebody was at the brink of death from a potentially disabling disease.
The Dr should still advise its safe, statistically, that is what the data is showing.

He is a professional and his personal experience should not come into it.
They do tell you all the risks at the vaccination centre and it also in the leaflet they give you

As I mentioned before, the ONE group of people who should trust to give you the best, latest and most objective data with respect to a treatment, drug or vaccine are the medical community.

When they tell you it is not safe then it is probably not safe.

Behind those guys are the scientific community who work all this stuff out and understand it better than anyone, you can trust them as well but its hard enough seeing ones GP these days.

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Suppose the doctor (or nurse) is one of the rare people who actually had a bad reaction to a vaccine - maybe an allergy, perhaps even a case of Guillain-Barre. Would you say that doctor should be fired also?
Surprisingly I had Guillain-Barre five years ago and am triply vaccinated for COVID without incident. Science is our societal stepstone .
Your hypothetical nurse is free to be whomever she wishes as are we all in the home of the brave. She is not free to define societal norms of behavior according to her own "truth". Nor is anyone else. We are collectively allowed to "promote the general welfare" in a way that might impinge upon individual freedoms using due process. Freedom is not free.

/

russ_watters, pinball1970 and BillTre
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Suppose the doctor (or nurse) is one of the rare people who actually had a bad reaction to a vaccine - maybe an allergy, perhaps even a case of Guillain-Barre. Would you say that doctor should be fired also?
Possibly. Perhaps temporarily moved to a different area of work if possible, or relegated primarily to something like video appointments where their risk of catching and transmitting the disease is minimal.

Note that there's a big difference between someone trying and being unable to do something versus someone refusing to do something. You can sometimes stay in the military for years while being unable to perform half of your duties if you've had an illness or injury that makes those duties impossible, but refusal will get you kicked out VERY quickly.

And yet, people at work can't tell you who had COVID in the office.
I doubt this. I'm a disabled vet who doesn't work, but my ex was constantly coming home and telling me that so-and-so at work contracted Covid and was going to be out for a few weeks. Of my close friends that I've talked to recently, most know who has had Covid at their work. My girlfriend's best friends also know who has had Covid at their work.

pinball1970 and hutchphd
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Possibly. Perhaps temporarily moved to a different area of work if possible, or relegated primarily to something like video appointments where their risk of catching and transmitting the disease is minimal.

Note that there's a big difference between someone trying and being unable to do something versus someone refusing to do something. You can sometimes stay in the military for years while being unable to perform half of your duties if you've had an illness or injury that makes those duties impossible, but refusal will get you kicked out VERY quickly.

I doubt this. I'm a disabled vet who doesn't work, but my ex was constantly coming home and telling me that so-and-so at work contracted Covid and was going to be out for a few weeks. Of my close friends that I've talked to recently, most know who has had Covid at their work. My girlfriend's best friends also know who has had Covid at their work.
Same here (UK, my place of work at least) one of us gets it we let everyone know.
EDIT: and not because we have to.

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