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Why Nebraska Governor Excluding Undocumented Workers from Vaccines Is Bad News for the Midwest

Governor Pete Ricketts announced a decision about who can and cannot be vaccinated that is inadvisable and not based upon the best evidence.

Governor Pete Ricketts announced that undocumented workers would be excluded from this batch of vaccines. The rationale was not shared but it is inadvisable and not based upon the best evidence. I can understand the pressure to make constituents happy or that this may appear to be the best choice. Still, the decision is poor and misguided. It is in direct opposition to any potentially sophisticated vaccine strategy. We made this mistake already; we don’t have to make it again.

“Infectious diseases do not respect borders.

-US National Biodefense Strategy

Infectious diseases don’t respect human labels of any kind, be it borders or citizenship. Nebraska residents and those in the states around you will be less safe as a consequence. As most officials in Nebraska well-know, the state has a significant undocumented population. The fact is that regardless of the legality and whether the well-being of these workers concerns the state, they are there and their presence will affect disease control. Ignoring that is at your residents’ and the Midwest’s peril.

Already 5,200 cases and 22 deaths came from 23 separate outbreaks at plants in Nebraska, according to the Midwestern Center for Investigative Reporting. Meat-packing plants will have more outbreaks and it will affect people beyond the worksite, like healthcare workers already burdened by the flow of cases. Perhaps an undocumented worker lives with someone who goes to a long-term care facility starting a massive outbreak that kills residents en masse. If there is any illusion that a virus will distinguish between people, viruses will not.

The state should strive to avoid every case it can, especially given the vast expanse of what we do not yet know. We have found concerning inflammation of the heart and damage to blood vessels in children and young adults with no symptoms. We don’t know what the long-term consequences of that will be, but many viruses had unpredictable consequences years down the road. It is a real possibility and we have just cause to worry.

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Will we someday find it causes premature heart failure? I pray not, but if it should happen, I want you to look back and say you did everything you could to protect the people under your care. Perhaps the decision is well-intentioned and means to prioritize residents, like making a hard choice in war. This is not one of those times. I assure you that this will not be good for your citizens or your neighbors.

In an outbreak, strategic vaccination allows us to gain control of the spread faster. Rather than handing them out to whoever comes first, we can study where and how transmission is happening and find out who we should vaccinate to get the most bang for our buck, as they say.

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By targeting the people going to places where spread happens most, we can have a much larger impact than we would have randomly vaccinating citizens. We know that 5–10% of cases are driving 80% of the cases in the next generation.

Imagine the economic and resource advantage to a state that stops those 5–10% of people or people going to locations that would to infect large numbers of people.

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Meat-packing plants have had major outbreaks because they put people in close proximity indoors for long periods of time. It will not matter whether those people are Americans or not.

A wedding in Maine where 55 people attended with one asymptomatic case resulted in 177 known cases and 7 deaths. None of the people who died had attended the wedding.

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Indeed, people in your state may die, though they are Americans and never set foot in a meat-packing plant. Science brought us the vaccine, but it can also help us reap even more benefit. We have a chance to not repeat our mistakes in forgetting the lesson from our National Biodefense Strategy: Infectious diseases do not respect borders.

Earlier in this crisis, we tried to keep the virus out of the US with a travel restriction placed on China. We knew immediately this restriction would fail, but some looked at the issue as something we could stop at the border or even by only allowing Americans to return. Although we knew the measure would fail before it took effect because the virus was already here, it would have failed for another reason.

We still allowed US citizens and their family to come back, as if being American conferred protection. Of course, it did not. When the policy started on Feb 2, the only thing we kept out was our hope of controlling this. We were foolish then, but we can do better now.

We can base our decisions on evidence rather than emotion or feeling. Continuing to fail is a choice, but so is improving. That will be yours to make.

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Public health biologist studying at Johns Hopkins | Science writer & artist | Views reflect me alone | Subscribe @ Novel-Science.com

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