Vaccine Passports and COVID-19: Ethical, Scientific, and Practical Considerations

Shreya Nalubola

Abstract
The COVID-19 pandemic has drastically limited international travel. Now that vaccines have been developed, many countries are considering ways to rework lockdown restrictions so that travel may resume. One proposed strategy involves the implementation of vaccine passports, which would allow those with digital or physical certification of COVID-19 vaccination to resume unrestricted travel. The introduction of such passports involves a number of important ethical, scientific, and legal considerations. This piece aims to elucidate some of the challenges and consequences regarding the use of vaccine passports, such as practical concerns about the length of vaccine immunity and post-vaccine viral transmissibility. Vaccine passports may also have damaging effects on those without adequate vaccine access, especially given the context of COVID-19 having already exacerbated harm towards disadvantaged and minority communities.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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To Tolerate No Harm: Medical Documentation of Excessive Use of Force by Police

Huzefa Diwan

Abstract
Over the past year, the death of George Floyd and the recent shooting of Jacob Blake, among countless others, by police have ignited massive protests against systemic racism and police brutality. Numerous instances of excessive use of force by law enforcement against protestors started conversations about the role of police in our communities. Police brutality, especially against minorities, is a well-discussed phenomenon and yet the medical documentation of such events is often rare or inaccurate. Hospital personnel, especially physicians, need to document these instances to help create a public record of excessive use of force by police. By crafting a framework in the medical ethics concept of justice, physicians can begin training to report police brutality when it appears in their emergency departments and help to eliminate one facet of systemic racism.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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The Impact of COVID-19 on Farmworkers: With Special Focus on the Black Dirt Region (Orange County, NY)

Brinda Raval

Abstract
This paper explores how COVID-19 has impacted farmworkers and demonstrates the way a community in the Mid-Hudson region of New York State, the Black Dirt area, has responded. It provides both a historical and sociological framing of the global systems of food production and a discussion of the vulnerabilities of H-2A workers. The main challenges seen in the Black Dirt region included crowded living conditions, fear of testing and/or sickness due to immigration status, financial instability, food insecurity, and transportation challenges.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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The Roots of the Pandemic: How Structural Racism Facilitated the Spread of COVID-19 in Marginalized Communities

Yazan Nagi

Abstract
The COVID-19 pandemic dramatically reshaped the world we live in and how we interact with it, and although its disastrous impact may have been shocking and unexpected to some, its effects continue to operate along very distinct patterns that have existed for centuries. The pandemic exposed the deep-seated inequalities in wealth, health status and access that exist and define daily life in the United States especially to many of its most marginalized groups.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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Pharmaceutical Development and Importation during the COVID-19 Pandemic

Holly Grace

Abstract
The purpose of this paper is to draw attention to the United States’ policies on drug importation and to raise awareness of the current process for obtaining treatment and prevention pharmaceuticals from foreign countries. Pharmaceutical importation has been a subject of global health and economic concern for many years, but it has heightened in intensity with the COVID-19 pandemic. There are concerns regarding government approval, quality regulations, and scarcity. The need for rapid mass production in order to meet the global demand while balancing the risks associated with rushing medical advances are highlighted. Resource-scarce nations will require support to combat the spread of the COVID-19 virus, and companies will face pressure to rush safety procedures. This article explores some of the impending issues facing the importation of pharmaceuticals during the COVID-19 pandemic, and it aims to express the need for ethical and compassionate consideration when dealing with a response to a global health crisis.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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The Erosion of American Faith in Science: Implications for COVID-19 Vaccination Efforts

Elias H. Kahan

Abstract
As the prospect of a viable COVID-19 vaccine becomes imminent, many are concerned that large swaths of the American public will opt out of being vaccinated. Whether it be due to their anti-vaccination beliefs or their concern regarding the speed and efficacy of its development, steps must be taken to improve Americans’ confidence and likelihood to get vaccinated. If measures are not taken, and many Americans chose not to get vaccinated, the development of a vaccine may be moot.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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Combating Systemic Racism in Medicine Requires Systemic Change: Addressing Implicit Bias in Medical Schools

Alexandra Schulz

Abstract
Over this past year, systemic racism has proven to be a pertinent problem in our society, revealing itself in forms of police brutality and healthcare inequality in the COVID-19 pandemic. One important step in addressing these issues is confronting implicit racial biases, our unconscious attitudes and stereotypes that may further perpetuate systemic racism. This article underscores the need for strategic and impactful implicit bias training in medical education. Medical students must become aware of their own implicit racial biases, and learn about racial injustice in the medical system in pre-clinical training so that they are prepared to combat systemic racism throughout their careers.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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Telemedicine, PPE, and COVID-19: A New Paradigm for the Patient-Physician Relationship

Justin Lapow

Abstract
The COVID-19 pandemic has altered multiple aspects of healthcare delivery. Both the ubiquitous use of personal protective equipment (PPE) and the rise in virtual telemedicine visits have challenged the ability for healthcare providers to communicate effectively, which could in turn impact the patient-physician relationship. That being said, each of these changes to traditional healthcare delivery have been necessary in providing safe and effective health care throughout the pandemic. Likewise, the vast benefits of telemedicine are now recognized more than ever and indicate that virtual healthcare will be here to stay. One challenge for clinicians is understanding how to maintain effective communication, both verbally and nonverbally, as well as a strong patient-physician relationship. This piece assesses some of the strengths and limitations of these changes to healthcare and what clinicians can do to maintain effective communication.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1
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Letter from the Editor-In-Chief

Rajkumar S. Pammal

Dear Readers,

2020 has been marked by simultaneous watershed moments: the COVID-19 pandemic, social unrest related to anti-black racism, and historic participation in this year’s U.S. Presidential Election. Conversations on healthcare, policy, and fundamental human rights have been central to these topics. Clearly, the medical field does not exist in a vacuum, and it is crucial for today’s physicians to understand the social, economic, and political factors that influence the health of their patients and their ability to care for them. The Roundtable Journal on Health Policy (RJHP) aims to provide medical students with a platform to engage with such themes.

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How Losing Your Job Might Impact Your Health

Samuel Dresner

 

Abstract
Using data from the Medical Expenditure Panel Survey, the impact of job loss on healthcare utilization is evaluated. Employment is often tied to insurance and the economic theories about how job loss might impact healthcare utilization. The major conclusion from this study is that job loss seems to increase utilization of health care through its intermediate impact on worsening health outcomes.  This is an intriguing finding especially since an initial hypothesis was that job loss leads to negative health outcomes through the mechanism of loss of insurance.

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Roundtable Journal on Health Policy  |  Volume 2  |  Issue 1

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