I begin with the Islamic greeting of ‘May the Peace, Mercy and Blessings be upon you’ What an intensely relevant phrase in today’s world of divisions due to viruses, transmission, policies and restrictions. The science, as always, is in transition, in evolution, and we are still learning about covid-19. The data and the evidence is also being constantly revised and updated yet it is mostly presented as irrefutable fact, the ultimate truth. To question is akin to heresy, to be chastised by your friends, family and fellow professionals. We are living in the era of “You’re either with us or with the enemy”. Discussions on covid have led to ‘splitting’ of society and to question the official narrative makes you a conspiracy theorist.

The medical establishment has not been immune to this splitting. Within the opposing forces of changing
evidence and urgency of the pandemic, what should guide our actions? For a start, first principles need to be consulted. For the medical profession, this must include principles of medical ethics (1). Without their guidance,
it is easy to lose sight of who we serve, why and how we must serve them. What does it say about the state of the profession when it not only complies with, but encourages and promotes breaking of its main principle, Autonomy?

As healthcare professionals, our patients and the populations we serve, expect us to not only raise our
concerns but to oppose draconian measures such as mandatory vaccination mandate for the healthcare staff.
The evidence is very clear. Covid vaccinations do not stop transmission. It may reduce it (2) but again there is
opposing evidence (3,4). How do these translate in the Omicron variant? In either case, it does not stop
transmission. Given this fact, are we professionals, happy to cancel personal autonomy as the main ethical principle? Where will this path lead? What will this mutate into over the next few years? History including from the Nazi era and the Soviet Union warns us that when healthcare professionals disregard medical ethics, massacres occur. Regardless of our views on covid related policies or vaccination, we either oppose loudly and lead our colleagues in healthcare to protect medical ethical principles, or follow the examples of  doctors who ignored these to carry favour with the establishment and become oppressors themselves.

1. Beauchamp T.L., Childress J.F. (2001), Principles of Biomedical Ethics (5th ed). Oxford University Press,
New York, pp 185-187.
2. Eyre, David W et al,, The impact of SARS-CoV-2 vaccination on Alpha & Delta variant transmission. https://doi.org/10.1101/2021.09.28.21264260
3. Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study, SinganayagamA, et al. Lancet Infect Dis Published Online October 28, 2021 https://doi.org/10.1016/ S1473-3099(21)00648-4.
4. Transmission potential of vaccinated and unvaccinated persons infected with the SARS-CoV-2 Delta variant in a federal prison, July—August 2021. Salvatore P, et al. https://doi.org/10.1101/2021.11.12.21265796