Op-Ed: As a doctor in a COVID unit, I’m running
out of compassion for the unvaccinated. Get the shot
BY ANITA SIRCAR
AUG. 17, 2021 9:28 AM
PT
My patient sat at the edge of his bed gasping for air while he
tried to tell me his story, pausing to catch his breath after each word. The
plastic tubes delivering oxygen through his nose hardly seemed adequate to stop
his chest from heaving. He looked exhausted.
He had tested
positive for the coronavirus 10 days ago. He was under 50, mildly hypertensive but
otherwise in good health. Eight days earlier he started coughing and having
severe fatigue. His doctor started him on antibiotics. It did not work.
Fearing his
symptoms were worsening, he started taking some hydroxychloroquine he had found
on the internet. It did not work.
He was now experiencing shortness of breath while doing routine
daily activities such as walking from his bedroom to the bathroom or putting on
his shoes. He was a shell of his former self. He eventually made his way to a
facility where he could receive monoclonal antibodies, a lab-produced transfusion
that substitutes for the body’s own antibodies. It did not work.
He finally
ended up in the ER with dangerously low oxygen levels, exceedingly high
inflammatory markers and patchy areas of infection all over his lungs. Nothing
had helped. He was getting worse. He could not breathe. His wife and two young
children were at home, all infected with the virus. He and his wife had decided
not to get vaccinated.
Last year, a case like this would have flattened me. I would
have wrestled with the sadness and how unfair life was. Battled with the angst
of how unlucky he was. This year, I struggled to find sympathy. It was August
2021, not 2020. The vaccine had been widely available for
months in the U.S., free to anyone who wanted it, even offered in drugstores
and supermarkets. Cutting-edge, revolutionary, mind-blowing, lifesaving
vaccines were available where people shopped for groceries, and they still didn’t
want them.
Outside his
hospital door, I took a deep breath — battening down my anger and frustration —
and went in. I had been working the COVID-19 units for 17 months straight, all
day, every day. I had cared for hundreds of COVID patients. We all had, without
being able to take breaks long enough to help us recover from this unending
ordeal. Compassion fatigue was setting in. For those of us who hadn’t left
after the hardest year of our professional lives, even hope was now in short
supply.
Shouting
through my N95 mask and the noise of the HEPA filter, I introduced myself. I
calmly asked him why he decided not to get vaccinated.
“Well, I’m not
an anti-vaxxer or anything. I was just waiting for the FDA to approve the
vaccine first. I didn’t want to take anything experimental. I didn’t want to be
the government’s guinea pig, and I don’t trust that it’s safe,” he said.
“Well,” I
said, “I can pretty much guarantee we would have never met had you gotten
vaccinated, because you would have never been hospitalized. All of our COVID
units are full and every single patient in them is unvaccinated. Numbers don’t
lie. The vaccines work.”
This was a common excuse people gave for not getting vaccinated,
fearing the vaccine because the Food and Drug Administration had granted it only emergency use authorization so far,
not permanent approval. Yet the treatments he had turned to — antibiotics, monoclonal
antibodies and hydroxychloroquine — were considered experimental, with mixed
evidence to support their use.
The only
proven lifesaver we’ve had in this pandemic is a vaccine that many people don’t
want. A vaccine we give away to other countries because supply overwhelms
demand in the U.S. A vaccine people in other countries stand in line for hours
to receive, if they can get it at all.
“Well,” I said, “I am going to treat you with remdesivir, which
only recently received FDA approval.” I explained that it had been under an EUA
for most of last year and had not been studied or administered as widely as
COVID-19 vaccines. That more than 353 million doses of COVID-19 vaccine had been
administered in the U.S. along with more than 4.7 billion doses worldwide without
any overwhelming, catastrophic side effects. “Not nearly as many doses of
remdesivir have been given or studied in people and its long-term side effects
are still unknown,” I said. “Do you still want me to give it to you?”
“Yes” he
responded, “Whatever it takes to save my life.”
It did not
work.
My patient
died nine days later of a stroke. We, the care team, reconciled this loss by
telling ourselves: He made a personal choice not to get vaccinated, not to
protect himself or his family. We did everything we could with what we had to
save him. This year, this tragedy, this unnecessary, entirely preventable loss,
was on him.
The burden of
this pandemic now rests on the shoulders of the unvaccinated. On those who are
eligible to get vaccinated but choose not to, a decision they defend by
declaring, “Vaccination is a deeply personal choice.” But perhaps never in
history has anyone’s personal choice affected the world as a whole as it does
right now. When hundreds and thousands of people continue to die — when the
most vulnerable members of society, our children, cannot be vaccinated — the
luxury of choice ceases to exist.
If you
believe the pandemic is almost over and I can ride it
out, without getting vaccinated, you could not be more wrong. This
virus will find you.
If you believe I’ll
just wait until the FDA approves the vaccine first, you may not live to see
the day.
If you believe if
I get infected I’ll just go to the hospital and get treated, there is
no guarantee we can save your life, nor even a promise we’ll have a bed for you.
If you
believe I’m pregnant and I don’t want the vaccine to affect me, my baby
or my future fertility, it matters little if you’re not alive to see
your newborn.
If you
believe I won’t get my children vaccinated because I don’t know what
the long-term effects will be, it matters little if they don’t live long
enough for you to find out.
If you believe I’ll
just let everyone else get vaccinated around me so I don’t have to, there
are 93 million eligible, unvaccinated people in the “herd” who think the same
way you do and are getting in the way of ending this pandemic.
If you
believe vaccinated people are getting infected anyway, so what’s the
point?, the vaccine was built to prevent hospitalizations and deaths from
severe illness. Instead of fatal pneumonia, those with breakthrough infections
have a short, bad cold, so the vaccine has already proved itself. The
vaccinated are not dying of COVID-19.
SARS-CoV-2,
the virus that causes COVID-19, has mutated countless times during this
pandemic, adapting to survive. Stacked up against a human race that has
resisted change every step of the way — including wearing masks, social
distancing, quarantining and now refusing lifesaving vaccines — it is easy to
see who will win this war if human behavior fails to change quickly.
The most
effective thing you can do to protect yourself, your loved ones and the world
is to GET VACCINATED.
And it will
work.
Anita Sircar
is an infectious-disease physician and clinical instructor of health sciences
at the UCLA School of Medicine.