COVID 19 vaccine mandates: Why the time is now.
I’ve seen this movie before.
It’s Jack Nicholson breaking down the door with an axe, a maniacal grin on his face, sticking his head through the gap to exclaim, “Here’s Johnny!” It’s the Andromeda Strain, an extraterrestrial virus spreading like wildfire as it threatened to exterminate the human race. It’s Michael Myers, the seemingly unstoppable masked killer of John Carpenter’s 10-film Halloween series, returning from the dead for the umpteenth time.
In mid-June, we saw COVID-19 waning. We thought we had it on the run. In Savannah, there were zero COVID-19 patients in the ICUs of our three local hospitals, and the number of COVID-infected patients in our hospitals was in the single digits. The community transmission index in Coastal Georgia was at 43 cases per 100,000—the lowest level in the 18 months since the pandemic began.
But that was then—before the advent of the super-contagious Delta variant, which now comprises over 83% of new COVID infections in the United States.
As of August 4, there were 160 inpatients in Savannah hospitals with COVID-19. Our community transmission index on that date was a whopping 606 cases per 100,000—the highest since January 2021, the month which was our all-time high ( https://covid19.gachd.org/chatham-county-covid-19-data/ ). And here’s the kicker: The vast majority of those hospitalized patients were unvaccinated.
That’s the case all across the country. Nationwide, ~95% of the current COVID-19 hospitalizations are among the unvaccinated (https://www.kff.org/policy-watch/covid-19-vaccine-breakthrough-cases-data-from-the-states/ ). That’s the reason that the current patients hospitalized with COVID tend to be much younger than during earlier spikes in hospitalization—the young are much less likely to be vaccinated. Moreover, they are getting severely ill more quickly, prompting the designation about the new wave of COVID patients as being “younger, sicker, quicker” (https://www.nytimes.com/live/2021/08/03/world/covid-delta-variant-vaccine#doctors-say-unvaccinated-young-adults-are-becoming-more-severely-ill-and-more-quickly ). Unvaccinated patients overall have worse outcomes—they are more likely to be moved to the ICU and are more likely to die. Recently published data show that vaccination results in an eightfold reduction in COVID infection and a 25-fold reduction in hospitalization and death(https://www.washingtonpost.com/context/cdc-breakthrough-infections/94390e3a-5e45-44a5-ac40-2744e4e25f2e/). The currently available vaccines, which were spectacularly effective against infection by the original strains of COVID-19, are also quite effective against the Delta variant (https://www.nejm.org/doi/full/10.1056/NEJMoa2108891). And the currently available COVID vaccines are very safe. For example, anaphylaxis, a treatable allergic reaction, occurs in 2-5 vaccinated persons out of every million and almost always occurs within 15 minutes after administration. Death after COVID vaccination from any cause is extremely rare (0.0019% as of July 26, 2021) (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html). Death after COVID infection, by contrast, occurs in 1-3% of all patients. In other words, you are over a thousand times more likely to die if you get COVID than you are to die of any cause after a COVID vaccination.
For the statistically challenged, that’s a significant difference.
Still, despite mountains of data showing the safety and efficacy of the available vaccines, the pace of COVID vaccination has stalled out across much of America. The state of Georgia has only fully vaccinated 41% of its total population—one of the lowest percentages in the country (the national average is ~58% of those 12 and up). Chatham County is only slightly better, at 42% fully vaccinated; Effingham County is far worse, at only 30% (https://experience.arcgis.com/experience/3d8eea39f5c1443db1743a4cb8948a9c/ ). A recent Gallup poll showed that while 76% of Americans are either vaccinated or plan to be, over half of the remaining 24% say that they are “not likely at all” to get vaccinated under any circumstance (https://news.gallup.com/poll/350720/covid-vaccine-reluctant-likely-stay.aspx). Yet it is that very same stubborn vaccine resistance which has gotten us into the mess we are presently in. Viruses mutate when they are replicating—and they can only replicate inside a living host. If there are no infected persons, variant strains such as Delta cannot emerge.
The bottom line? We could have had control of COVID by now. We had the tools to do so, safe and effective tools developed by our outstanding medical research community. But for reasons that make absolutely no sense from a scientific standpoint, we failed to use them.
It’s past time that changed.
I’ve heard all of the arguments. People prattle on about their “rights,” as though being a public health menace is somehow protected by the Constitution. They cite all sorts of absurd fabricated science fiction about tracking devices and alterations in DNA, none of it based in any version of reality. And frankly, it makes no sense.
Folks, this isn’t about liberty. It’s not a matter of “freedom” or individual choice, like deciding what clothes it’s OK to wear after Labor Day. This is a public health issue. Typhoid Mary didn’t have a “right” to infect people with salmonella. People don’t have a “right” to drive drunk. The “freedom” that we all hold so dear does not extend to one’s right to place others at risk. It’s misguided thought processes like this which have gotten us to this point. And as a health care professional who has had to put my health and the health of my family at risk for the last 18 months, I’m tired of this misguided narrative.
So here’s what is coming: The federal government, local municipalities and large-scale employers like Google, Disney, Walmart and Facebook are about to mandate vaccination among their employees. Mandatory vaccination of U.S. armed services personnel is coming. The American Medical Association and the American Nurses Association also recently called for mandatory COVID vaccination of health care workers (https://www.nytimes.com/2021/07/26/health/health-care-workers-vaccine-requirement.html?referringSource=articleShare ). In New York City, you will soon have to show proof of vaccination to enter all indoor restaurants, entertainment venues and gyms (https://nypost.com/2021/08/03/nyc-to-mandate-proof-of-vaccination-for-many-indoor-settings/). And just in case someone wants to crow about potential legal challenges to such actions, mandates like these are legal, and in no way constitute a violation of HIPAA laws (https://www.nytimes.com/2021/06/09/business/covid-vaccine-employer-rules.html?referringSource=articleShare ).
The health care workers of this country have toiled ceaselessly for the past year and a half to fight the good fight against COVID-19. Out of a sense of duty, we’ve worn N95 masks for 12-14 hours a day, distanced ourselves from our families, cancelled time off, hand sanitized until our knuckles were bleeding, and dealt with the heavy psychological burden of watching COVID 19 do some pretty horrible things to people. Over 3800 health care workers died during the first year of the pandemic alone (https://khn.org/news/article/us-health-workers-deaths-covid-lost-on-the-frontline/ ). Frankly, as one of my ICU colleagues recently said in a poignant piece in the Huffington Post, it’s quite frustrating to care for people who refuse to care for themselves—or others (https://www.huffpost.com/entry/icu-doctor-health-care-workers-unvaccinated-patients_n_6102ad2ae4b000b997df1f17?utm_source=pocket-newtab).
Like the rest of you out there, I want my life back. I want to go to a concert in the new Enmark Arena, eat maskless in a restaurant without paranoia, and scream myself hoarse at the Georgia-Clemson game. Most of all, I want to see an end to senseless death and debility. I don’t want to watch as another 28-year-old gasps for breath despite being on 100% facemask oxygen. I don’t want to tell the family of another 35-year-old in multi-organ failure who is bleeding profusely from an ulcer after a month on the ventilator that there’s nothing more that we can do. Most of all, I don’t want to worry that Violet, my three-year-old granddaughter who cannot be vaccinated yet, will catch COVID from someone at school and end up in the ICU, her precious life potentially cut short even before it starts.
Get your vaccines, folks. It’s past time we ended this.