Wednesday, December 29, 2021

Triage: Prioritize the Vaccinated in ICUs

Each evening for more telecasts that I care to remember I am advised by the nightly national news on CBS, NBC, or ABC that a Covid vaccination and booster shot are the best shield to prevent or minimize becoming a pandemic statistic.


Here’s how Dr. Paul Offit, director of the vaccine education center of Philadelphia’s Children’s Hospital, responded Saturday when NBC’s Kristen Welker asked what viewers should do: “To help stop the spread of Omicron, get vaccinated. It’s simple…There is a ticket out of this. Just get vaccinated.”


Being a rational person I had already taken those steps. So I listen passively as I daily sit through similar admonitions from doctors and infectious disease experts. 


Passively? Not really. I’m actually quite disturbed that in the face of all this advocacy, after time and again seeing an unvaccinated patient regret their decision not to get the shots while imploring other holdouts to roll up their sleeves, I wonder how could millions ignore these pleas? Could it be that they just don’t hear it?


I don’t watch or listen to Fox News, One America News Network or other conservative media so I don’t know if their newscasts carry similar pleas from and to the unvaccinated. I don’t know what they report from medical experts, though I kinda doubt they link up with credible health officials given their reported attacks on Dr. Anthony Fauci, the government’s lead expert on infectious diseases.  


I do know that Fox News commentators like Laura Ingraham and Tucker Carlson have disparaged calls for vaccination and mask mandates. They have contributed to the politicization of medical information. They have engendered medical misinformation and disinformation. 


Having inflamed seeds of distrust in government, the godfather of the vaccines, Donald Trump, has not been able to sway his followers to get inoculated. During recent rally appearances he has been booed after advocating vaccinations.


It has been widely documented that the highest levels of Covid infections occur in counties that voted overwhelmingly for Trump in 2020. 


Sadly, failure to get vaccinated is not confined to Trumpers. It’s prevalent overseas, as well. 


“The inertia (to get vaccinated) comes because they can’t be bothered, because as far as they are concerned the fear of Covid is overblown and affects only the elderly or the chronically sick and vulnerable,” says Dr. Charles Martey of Accra, Ghana.


His solution to overcoming their resistance: “Don’t tell them about the wonders of the vaccine, tell them about the horrors of Covid,” he advised The Clarion, a northern England online news outlet.


I’m not sure that is extreme enough to get their attention. Already, some companies, such as Delta Air Lines, are assessing unvaccinated workers an extra health insurance fee—Delta’s surcharge is $200 a month. Delta saw an uptick in vaccinated employees after the surcharge was announced.

 

Pocketbook penalties might not be enough.


With daily reports that hospitals are overwhelmed, with staff near burnout status, perhaps we need to implement a triage approach: Given a choice between treating a vaccinated patient or an unvaxxed one, admit the former to intensive care. Send the unvaccinated home.


It’s a cruel choice, one made every day on battlefields, scenes of disaster, and emergency rooms. “In medicine, triage is a practice invoked when acute care cannot be provided for lack of resources. The process rations care towards those who are most in need of immediate care, and who benefit most from it,” says Wikipedia. 


In the case of unvaccinated Covid patients, I would add a criterion—having rejected exhortations to get inoculated, even the most dire unvaccinated do not deserve to benefit from the best practices of the medical and scientific communities. 


Government has provided a means to combat the pandemic. To take advantage of the process, individuals must first demonstrate a willingness to be part of the solution. Easily done. As Dr. Offit said, “It’s simple…There is a ticket out of this. Just get vaccinated.”

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