As a physician, I’m grateful to be one of the first to be vaccinated against COVID-19, but I never wanted to be one of the only. As vials sit on freezer shelves and trickle out into outstretched arms, thousands continue to die each day. Some lives are chosen over others.
Inside the doors of the hospital, all are similarly exposed to the coronavirus. While doctors and nurses type notes between patients, food service workers walk in and out of rooms taking orders and stacking dishes. Physical and occupational therapists encourage weak and deconditioned limbs. Transporters weave patients throughout the vast network of hallways. Social workers sit at a patient’s bedside. How do we avoid the impossible value judgment that prefers protecting one life over another?
We vaccinate all, and quickly. It's a difficult task, yes. But far from impossible.
Imagine this scenario: I’m called to see a patient in the ER. As I do my examination, it becomes clear the patient is having a stroke. And not just any stroke, something called a basilar artery occlusion. In this terrifying and very real condition, a blood clot suddenly deprives the brainstem of oxygen and nutrients, causing severe damage and even death. The good news? A life-saving treatment exists, called a thrombectomy, a procedure during which the culprit blood clot is pulled from the brain. In many cases, the patient is able to return to a normal life. The catch is, a thrombectomy only works if the stroke is caught early. Once a critical mass of precious brain tissue is damaged, the potential benefit of the procedure is lost.
Now imagine if I saw this patient, fully aware of the diagnosis, but left the ER to continue my day, instead of sounding the alarm bells. That would be unconscionable, a violation of the Hippocratic oath, illegal.
How do we avoid the impossible value judgment that prefers protecting one life over another?
But we find ourselves in a similar situation today. Having partially won a battle against time, having harnessed science to the fullest extent, we are leaving the unvaccinated on the hospital stretcher to die at the 11th hour.
The initial vaccination response started woefully behind schedule. Some improvements have now been made: roughly 1.6 million Americans are now being vaccinated daily. Rates of new infections, hospitalizations and deaths have started to fall.
Still, what we’ve accomplished so far is not enough. Thousands continue to die daily while newer and more infectious strains rear their ugly heads. Production delays, poor infrastructure, vaccine hesitancy and uneven administration among states continue to plague the rollout. Among those lucky enough to receive a dose, disproportionately few are being given to people of color.
If we cannot bring forth solutions, not only do we force ourselves to choose between our health care workers — between nurse and social worker — but we're having to choose between teacher and grocery store clerk, waitress and the taxi driver.
So what is the remedy? We must focus all our efforts on creating a unified federal plan.
So what is the remedy? We must focus all our efforts on creating a unified federal plan. We must involve our private sector by incentivizing wealthy individuals and corporations to help. We must recruit thousands more people to help administer the vaccine, a task that can be taught with minimal training. We must develop and expand strategies to reach vulnerable and hesitant populations such as mobile vaccination sites, and incentivize participation.
This massive effort to inoculate billions already underway will probably trip and stumble forward. But at more than any time in the last 11 months, I'm hopeful.
In our hurry, we must not restrict access only to the highest bidders, or we risk writing yet another chapter in the book of privilege: a book that has previously told of rich countries hoarding medicine away from the Global South. We should advocate for our most vulnerable by making sure our hospitals and governments are effective custodians of this precious medicine.
These days, it sinks in how lucky I was to be one of the first. But I am also angry. My mother, a teacher’s assistant in her 60s who continues to teach in-person, just tested positive for COVID-19.
She was three days from her first vaccine appointment.
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