You can hear it in their voices:
“My apologies for calling so late. We had a number of critical cases late in the day and I’m just now getting off service.”
“Sorry it took me so long to get back to you. I had a bunch of emergencies come in the door since we last talked.”
“I’ve been in nursing for over 30 years and never seen anything this bad.”
“Dr. Meyers, it’s rough. We’re doing everything we can, but we’re just barely staying on top of it.”
These are dedicated health care professionals, people who have devoted their lives to helping others. And they are depleted — physically and emotionally. The anguish in their voices is palatable, even through phone lines.
And it’s not just local: Idaho and Alaska are formally in crisis standard of care. This means they are rationing health care services, providing it only to those who have the greatest likelihood of survival. Other states are on the cusp. For clinicians committed to saving lives, such rationing is a unique kind of torment, producing the highest levels of moral distress.
Area hospitals — with assistance from Kern County Public Health — have to date achieved near-miracles, shifting resources, getting outside help, and working overtime. Those clinicians and administrators deserve highest accolades, but whether they can continue to avoid having to declare CSC is wholly dependent on the number of new cases and new patients.
There is also “hidden triage,” patients facing delays in receiving less-urgent treatment, but who suffer — in some nationally reported cases, die — because of the lag. These range from heart catheterizations, to broken bones, to non-emergent surgeries, to cancer treatments. The staff and equipment one would normally rely on to provide such services are all tied up with COVID patients.
This crisis is wholly preventable. Fewer than 2 percent of Kern County patients hospitalized with COVID-related diseases are vaccinated. Almost no vaccinated persons end up in the intensive care unit and deaths among the vaccinated are so rare as to be mere blips in reporting data.
Yet health care professionals cannot ethically discriminate against the unvaccinated. Instead, they tamp down their anger and frustration and provide everyone the highest level of medical care available, no questions asked. By-and-large, patients and families appreciate these efforts, even when they prove futile.
But not always; some families still reject the COVID diagnosis or insist, “if only you had done this instead of that.” They even sometimes accuse the treating team of not caring. This after a months-long full-court press, in which physicians and nurses do everything they can to save the patient’s lungs, to get them home to those same families.
On top of all this, a new irony has emerged: social media is rife with complaints that hospitals are not providing proper treatments. Setting aside such inane options as Ivermectin and Z-packs, the one valid remedy being clamored for is monoclonal antibody infusion. Like the vaccine, however, these therapies were also lab-developed (what medications and vaccines aren’t?) and are similarly new to the market. They only work when given in the early phases of infection and are now in such short supply that the Biden administration is having to do triage-style allocation across the states. The treatment is also expensive — over $2,000 per infusion — and does not sustain across future infections.
The vaccine? A mere $20 (free to recipients) and it provides ongoing protection. Current evidence shows that for most persons, it safeguards for at least eight months, and there is now the booster for more vulnerable persons. The vaccine also reduces the likelihood that a breakthrough infection will be passed along to others.
Avoiding the vaccine in the hopes of lucking out and finding a scarce option that only works when taken early and is 100 times more expensive? One cannot rationally think this is a smart — or system-sustainable — health care strategy.
Hence the anguish: Despite astounding efforts, extraordinarily long hours, stress upon their own health and their family’s well-being, health care professionals are losing patients in the prime of their life, to a disease they need not have.
Early in the pandemic we recognized the heroism of these efforts and of the professionals who undertook them. Given the ongoing surges, that heroism never really lapsed and has now attained Herculean stature. Recognition events like Jim Burke Ford Lincoln’s free meals for frontline workers are wonderful and no doubt much appreciated.
But there is a better way to show gratitude: Reduce the strain on hospitals. Happily, that is absurdly easy to do: Wear a mask, practice proper distancing, and if you’ve not done so, get the shot.
Christopher Meyers, Ph.D., is a CSUB professor emeritus and has been a clinical ethicist for over three decades. The views are his own.