Why the unvaccinated live in an alternate universe
BY Dr. Alex Busko
During my final months of residency training in Florida this past spring, I lost count of how many young, healthy Covid-19 patients I cared for in the emergency room who just never imagined that they — of all people — could become seriously ill.
In the early stages of the pandemic, my sickest patients were almost exclusively older people with chronic health problems. But after the vaccine rollout and the giddy days of “reopening” — followed by the arrival of the more contagious Delta variant — all that changed.
Now the patients I see, frightened and struggling to breathe, are mostly in their 30s, 40s and 50s. They come from different racial and socioeconomic backgrounds. Many of them have no identifiable risk factors. The one thing many of them have in common: They are all unvaccinated.
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About seven months ago, at the beginning of the vaccine rollout, the United States was averaging more than 3,000 deaths each day — for nearly a month. The surge in cases back then pushed hospitals across this country to their breaking point. People with cancer and chronic illnesses had their treatments interrupted. Without the tens of millions of Americans who lined up to get the vaccine last winter, there is no telling how long that would have gone on.
“One patient I cared for, an unvaccinated man in his late 30s, was only a few days into his illness and was already severely short of breath and requiring oxygen.”
Half of America has rolled up its sleeve and done its part so we can all move on from this. My colleagues and I have been working tirelessly for over a year to end this pandemic. But here we are, staring down the barrel of yet another wave of death. What a senseless, self-inflicted wound.
One patient I cared for, an unvaccinated man in his late 30s, was only a few days into his illness and was already severely short of breath and requiring oxygen. Neither his clinical appearance nor his chest X-ray was particularly encouraging. I told him that there was a good chance he would get worse and that he would need to be admitted to the hospital. He asked me if I could give him the vaccine before he got worse, seemingly unaware that it does not treat the disease or cure you once you become infected.
Many of my patients exhibit stunning levels of ignorance when it comes to this disease and the vaccine, which, it’s worth noting, has so far saved an estimated 275,000 lives and prevented over a million hospitalizations in the US alone, according to research from Yale University and the Commonwealth Fund.
The list of debunked myths and misinformation I hear — presented to me as fact — grows longer by the day. No wonder the US Surgeon General has called Covid-19 misinformation an “urgent threat” to public health.
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I hear often from patients that the vaccine development was “rushed” or that it hasn’t been “studied enough” despite the fact that the Covid-19 vaccine was assessed for safety in tens of thousands of patients — far more than widely-used drugs like were. More than 3.8 billion doses have been administered worldwide, over 340 million of them right here in the US.
Many of these same patients, unwilling to be what they term as vaccine “guinea pigs,” end up hospitalized, deeply regretting their decision. Ironically, pretty much every therapy that hospitals have used to treat Covid-19 — like dexamethasone, remdesivir, hydroxychloroquine, and monoclonal antibodies like tocilizumab, sotrovimab, bamlanivimab — has far less data behind it than the vaccine does.
Another young man in his 20s with no pre-existing medical conditions was admitted to a Florida hospital in the spring after catching Covid-19 at a concert. He quickly ended up on a ventilator. Though I was not involved in his care, the story has been widely reported by CNN and others. He spent several months in the intensive care unit and ended up on extracorporeal membrane oxygenation, or ECMO, a last-ditch therapy that uses a machine to oxygenate your blood outside of the body. He ultimately underwent a double lung transplant and is expected to recover.
Many young women tell me they are concerned about infertility or miscarriage, despite there being zero scientific evidence to support such fears. In fact, there is now a large body of evidence that vaccination is safe before and during pregnancy, and it’s recommended by both the American College of Obstetricians & Gynecologists and the American Society for Reproductive Medicine.
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The risk to mom and baby posed by Covid-19 is real and cannot be overstated. Pregnancy increases a woman’s risk of severe illness, respiratory failure requiring intubation and death from Covid-19. Pregnant women are also more likely to go into premature labor, and their baby is more likely to require admission to the neonatal intensive care unit.
I will never forget some of the pregnant women I have seen with this disease. Early on in the rollout, one young woman I cared for, so young she did not yet qualify for the vaccine, presented severe respiratory failure, and she underwent an emergency Caesarean section to save her baby. In the ICU, she developed multi-organ failure and spent weeks in critical condition. Her child will never truly understand how close he came to growing up without a mom.
It sounds strange to say this, but the patients I’ve just described are some of the lucky ones. We still do not understand why this virus causes mild symptoms in some people but severe organ failure and death in others. I have seen bedbound nursing home patients get asymptomatic infections and teenagers end up on ventilators, and I have read numerous case reports of young athletes in peak physical condition who die from this. I cannot urge people strongly enough not to mistake their youth or good health for invincibility.
When it was first reported that an American contracted this disease in January 2020, we knew virtually nothing about the virus and even less about how best to treat it. By December, the Food and Drug Administration had given emergency use authorization to two vaccines with over 90% efficacy against Covid-19. A generation ago, there’s no telling how many years that would have taken.
In the beginning, ending up on a ventilator was basically a death sentence. Now, if you become that sick, there’s a decent chance we can save your life. The one thing we haven’t figured out yet is how to convince someone to save their own.
ABOUT THE AUTHOR – DR. ALEX BUSKO
Alex Busko is an ER physician and critical care fellow. His writing has appeared in the New York Times, New England Journal of Medicine, Emergency Physicians Monthly and Neurosurgery. The opinions expressed in this commentary are solely his own.
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