Personal vs Public

For the past three months I’ve tried to find something to write about, but only Covid issues surrounded my life. It’s been ever-present at work (my hospital), it’s everywhere in the news, and it’s now seeping into my personal life. I refused to dwell on it from a literary perspective, but I’ve given in. The issue is pressing in on my boundaries of complacent living such that I’ve had to make decisions about who to socialize with. Decisions, I might add, that would have been obvious two years ago; now, however, there are issues that make those decisions quite complicated.

Though pandemics are usually considered a public health care crisis, this time around, it’s gotten personal. To be fair, pandemics are all encompassing and so intrusive that they’re likely to have a personal element—do I act in my self-interest or the interest of the greater good. Today’s news, however, has employees quitting their place of work because of a vaccine mandate, sometimes leaving the company in a lurch, unable to provide services. Schadenfreude comes to mind (Blog 2/2021). Of course, it’s understandable. A company forces you to do something decidedly personal (get a vaccine), and the company suffers from the consequence of you refusing their demand. It all seems balanced—they get what they deserve for forcing you to get jabbed (Washington Post 9/12/2021). But it’s not so simple. The company in question is a hospital, a place where people go to get care and not get sick from someone else’s infection—a preventable one to boot. That the ward is a labor and delivery floor where young mothers and newborn babies are everywhere, makes matters worse. Patients having undergone surgery, sometimes with general anesthesia and significant blood loss, and babies with immature immune systems, can balance the issue quite significantly. The low hanging fruit question is, why would a nurse (they were predominantly nurses) want to inadvertently infect a newborn? If you’ve worked labor and delivery, as I have, there’s a lot of intimacy. Despite compliance with masks, nurses must get face-to-face with their patients, moving them around in bed, adjusting monitoring equipment, and simply holding (cuddling) a newborn. Masks don’t quite work when you violate the two-foot boundary of someone’s exhaled gases. Imagine if in the picture above that was your newborn baby, would you want the nurse to be vaccinated or not?

Of course, hospitals are not the only area of recent concern. Steve Lopez is now Los Angeles Fire Department persona non grata for outing the antivaxxers in the department (Los Angeles Times Sept 4, 2021). Again, the question begs to be asked, why would someone whose job requires them to get up close and personal with victims in need of help, want to inadvertently pass on a preventable virus that can be debilitating? This situation is echoing in police and fire departments throughout the United States (San Diego Union Tribune September 9, 2021).

The complex social scenario is not with public servants or health care givers, but with my family and friends. I’ve often been asked to vet online “news” sites to fact check touted Covid stories with pseudoscience conclusions. Invariably, the ask is from an antivaxxer looking to add another notch on their belt that vaccination is unsafe, a canard imposed by the pharmaceutical industry, a solution for a manufactured virus outbreak, or simply just not necessary. The not necessary part is because their immune system is robust—that, from twenty-five-year old’s and sixty-five-year old’s alike. Somehow, people think that over 650,000 deaths, and several million infections with post-infection disability, has only happened to marginally average immune systems; that their robust immune system (read: I eat right and exercise, so my immunity is way better than most) is resistant to anything Covid can bring. I’ll either not get it or only have a mild version of it, and if I get it, I’ll take all the right meds (duplicitous salute to pharmaceuticals) to knock out Covid before it gets a hold on me. Maybe I should just let it be and not mention that it’s the immune response that’s killing people. Yeah, people don’t think of that. That’s why Dexamethasone, a steroid that inhibits the immune system, is the first drug given to hospitalized patients. The virus gets the immune system revved up and that revving is what destroys organ tissue. If yours is robust then you’re at a distinct disadvantage (Tulane News December 1, 2020 and Nature January 19, 2021). In the medical community, we never speak of robust immune systems. There’s normal and compromised. There’s no such thing as robust, regardless of what your nutritional or athletic status is.

Despite these dubious claims, I still believe in live and let live. I don’t really have the bandwidth to concern myself with the personal choices of others. But here’s the rub, recently, I’ve often been around these antivaxxers, or asked to be. It has become the norm to assume their unvaccinated status is not an issue for me. Unfortunately, it is. Though vaccinated individuals get Covid at a lower rate and survive it at a higher rate, (NY Times August 11, 2021 and CDC MMR August 24, 2021), this does not mean that the vaccinated want to be near the unvaccinated. As these reports reveal, the vaccinated population is also at risk of infection and the more vaccinated people there are, the more breakthrough Covid infections we will see among the vaccinated. This is simple statistics and explains why the New England outbreak was predominantly vaccinated (CDC MMWR August 6, 2021). As the prevalence of vaccination rises, so will their representation among the Covid infected. Though vaccinated Covid infections are less threatening, they still put patients at risk for Long Covid. It’s a rare phenomenon, I grant you. Long Covid is certainly more likely in the unvaccinated than the vaccinated, but recently, my wife’s vaccinated colleague reported their third month of no taste due to Covid. Unfortunately, the loss of taste may last for months, or indefinitely. Though vaccinated people can get Covid from other vaccinated people (that passport concept does have a downside), the real risk of Covid remaining in our community is directly related to how many people remain unvaccinated. Your non vaccination will affect numerous vaccinated and unvaccinated alike. The vaccinated get sicker less often, are asymptomatic more often, shed the virus for less time, and therefore infect others less.

I get it though, If you’re unvaccinated, the idea of it is not taboo. You’ve already accepted it as a norm. Others being unvaccinated doesn’t scare you because you’ve already processed your risk stratification and deemed yourself on the low end of the spectrum. Your outcome in life may depend on your vigilance in social distancing. Period. Full stop. Your success as an antivaxxer is not dependent on who’s wearing a mask because, these days, very few are. It’s not dependent on your immune status because we’ve already dispensed with that above. So, if you’re not vaccinated and have no intention to any time soon, you pretty much are dependent on working from home, with a mate who also works from home, finding the shortest lines in the supermarket, eating-in entirely, and visiting friends and family that are low risk. Who might they be? The vaccinated, of course. If I were unvaccinated and had a choice of socializing with other unvaccinated or with the vaccinated, I’d choose the vaccinated, hands down. Deep down, I know the unvaccinated want to remain Covid free and what better way than to play in a safe sandbox. If you’re gonna socialize, if staying home—alone—gets old, if you must get out once in a while, doing it with the vaccinated is the way to go. Ironically, the vaccinated provide the unvaccinated with some modicum of safe entertainment. 

My complication is that some of us vaccinated individuals are teachers, health care workers and first responders and we are not as replaceable in our work as one would think. If I get Covid and spread it to a few of my colleagues before symptoms alert me to my condition, my hospital will have to shut down operating rooms preventing others from getting necessary care. Rationing of health care becomes real (HuffPost September 16, 2021). If my wife finds herself in a similar situation, an entire classroom and other teachers are at risk and classrooms may need to return to remote teaching. This, all due to one social interaction. It could happen with a vaccinated social gathering, but the odds are certainly worse with an unvaccinated one.

If you’re unvaccinated and would like to spend time with family or friends, understand their hesitation to mean a concern for their extended workplace and whomever else may be impacted by their willingness to be generous. Better yet, initiate the offer to make socializing a safe event. Offer to stay outdoors, spread things out and remain at a distance. Wearing a mask, even in your own home, would be very thoughtful. I’d be appreciative of your generosity in-kind.

© Eric Clark 09/12/2021

Photo by: Christian Bowen @ Unsplash