Wave of ‘avoidable’ anti-vax Covid deaths takes its toll on US health workers

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The writer is an FT contributing columnist

Dr Nicole Linder’s voice breaks as she tells the story of Kathy, a “vivacious and gregarious” patient who had to be sent home to die of Covid-19 because she refused to be vaccinated against it.

Kathy is one of millions of Americans who have decided, for an array of very different reasons, not to get the coronavirus vaccine. Linder, chief hospitalist at OSF Healthcare St Francis Hospital in Michigan’s remote Upper Peninsula, expressed her pain and frustration at the death toll when I spoke to her: “This time is much more challenging for me than the last go round. The suffering just seems so unnecessary. It’s like patients are tied to a train track and you can see the train coming and they can see it coming and . . . it just rolls over them. And all this could have been avoided.”

Some healthcare workers say they are struggling to cope with feelings of resentment and blame against unvaccinated patients who are driving the latest surge of Covid-19 in the US. 

President Joe Biden became the voice of national impatience over the issue when he demanded earlier this month that big US companies force their employees to be vaccinated, or submit to weekly Covid-19 testing. Only 65.2 per cent of US adults are fully vaccinated.

Hospital workers pay a high price for the unvaccinated. Some resent risking their lives, and putting relatives at risk, to care for those whose personal choices made them ill. “People who have liver disease from alcoholism or lung disease from smoking, the consequences of their choices really only impact them”, says Jeanne Wirpsa, medical ethicist at Chicago’s Northwestern Memorial Hospital. She adds that the choice to refuse a vaccine impacts healthcare workers in a much more direct way.

“They feel like, ‘there was something you could have done, why didn’t you do it? You say you don’t believe in science and vaccines but then you want us to fix it, but if you don’t believe in science what are you doing here?’”

Healthcare workers saw light at the end of the pandemic tunnel after vaccines were introduced, so it’s even more painful to see it being extinguished now, Wirpsa says. “It runs through people’s minds, understandably, that ‘you made your bed now lie in it’.”

But ethicists like Wirpsa are clear that all sufferers must be treated equally. “We give the same care to the guy who shot the five-year-old as to the five-year-old,” she stresses. And she cautions against lumping together all vaccine refusers since their motivations — and their politics — are very diverse.

“Not all the unvaccinated are aggressive, violent anti-vaxxers that spit in your face,” says Nina Redl, chaplain at Bryan Medical Centre in Lincoln, Nebraska. Redl has been ministering to Covid patients since the pandemic began. “They say, ‘I normally trust my pastor, my friends, they said it wasn’t a great idea . . . and I looked at the internet, there were 500 different opinions, I just didn’t know whom to trust. I was scared and I shut down’.” Redl runs support sessions for staff who are frustrated at vaccine resistance, to help them over their compassion fatigue. 

Some healthcare workers have themselves refused the Covid vaccine, and Redl notes that the reasons behind their resistance are often as complicated as those of unvaccinated patients. Simply condemning them does not help, she says.

Both Redl and Wirpsa say that giving vaccinated patients priority over unvaccinated patients is an ethical non-starter. “People have a right to make their own very unhealthy decisions . . . that doesn’t mean we can’t treat them,” says Redl.

Treating vaccine resisters “affects us in a very different way than somebody dying because they smoke too much”, she says. She notes that after 18 months on mandatory overtime, the new wave of Covid has been the last straw for some staff. Many have quit, exacerbating an already severe shortage of healthcare workers. 

Linder says she is “sick and tired” of all the needless pain, but she’s not angry. “You can’t watch people suffer like that and be mad at them”. But such heroics of compassion take their toll on medical staff. We have asked the impossible of them for long enough.