Ask any physician how they are doing today, and you’ll probably hear some version of frustrated, tired, and sad. It’s not the lump-in-your-throat type sadness. It’s that my-mind-and-soul-are-tired sadness. The feeling you have when all you can see is the conflict and the angst that seems to fill the world right now. The feeling that the world is burning and we are powerless to stop it.
I am a physician who has been treating COVID patients since the beginning of the pandemic. For a year and a half, my world has been a combination of fear and frenzy as we tried to find answers to questions we never expected. How do we protect ourselves from this new disease? How do we make our patients better? How do we keep our children and families safe? Rationed PPE, constantly changing treatment guidelines, virtual learning that isolated our kids from their friends. All we had were imperfect answers. Day after day, we kept going, hoping that if we followed the science, eventually we would all get through it together. And sure enough, slowly the fog started clearing. An antiviral was improving outcomes in hospitalized patients. A president was treated with an antibody that helped him recover and subsequently kept many patients out of the hospital. And most significant, a vaccine emerged that turned out to be extraordinary in terms of safety and efficacy. Science was working! As physicians and scientists, we aren’t supposed to believe in miracles. But if there ever was an example of a “miracle of modern medicine” this was it. For a brief precious few weeks, we were finally flattening the curve.
And yet, here we are again. Hospitals are full, patients are being turned away from ERs, elective procedures, and treatments like chemotherapy are being postponed. These are first-hand reports from doctors in overfull ICUs, families, and friends who had medical needs but couldn’t find a place to go. The health care system is stressed to breaking point, and still, so many people keep pushing forward as if everything is already back to “normal,” attending large gatherings and rejecting masks and vaccines. But there is nothing normal about people being denied life-saving procedures when they need them. There is nothing normal about the mental fatigue of physicians everywhere.
The combination of fear, misinformation, and competing political interests has led to an unyielding debate on simple public health measures, rules that are no different from universally accepted practices like wearing seatbelts or not smoking in public. Sides have been chosen, and battle lines are drawn, and there is no going back. Every day in my primary care practice, patients seek my advice on how to improve their health. They trust that I am giving them accurate information based on my qualifications and experience – until I bring up the COVID vaccine. That’s when the walls come up and conversation halts, and suddenly we are on opposite sides. When it comes to the COVID vaccine, my expertise is superseded by social media posts, dubious anecdotes, and politicians with agendas. What is it about the COVID vaccine that makes the patient perceive us as adversaries instead of advocates? We as a physician community are frustrated and tired but also just baffled at how patients are unwilling to accept advice on a vaccine that could save them from a life-threatening illness but will rely on the same doctors for medical treatment when that threat becomes a reality. The result has been a constant gaslighting of physicians who are still desperately trying to care for the community against all odds.
The desperate desire to return to normal is something we all share. Physicians would like nothing more than for all this to be over. Our collective heart aches to see so much suffering and loss, much of which could have been prevented. But the path to normal requires that we all work together and redouble our efforts to curb the spread. Today, as we see the effects of the new variant on our patients and hospitals, calls for universal masking and vaccines have a renewed urgency as these are the best tools we have to keep everyone safe. When faced with the challenge of a highly infectious disease, prevention is far better than cure.
Vaccines, in general, are arguably the most effective public health intervention ever to exist, leading to the complete eradication of some diseases from the face of the earth. No other medical treatment has the same claim to fame. The current mRNA vaccines have shown 95 percent efficacy in preventing infection, which is an astounding number. While this number is likely to be somewhat less in a world without social distancing and masks, it still makes COVID vaccines some of the most effective vaccines in history.
But their success is also their downfall. They were too fast, too effective, too timely. In my many discussions with patients, I have heard it all, from government conspiracies to religious beliefs that the vaccines use fetal cell lines (they don’t), to concerns about fertility (there is no evidence of this), to those who are adamant that they have “done their research” and “don’t want an experimental vaccine.” In reality, whether we like it or not, we are all part of the real-life experiment comparing those who are vaccinated and those who are not, and the results are compelling. More than 90 percent of patients in the ICU for COVID-related complications are unvaccinated.
Perhaps this resistance to medical advice speaks to the expectations our community has come to have from our medical system. Years of frustration with health care policies make people suspicious when anything truly remarkable happens. When all this is over, serious conversations must be had about the causes behind the growing mistrust in our health care institutions. But today, we need to find a way to weather the storm together and make it back to shore, back to normalcy. And as we are drowning under this new wave, rejecting sound medical advice such as the vaccine is like rejecting the only lifeboat we have.
Nida Zakiullah is a family physician.
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