No Vax, No Treatment?

Social media is an interesting place. There is no doubt its driven a giant wedge in society. Everyone has been forced into one camp or another. There is no longer respectful debate or differing opinions… on anything. People are constantly outraged at something. Outraged and extreme. There are no shades of gray, just black and white. The latest outrage seems to be a massive amount of self-righteous indignation over people choosing not to get the vaccination for the virus we shall not name.

Post after post on Twitter and Facebook of people calling folks who haven’t been vaccinated uncaring monsters, selfish, and worse. What I’m seeing a lot of lately are people saying that if an unvax’d person gets Covid they should be denied a hospital bed, relegated to tents in the parking lot, or “go to the back of the line”.

Not only does that opinion lack any compassion, it also shows a complete lack of understanding of our healthcare system. I’ll estimate that at least 50% of my hospital (probably more) is full of people being treated for something self-induced. Obese, smoker, throws a clot and has a stroke. Uncontrolled diabetic who has non-healing necrotic foot ulcers. Alcohol detoxing. Drug overdoses. Alcohol induced cirrhosis. Suicide attempts. Intravenous drug users with massive septic abscesses. The list goes on and on.

All these folks get treated. We don’t withhold care because they are responsible for their illness. We don’t judge your poor life choices. Oh, and by the way – the vast majority of these folks are unfunded. They do not have insurance. They still get the same care as everyone else. The hospital has to eat that cost, and so it gets passed on to you.

Are hospitals starting to see a lack of beds? Yep. But it’s for a variety of reasons. Prior to Covid we were starting to see a decline in the number of rehab, skilled nursing, and assisted living facilities. We have patients in the hospital that are medically cleared, but have been there for weeks (months sometimes) because we can’t find a facility that will accept them. Covid made that problem 10x worse. I’d guess that at any given time close to a quarter of the beds on my floor are occupied by patients who have been cleared to go but we can’t find placement for them.

The other issue is one of staffing. Many, many hospitals were starting to see staffing shortages pre-covid. With the pandemic, the bottom simply fell out from a staffing perspective. We often have physical beds available… just no staff to be able to accept more patients. I receive text messages from management nearly daily, begging for folks to come in and work additional shifts. Overtime pay, premium pay, covid bonuses, and we still can’t cover all the staff shortages.

So now we have a new variant that’s hitting the world pretty hard and that’s making everything worse again. Is this new wave impacting care for non-covid things? Absolutely. We’re now limiting elective surgeries again and postponing non-urgent procedures. That sucks. The trickle down effect of people postponing care will hit us hard later. All in all, this is a mess. Covid will be with us forever and the impact on our nation’s overall health will be a generational one. The point is that hospitals being “overwhelmed” is a multi-factorial problem, not just due to Covid. Surges in Covid cases simply exacerbate what was already an issue in healthcare.

So back to my original point. If you think that we should start rationing care based upon a personal choice about a vaccine… be careful what you wish for. We go down that road and you better not show up to the hospital slightly overweight with hypertension and a smoker, and complaining of chest pain. You may get put to the back of the line so we can treat someone with cancer first. So sorry you’re having a heart attack, I guess you should have taken better care of yourself. Bottom line, this pandemic sucks for everyone. Stop with the indignant, self righteous outrage. We’re divided enough already as it is. No need to add to it so you can feel morally superior over someone who makes different choices than you.

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