March 3. The last post featured Britain’s Queen. This time it is America’s, singing as she was vaccinated, to the tune of ‘Jolene’:
“Vaccine, vaccine, vaccine, vaccine, I’m begging of you, please don’t hesitate.
Vaccine, vaccine, vaccine, vaccine, because once you’re dead, then that’s a bit too late”
I have just read the latest of the doctors’ diaries of the early months of the pandemic. Jim Down is a consultant anaesthetist at University College Hospital London. His account nicely balances a self-deprecating perspective with a clear-eyed account of the scale of the difficulties he and his colleagues faced in the Intensive Care Unit.
There is plenty of detail on the medical processes involved. If you want to know exactly how a doctor intubates a patient, what the techniques are, what are the risks of failure, this is the place to go. At the end there is a useful glossary for the scientifically challenged.
Two features of the experience stand out, beyond the mounting exhaustion experienced by all the staff in the crisis months of late March and April. The first is the constant uncertainty about what to do. We are used to politicians and epidemiologists working through their doubts in news conferences. On the wards, large teams of professionals were debating day in and day out the correct procedures in the absence of any reliable data about how to manage the disease.
The second is the pervasive low-level apprehension that they might themselves become victims, or take the virus home to their families. When their own colleagues began to be admitted to the Intensive Care Unit, the anxiety increased. “I was stressed and I was fearful” writes Down. “I am not claiming that Covid didn’t frighten me. Like almost everyone I was waiting to get it, expecting at any moment to develop a fever and a cough, and take to my bed.”*
Nearly a year later, we have the means of addressing those fears. At the same time, as discussed in my previous post, there is evidence of a deliberate refusal of the vaccine by some medical staff.
The issue was addressed in an opinion piece in yesterday’s Guardian. It went through all the reasons for hesitancy, including the factors of race and class. But it came to a conclusion which both Queens would endorse:
“Compulsory vaccinations for all NHS and care staff are surely a valid last resort. Concerns about protecting individual liberties are reasonable, but vaccines for healthcare workers cannot be spun as a matter of personal choice. Your freedom does not include the right to potentially harm others. Besides, if the pandemic has taught us anything, it is that we each have a collective responsibility to protect one another – something that is never more true than for those who have signed up to do so as a professional duty.
“These are complex ethical and practical questions to address, but there are lives at stake. For the past year, high-risk people have had to fear every interaction with another person. It is unfathomable that they will be expected to see potentially infected nurses and care workers at a time when they are already at their most vulnerable – not least when the vaccine now offers such an easy solution.”**
Difficult to sing that though.
* Jim Down, Life Support. Diary of an ICU Doctor on the Frontline of the Covid Crisis (Penguin, London, 2021), p. 111.