I would love to say 2021 outshone 2020. But I think sometime around mid-fall of last year, we realized the joke was, sadly, on humanity, and that was not going to happen. Yes, we finally had vaccines (thank God and bless those involved forever), but the life purpose of a virus is to replicate, somehow, someway — and Delta was born. The tragedy of the preceding winter still haunted all of us in health care. It was the worst sense of “déjà vu all over again” with Delta. People were exhausted, and by then, we had passed the rapid uptake phase of vaccination. One problem: viruses don’t get exhausted. They thrive on vulnerable hosts (mainly, the unvaccinated. I fully recognize not everyone can get the vaccine, nor will it work in everyone, especially those most vulnerable to the virus). The problem was the internal struggle between compassion and anger that many of us in medicine felt (and still feel). Physicians take care of people and try (hard and usually with success) to treat the human being in front of us with great care and with little or no judgment. Let’s face it: no 5-year-old ever said they wanted to be addicted to drugs or a sex worker when they grew up. Every human’s life is its own — with all the complexities, convolutions of events, and interplay of facts, emotions, and circumstances both internally and externally. However, that ability has been sorely taxed by those who still eschew the reality that vaccines work, prevent severe disease and death in the majority of recipients, and help protect the vulnerable among us who can’t (infants) or are unable to get vaccinated (medical issues) or for whom the vaccine is less effective (the immunocompromised- which is a far wider category of people than most realize). Those non-vaxxers politicize a very rational, science-based fact: vaccines work, and the risks are extraordinarily small. We all understood the initial fear and skepticism but continuing to hold on to it now, after time and millions of doses, is akin to deciding the Earth is still flat because one simply wants it to be. And yet, these are the people who show up in the hospital (often after exposing others as they often refuse to wear a mask as well) and demand that they get everything done, including — ready for this? — the experimental therapies we are desperately trying to develop to cure this destructive disease). They do all of this while concurrently exposing the very groups of people who they continue to denigrate for pushing the vaccine to the virus (of whom many have some protection due to vaccination. Honestly, it is not 100 percent. Even if it does prevent severe disease for an individual in that group, who knows who they care for at home or live with and their vulnerabilities? To be blunt, medicine has responded to COVID in nothing short of a miraculous way. For most health care workers, to have large parts of society sneer at the most effective prevention measure we have and assert that they “know better” is demoralizing. Having those same people show up deathly ill and exposing the health care workers whilst simultaneously demanding that every other “miracle” of medicine be given to them and still refusing to concede their mistake in refusing the vaccine miracle is nothing short of infuriating. It’s infuriating — having to be asked to see a patient in their 40s with young kids at home on a ventilator, knowing they are so sick they will soon have their blood diverted from their lungs through a machine in an effort to oxygenate that blood because the lungs can’t. All the while, their risk of death is huge (which means their risk of leaving children who have lost a parent and those long-term ripple impacts) because they “didn’t believe in the vaccine.” This is followed by recognizing that anger and instant, overwhelming guilt about that anger even existing, and the internal pas de deux between those emotions that have to play out before the intellectual mind can assert itself fully to ensure nothing but good health care is rendered. All of this is not only exhausting, it is demoralizing, induces feelings of shame and questions about one’s humanistic abilities to be a physician, and generates a sense of frustration that permeates all of our endeavors. In short, it generates a true moral injury for those of us in health care and no clear path on how to treat or heal that injury both short and long term. I am grateful that Omicron does not “love the lungs” like Delta does but horrified at how incredibly infectious it is. I am terrified Omicron and Delta will “create” a progeny virus. Source
