Covid Compassion Fatigue

Having a practice where just about every patient is immunized has its benefits.  Despite being in the midst of Covid-19’s fourth surge with the Delta variant, we’re seeing no new Covid cases. Phew!

Other physicians aren’t having such good fortune, as this doctor reports in The Atlantic, the first place I’ve seen the term “ covid compassion fatigue.” When the pandemic first hit two years ago, catching us all off-guard, those of us involved in health care–from physicians and lab techs to nurses, ambulance drivers, and hospital maintenance staff–felt their hearts breaking several times each day as the death tolls mounted and kept growing. Tragedy everywhere.

Even back then there were deluded people, though, convinced the virus was a political hoax or maybe divine retribution. Some Covid sufferers took out their disbelief and anger on hospital staff and even cursed the nurses giving them oxygen. Experienced healthcare personnel know this type will always be around to make the day a challenge.

But then came the vaccines, more effective than anyone dreamed and a hopeful light at the end of the tunnel. Who could have guessed that the highest rate of refusal, almost a third, would be among rural White Evangelical Republicans? Another group was less surprising: older Black Americans in the South, still distrustful after the evil Tuskegee syphilis experiment, which infected hundreds but provided no treatment even though penicillin was available. Click here for a shower of stats on who is and is not getting vaccinated.

Vaccine avoidance affecting younger people

Vaccine avoidance has created horrifying new hot spots throughout the US, especially in Florida, Louisiana, Arkansas, Mississippi, and Alabama. Many state governments are complicit. Gov. Ron DeSantis in Florida has made it illegal for any business to demand patrons wear masks. Gov. Greg Abbott of Texas has taken the same stance, although local school districts are defying him.

Just about everyone now hospitalized with Covid has Delta. And the numbers show that 97% of hospitalized Covid patients arrived unvaccinated.

Unsurprising because older adults were the very first to be immunized, the Delta variant is now affecting an unprotected younger population (as well as unvaccinated adults). Hospitals in hotspot states, and especially ICU beds, are virtually at capacity.

Because many patients are younger than those in the original wave, the death rate is lower, but the illness remains devastating. It’s worth underscoring that the overall symptoms, clinical course, and complications are all far worse among the unvaccinated than among vaccinated people who get Covid.

Delta is highly contagious

As you’ve undoubtedly read, Delta is extremely contagious, so contagious that it can be carried by a vaccinated person, though the virus is in a weakened state. This makes it difficult to transmit from one vaccinated person to another vaccinated person, though a vaccinated carrier can transmit to an unmasked unvaccinated person.

However, there’s also the emerging issue of reduced effectiveness over time of the mRNA vaccines (Moderna, Pfizer) against symptomatic Delta infection. The vaccines’ effectiveness against hospitalization and death remains solid.  Click here for more.

The notorious Covid long-haul complications (chronic fatigue, brain fog, nerve pain, lightheadedness) can certainly occur in Delta variant sufferers regardless of age. Moreover, scientists have recently uncovered an especially unpleasant variation: the appearance of classic long-haul symptoms occurring in people who have no recollection whatsoever of ever having Covid. This is called asymptomatic Covid long haul.

As a result, doctors should be screening for Covid antibodies in any patient experiencing chronic fatigue, brain fog, etc., despite no history of Covid infection. Likely the only way to avoid this new cause of chronic fatigue syndrome is to get vaccinated.

A word about “rights” and “freedom”

If you choose to be unvaccinated, I don’t think you have the right to endanger the lives of everyone on a bus or train or in a restaurant, movie theatre, or airplane.

I also don’t think you’re free to choose to deny scientific evidence until the minute you get Covid and then change your mind, insisting everyone do everything to save you while you endanger the lives of your ambulance driver, doctors, and nurses.

Should you be lucky enough to avoid catching Covid, there will still be consequences. Let’s say your favorite restaurant changes its entrance policy and now requires proof of vaccination before seating you. Deprived of your meal, you might give vaccination a second thought. Same for concerts. Good.

Signs on restaurants might start to change: “No shoes, no shirt, no shot, no service.”

If you need help locating a Covid vaccine, just let us know.

Be well,

David Edelberg, MD