Why 1 physician thinks the US needs a widespread vaccination mandate

A vaccination mandate may be the only way to break the cycle of surging COVID-19 infections that are pushing some hospitals to the brink, Rob Davidson, MD, emergency physician in a rural area of West Michigan and executive director of the Committee to Protect Health Care, wrote in an op-ed published Dec. 8 by The New York Times.

As of Nov. 29, nine hospitals in Michigan were 100 percent full, Dr. Davidson wrote, adding that nearly 1 in 4 hospital patients in the state has confirmed or suspected COVID-19. As of Dec. 7, six states — one being Michigan — account for more than half of all U.S. COVID-19 hospitalizations reported in recent weeks.

A majority of patients at the Fremont, Mich.-based hospital where Dr. Davidson works are unvaccinated, including 98 percent of acute critical care patients.

"Given that only about 62 percent of Michigan residents have had at least one dose of vaccine, lagging behind the national rate by about nine points, I fear we won't see an end to the tide of sick people anytime soon, and hospitals can absorb only so many surges," the physician wrote.

Dr. Davidson said losing patients when "death could have been avoided with a free, safe and effective vaccine is devastating."

Dr. Davidson said he was "frustrated with people who aren't doing more to protect themselves and their loved ones," adding that sometimes he just feels a "seething aimless anger." However, he said, "Even on the hardest days, I box my emotions and get back to the work of caring for patients because I made a commitment to heal people, not hold grudges."

Dr. Davidson detailed recent shifts where there weren't enough nurses to properly triage everyone, noting that nurses at his ED work tirelessly, "with no end in sight," just as they did amid surges this summer, spring and last winter. "One of the best emergency nurses I've ever worked with told me that she cries on her drive home after every shift," Dr. Davidson wrote.

Michigan's health infrastructure isn't the only one on the verge of collapse, Dr. Davidson warned, writing that the "domino effect of strained operations carries a cost," and suggesting that patient safety is suffering amid high patient demand and staffing shortages.

As immunity from initial vaccinations wanes and a large number of people remain unvaccinated, Dr. Davidson believes a vaccination mandate is the only way to save lives in communities like his, "where COVID-19 misinformation is pervasive and death rates are far higher" than other areas.

For almost two years, public health officials have tried to use science and facts to persuade Americans to wear masks and socially distance. But citing facts isn't working, Dr. Davidson said, because millions of Americans are still unpersuaded.

"The choice to not get vaccinated is not personal," Dr. Davidson wrote, noting that the action can force other patients to wait hours for emergency care, postpone surgeries and burn out providers.

As new variants emerge and the flu season approaches, Dr. Davidson concluded: "Personal choice cannot be an acceptable reason to endanger other people. With cases and deaths continuing to rise and antivirals in short supply, time is not on our side. A widespread vaccine mandate may be the only thing that can save our hospitals and our patients."


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