Is It Reasonable to Treat Vaccinated Covid Patients First?


Around the world, hospitals and clinics have widely agreed that both Covid and non-Covid patients should have the same triage principles applied, that caution should not be first, first service (due to differences in access), and that the main measure should be to get the most people. to leave the hospital alive. Cultural values ​​are sometimes discussed when considering the more subtle prediction: quality of life, or years lived or, like, which person is more valuable, if that even countable. (And triage is not the only way to divide vaccinated and unvaccinated people; the fact that private insurers recovery of payment for Covid care seems like a very good rejection of the idea of ​​stopping a shot.)

One thing that has been repeated over and over again in ethics and clinics is the avoidance of “category standards that are irrelevant,” qualities that can drop a person from running triage. For example, before the widespread availability of vaccines, elderly Covid patients died at a much higher rate than children. But no one wants to involve the elderly in treatment, right? That can be horrible. Or, as a group of Swiss ethics arguing last spring, you could tell the difference between “first-order standards,” such as demographics, and “second-order standards,” a more subtle thing that could only be played in a tiebreaker-two patients, same in every possible way, same prognoses, same diagnosis. But judging what diversity is to be considered too deceptive If it is a state of health, how can you diagnose it? How does the socioeconomic situation influence the prognosis, and can you account for it fairly? What floats morale and the task force in Texas, in fact, is whether the vaccination status can be a standard without involving placement – even if, to be clear, one of the main points of the task force so that the vaccination condition is not possible. an opposite measure of irrelevance.

In part, that’s because the whole idea has come to be a cave the size of, that is, Texas. Yes, very few vaccinated people are seriously ill. But no one knows how serious the disease is vaccinated people have a much better outcome — more survival — than serious illness not changed people It seems likely that if you are sick enough to go to the hospital, you will have the pain to be in the hospital. But as far as I know, no published data is available. “I personally have that insight from the data I’ve seen, but that’s the preliminary data. No peer-reviewed study has shown that,” Fine said. “So you have to be careful.”

Be very careful. A large part of the rationale for triage instructions is consistency, so individual physicians should not have to rely on their intuition. “Covid has taught us a lot of things, but there is definitely a lot of implicit bias in the interior of the health care system, and there are definitely consequences to Covid,” Lo said. “And we want it not to get worse.”

Moreover, as far as we can all understand and feel guilty for the anger and frustration of health care workers-emotionally exhausted, at risk of epidemic-any blame we may place could be in the wrong direction. “We know people are frustrated and angry, but that’s not the basis for making a decision,” Fine said.

The vaccination situation, like the Good notes, is more complicated than anger allows. “I think we need to be really careful about being told that someone chooses not to be vaccinated. Other people do, ”Lo said. Yet there are people who have difficulty teaching, who are not internet savvy, who cannot speak English as a first language. Many people work jobs where they don’t have a break, or if they get even a day of side effects from the vaccine and don’t work, their wages increase. ”And how can a clinic that seeks to test based on vaccination status be identified among those groups, even if they are allowed?

For that reason, either people stop vaccinating because they think they will never get sick, or that if they do it a horse deworming remedy they’ll be saved, or that the vaccines will have internal magnetizing 5G antennas through which they can be Bill Gates werewolves (They’re not! None of that stuff!) – people are being bullied by leaders they trust . Bad information is cheap; information is more expensive. And just as ugly as Covid’s numbers may go south, the anger could be more directed at political leaders who oppose basic public health measures rather than people suffering as a the consequences.


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