Apathy and complacency — not anti-vaccine sentiment or denial of the existence of the pandemic — drove the vast majority of new COVID-19 patients filling up hospital beds in Tulsa to choose not to be vaccinated.
And physicians on the front lines of the latest surge in cases say the consequences have been both stunning and devastating.
“I’ve had a lot of ‘I was going to wait and see what it did for other people,’ ‘(see) if other people had side effects,’ or ‘there are too many unknowns,’” said Dr. Ryan Parker, chief of emergency medicine for Saint Francis Health System.
“Some people, I feel like, have the perception that (COVID-19 is) not as bad as people are making it out to be — ‘If I’m 18, I should be fine,’ or ‘If I’m 25, I should be fine.”
Stalled out, too-low vaccination rates have combined with the onset of the much more contagious delta variant to make that “wait and see” attitude a losing gamble locally.
Like other health care facilities in hot spots, Saint Francis has seen its COVID hospitalizations soar from the single digits to figures not seen since the peak of the pandemic last fall and winter in a matter of only two to three weeks. As of Friday afternoon, 145 people were hospitalized there.
But doctors say this surge is different in two ways that are particularly haunting to them as caregivers.
First, it’s now commonplace for previously healthy, younger adults with decades of life expectancy on the line to be among the sickest of the sick. The average age of COVID patients on ventilators at Saint Francis as of Friday was 55 – far lower than when vaccines weren’t yet available.
Local doctors say that’s because the vaccine rates for older Oklahomans are strong while rates for ages 18-35 are particularly abysmal.
“My youngest patient is 20 years old. So 20s to 50s is a very common age group right now, which is very scary,” said Dr. Kamran Abbasi, an internist who, colleagues shared, was the first physician to volunteer to work in Saint Francis’ COVID units at the start of the pandemic.
Second, doctors are now being confronted by critically ill patients begging them for a life-saving vaccine that they cannot administer at such a juncture. Only 9 of the 145 patients, or 6 percent, hospitalized at Saint Francis on Friday were vaccinated.
“It breaks my heart. We’ve got people coming to the ER, and I’m admitting them to the hospital. They realize this is worse than they thought it was going to be — whatever perception they had of COVID was incorrect,” said Abassi. “Now they’re here and they feel horrible and they’re terrified.
“They know what the numbers are. For the last year, we’ve all seen death. We all know someone touched by this pandemic — and no one wants to be that person. So they’re asking: ‘Can you give me the vaccine now?’ I’m like, ‘I’m sorry. It’s too late.’”
Parker said she constantly sees that kind of desperation in the ER — but also denial and disbelief about the harsh realities confronting so many people anew.
“I had a patient last week, a 40-year-old whose mom was with him. After we intubated him and put him on the ventilator, I was talking to her about what was going to happen in the next couple of days and that we were going to have to wait and see,” Parker said. “We were going to do everything we could but that I couldn’t promise her he was going to get better.
“She said, ‘Oh, wait — you mean he could die from this?’”
Spell of misinformation
All of the doctors interviewed said the introduction of vaccines and their extraordinary effectiveness at suppressing transmission and deaths initially had given them great hope.
But that hope has been replaced by anger, frustration and demoralization as they try and try and try to break the spell of misinformation their unvaccinated patients have fallen under — and fail.
“There is so much ‘wait and see,’” said Dr. Mike Angelidis, chair of Saint Francis’ hospitalist services and chief of internal medicine, addressing patient concerns ranging from false claims that vaccines cause infertility among women to the temporary side effects the vaccine can cause for a day or two.
“What I try to tell patients is that this is different than any other vaccine we’ve had in a lot of ways, and one of those ways is the widespread use of it. There is so much research and data on these vaccines. But they already have these ideas about it.
“Where are they getting their information from, and why are they so scared? It’s very frustrating.”
The local doctors said the only success they’ve had in changing anyone’s mind about getting the vaccine is after they’ve become infected with COVID. And Angelidis said his unvaccinated patients are also not wearing masks.
“When I tell them they still should, they give me a shocked look and say, `Well the government told me I didn’t have to,’ but that (previous) recommendation was only if you’re vaccinated,” he said. “The people who are getting this are not fine, whether they die or they have long-term effects where it takes a month or more to recover.
“I really, truly believe the vaccine is a ticket to this pandemic getting better. I don’t know why there is so much misinformation.”
Anger in the ER
Parker said it has been disturbing to have segments of society turn on the very health care providers who were universally lauded when the pandemic gripped the globe in early 2020.
She’s encountered anger in the emergency room just for inquiring about a patient’s vaccination status and even attacks on her integrity in her private life.
“I’ve gotten texts from acquaintances and family members that insinuated I was participating in a genocide because I was encouraging vaccine or COVID treatment, or that I was getting extra money from the government for treating COVID patients. It’s just infuriating for me,” Parker said.
“We went very quickly from being ‘Heroes work here’ to people getting angry with us for asking them to get vaccines and stuff like that.”
Their pleas to the public:
1. If you are unvaccinated, discuss the matter with your own trusted physician and reconsider as soon as possible.
2. Wear a mask in public places to help cut down on transmission, especially for the immunocompromised for whom current vaccines are not effective and for children ages 11 and under who are currently ineligible for vaccination and are much more susceptible to the delta variant.
“We are showing up every day. We will take care of you whether you got the vaccine or not, or whether you cuss us — we are here no matter what,” said Parker.
Abbasi said it is clear: “The vaccines work. Go to the right source to get your information. No one wants to be a statistic. This is not a hoax; this is real. Please protect yourself.”
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"I really, truly believe the vaccine is a ticket to this pandemic getting better. I don’t know why there is so much misinformation.”
-- Dr. Mike Angelidis, chief of internal medicine
“We went very quickly from being ‘Heroes work here’ to people getting angry with us for asking them to get vaccines and stuff like that."
-- Dr. Ryan Parker, chief of emergency medicine