I was fortunate to recently complete my first and second COVID-19 vaccinations. No, that’s not the real Dr Fauci, my hero, celebrating my second shot me—just a cardboard cut-out. But my hero Dr. Fauci was surely there in spirit.
The start of 2021 finds us still in the midst of a global SARs-CoV2 pandemic. Thankfully vaccinations have begun. Hopefully, this global catastrophe will end. I anticipated the roll out of the COVID-19 vaccination program to be difficult. The sheer numbers of people to be vaccinated with an as yet scarce vaccine is a logistical nightmare. However, what shocked me is the number of people here in the US refusing the vaccine. Some 30% of health care workers in Southern California have said they will not be getting vaccinated. Even a few of my own surgical colleagues just told me they have no plans to get vaccinated. Sadly, many people are basing their decision on misinformation.
I alway strive to avoid politics on this blog and will continue to do so. However, the conversations I had with my surgical colleagues were disturbing. I feel I need to address the questions and concerns that they raised.
The mRNA Vaccines Will NOT Rewrite Your DNA
My OR colleagues expressed concern that the mRNA vaccines from Pfiser and from Moderna could rewrite DNA and cause harm. Worry not. These vaccines cannot create the zombie apocalypse.
The mRNA vaccines contain messenger RNA (mRNA) encapsulated in a lipid layer to allow entry into the cellular cytoplasm. There, ribosomes translate the message into protein that mimics parts of the spike protein. The cell releases that protein and it becomes an antigen that prompts an immune response. The mRNA can’t enter the nucleus and therefore can’t interact with any of the cellular DNA or be incorporated into the genome. In addition, the vaccine does not contain any of the enzymes that would be needed for mRNA to be incorporated into DNA even if some of it were somehow to enter the nucleus. A detailed description of mRNA vaccines can be found here.
The mRNA itself only lasts for a few weeks at most before being degraded by normal cellular housekeeping.
Can the vaccines cause some other type of harm? So far testing shows that they are safe. The risk of a rare event, like a severe allergic reaction, is certainly less than the risk of catching a widespread, potentially lethal virus — or of asymptomatically spreading that virus to your loved one.
The Pandemic is Not A Hoax
A few of my surgeons and staff told me that the pandemic is a hoax designed for political reasons. I can safely say, “No, the pandemic is not a hoax!” The majority of us in health care have seen what COVID can do first hand. We have lost friends and family to it. We have friends who are “long haulers”, suffering from fatigue and disability long after the infection has cleared.
Unfortunately, my colleagues are not alone in their beliefs. A November 2020 Oregon study found roughly 40% of people surveyed believed COVID-19 is no worse than the flu, and about 25% think the pandemic is a likely hoax. There are sadly some political leaders in Washington, who shall remain nameless here, that helped spread this disinformation and thereby raise distrust in the medical system.
However, the evidence is clear. At the time of this posting, there are almost 2 million global deaths, and nearly 400,000 in the US alone. In the past week the US has suffered more than 4,000 daily COVID deaths multiple times. Infection is running rampant through communities. As of January 2021, in Southern California where I live, the ICUs are full, the ambulances sometimes must wait 17 hours to offload their patients, and most hospital based elective surgery is cancelled. Last week one person was dying of COVID every 10 minutes.
And the pandemic is affecting more than just COVID patients. My own 93-year-old father developed urosepsis last month. He spent 30 hours lying on an emergency room gurney because there were no beds in the hospital. Fortunately, he survived the experience and didn’t catch COVID in the process.
COVID-19 IS Worse Than Flu
To my colleagues that say COVID-19 is no worse than the flu, the data show that in-hospital mortality is nearly 5 times higher for COVID-19 than for influenza. Patients with COVID are twice as likely to need mechanical ventilation (9.9% vs 4%) and have longer ICU stays (15 days vs 8 days).
My one surgeon friend pointed out that “COVID only kills old people who are dying anyway”. Yes, age is a risk factor. Compared with persons under 54, the mortality rate of those 55-64 years has been reported as 19 times higher. Among those older than 65 the mortality is 62 times higher. I pointed out to this 40-year-old that when he reached my age of 67 years, he would have an entirely different perspective on what constitutes “old” and on how much useful life remained.
I mentioned to him that the median age for people hospitalized with COVID-19 as of November 2020 was about 40 years. As of November 2020 over 3500 young people had already died. Young people can suffer “long haul” symptoms. Those young people can also spread the disease to their older loved ones, sometimes with fatal consequences.
Getting Vaccinated Is Our Responsibility to Protect Our Community
It’s important to remember that millions of people have risk factors for severe COVID-19 infection. In the US 85 million Americans are obese, 37 million Americans have chronic kidney disease, 34 million Americans, 30 million Americans have Diabetes, and 6.4 million Americans have COPD. You can’t see whether a patient has immune compromise or an organ transplant by looking at them at the super market check-out stand.
Even if we consider ourselves low risk for a bad outcome, we can still spread COVID-19 to untold numbers of people that have a high risk of dying or being seriously disabled.
It is our responsibility to take this pandemic seriously. We must do what we can to minimize our risk of infection and our risk of infecting others. Get vaccinated as soon as it’s available to you. Continue to socially distance, wash our hands, and wear masks. Treat all patients as though they were COVID-19 positive. We really are all in this together. Play your part to end this pandemic.
May The Force Be With You
Christine Whitten MD, author of
Anyone Can Intubate, A Step By Step Guide
Pediatric Airway Management, A Step By Step Guide
Note: Both books are available on amazon.com at cost during the pandemic to help promote safe airway management in this global crisis.