by Alyssa Burgart, MD, MA
I could be vaccinated against COVID-19 before Christmas this year. I’m ready to roll up my sleeve and accept the injections. As an anesthesiologist who places breathing tubes in patients’ airways for surgery, I’m at unique risk for contracting COVID-19. But I’m not sure I should be first in line. I am fortunate to work in a hospital where I have access to PPE (personal protective equipment), received numerous training sessions on safety, and most of my patients are tested for SARS-CoV-19 before surgery. I have easy access to testing if I’m exposed or feel unwell. I am paid even if I need to stay home due to symptoms. I have remained fully employed throughout the pandemic, as a highly paid physician with generous healthcare benefits. Not once in the last year have I worried I wouldn’t be able to pay my rent or feed my family. Analysis shows that with universal masking in the hospital, healthcare workers’ risk of exposure decreases dramatically, even during times of high community prevalence. Today, I feel safer at work in the hospital than at the grocery store.
The CDC guidance for vaccine allocation prioritizes clinicians like me. There are frontline workers I would prioritize for COVID-19 vaccination ahead of myself: healthcare workers caring for COVID-positive patients and other essential workers interacting with the general public during a massive surge of infections (such as postal workers, grocery store clerks, and retail workers).
Vaccinate the hospital janitors before vaccinating me.
I’m worried about healthcare workers on the frontlines – those transporting, diagnosing, and caring for COVID-positive patients. Nursing home employees, home health aids, emergency services providers like paramedics and firefighters, emergency room staff, and those working in COVID units where many patients are infected should be vaccinated as soon as possible. It makes sense to get those folks fully vaccinated, especially as they have risked their own safety to continue to care for the sick. Worrying about vigilantly protecting one’s personal safety is exhausting, even moreso when PPE is limited. I’m worried about the physical and emotional toll on them. I know with vaccination, the work will be slightly less stressful and they will be less likely to burnout and leave their jobs. It’s not just physicians and nurses that need protection, there are many essential workers critical in this care – custodial staff, social workers, respiratory therapists, home health aides, and many others. We need these folks healthy to care for the surge of patients hitting hospitals this holiday season. Many in the lowest paying jobs, like custodial workers, medical assistants, and home health aids, do not have the financial luxury of taking time off or quitting if they feel unsafe, or even if they feel ill. They need to pay their bills and feed their families. They will feel pressure to take on more risk to their personal safety to make ends meet. Vaccinate the hospital janitors before vaccinating me.
While some in healthcare have embraced the “healthcare heroes” label, too often it excludes essential workers out of the hospital, many in low paying jobs without health benefits, who are absolutely vital in a functioning society. If we are embracing the “heroes” label then these people are heroes too. With reports of the nation’s shopping malls full of people, I am far more concerned for the safety of retail clerks, grocery store employees, and postal workers than myself, especially in communities where there is resistance to even the simplest public health measures, like mask wearing. I worry about teachers, rideshare and delivery drivers, and many others for whom staying home has not been an option in 2020. As public health departments across the country determine how to allocate vaccine doses, I urge them to prioritize these essential front line workers.
Those who work in pre-hospital, emergency services, and in COVID units have made greater sacrifices than I have. So have many other non-healthcare front line workers left with only the hope that the public will wear masks and stay home if they’re sick. Many healthcare workers have not had the luxury of consistent access to PPE and rapid turn-around testing for their patients.
Vaccinate them first. I’ll be ready when it’s my turn.