Mandatory COVID-19 vaccination provides best opportunity for a path forward
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For more than 1 year, we have had to change the way we practice due to the COVID-19 pandemic.
Health care providers, as directed by government agencies, have been mandated to wear face masks when providing face-to-face patient care. Face masks have been shown to negatively impact the relationship between patients and their care providers. Although N95 masks are preferred, many physicians use a loose-fitting standard face mask which creates a less effective, yet more acceptable, physical barrier to potential viral particles. When the risk of COVID-19 exposure is high, such as when physicians are treating patients with a positive COVID-19 diagnosis, multiple barriers are recommended, including N95 masks and face shields.
The recommended guidelines for handwashing have been expanded to include scrub duration of 20 seconds or longer, which has led to the preferred method of using a hand sanitizer with more than 60% alcohol between every patient contact. With the persistence of the current pandemic, facilitated by highly infectious variants and the lack of herd immunity, a return to a more personalized, mask-less face-to-face interactions seems unlikely any time soon.
Delta variant
The emergence of the delta variant of COVID-19 confirms that we do not have an effective system for eradicating the virus for the foreseeable future. The delta variant, which is believed to have originated in India, is more contagious than the original virus, as well as influenza and viruses that routinely cause the common cold. All viruses evolve over time, so it is not surprising that a more infectious viral variant developed in a location where millions of people live in close contact and have limited access to vaccinations. The delta variant now represents a major factor in the resurgence of the pandemic.
Remarkably, the rapidly developed vaccinations for the original SARS-CoV-2 virus appear to be highly effective in the prevention of infection from the original virus, as well as variants, such as delta. Breakthrough cases, where fully vaccinated people become infected, are reported in less than 1% of all U.S. cases. Predictably, the highest spread of cases and severe illness is happening in areas of the United States where vaccination rates are low, and the spread of the illness is faster than with the first wave of COVID-19 due to the infectivity of delta. It is now estimated that 97% of all COVID-19 cases that result in hospitalizations and deaths are in unvaccinated people.
Full vaccination
The most effective strategy to protect against COVID-19 and its variants is to be fully vaccinated. We have accepted the evidence for this, and a recent AMA survey shows more than 96% of physicians are vaccinated. Unfortunately, slightly less than 50% of the U.S. population is currently fully vaccinated. While it is important to appreciate patients’ rights and liberty, the evidence is overwhelming that we have a legitimate reason to support a government mandate for mandatory vaccination — not just for health care and government workers, but for the entire population.
Failure to be vaccinated does not limit the risk of this illness to just one unvaccinated individual. It provides an opportunity for this virus to harm others. For our health care system and for the best overall wellbeing of society, we have a responsibility to support mandatory COVID-19 vaccinations. The evidence is clear. COVID-19 represents a continual threat to public health including having a high impact on health care workers. The safety and effectiveness of COVID-19 vaccination is equal to other mandatory vaccinations. There is no alternative that can compare to vaccination in terms of safety and effectiveness.
The cost of noncompliance is both a personal risk and a risk to society in terms of cost and the burden of caring for unvaccinated people. A mandatory vaccination program against COVID-19 provides the best opportunity for a pathway toward a return to our previous practice environment and is consistent with our efforts to provide the best health care to patients.
- References:
- www.ama-assn.org/press-center/press-releases/ama-survey-shows-over-96-doctors-fully-vaccinated-against-covid-19.
- www.whitehouse.gov/briefing-room/press-briefings/2021/07/22/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-46/.
- For more information:
- Anthony A. Romeo, MD, is the Chief Medical Editor of Orthopedics Today. He can be reached at Orthopedics Today, 6900 Grove Road, Thorofare, NJ 08086; email: orthopedics@healio.com.
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