mandating the medical choices of medical professionals

if you fire them for not taking the covid vaccine, you do not get to whine about "overwhelmed hospitals." the carnage will be on you.

cliff notes:

• we’re about to have a set of manmade hospital crises from covid policy

• it will be entirely the fault of state bureaucrats and governors

• 20-40% of health care professionals do not want a covid vaccine

• they are about to be forced out en-masse over it and many will leave rather than take medical risks against their own medical judgement

• when there is a shortage of docs and nurses, this will not be covid, it will be vaccine mandates decimating their ranks

• forcing medical choices on medical professionals is going to undermine the healthcare system, perhaps badly enough to knock it over

• and wait until you see what it does to nursing homes…

many states like new york, new jersey, oregon, and california are mandating covid vaccination for healthcare workers. in other places, like houston, specific health systems have done the same and courts have supported them.

leaving aside the towering arrogance of state officials like governor hairdo substituting their one size fits all medical mandate for the judgement of, you know, actual medical professionals with specific knowledge of their own circumstances and risk/benefit profiles from vaccination, the whole policy is pointless.

• these vaccines are non-sterilizing. they have not stopped spread, will not stop spread, and cannot stop spread.

• it’s not even clear how well their mitigation of severe cases is holding up once you get out of the halo effect of the initial immune activation.

• they never offered good risk reward for the young or the healthy.

• and it’s looking more and more as though they may actually be accentuating covid spread and making the disease itself worse by enabling the vaccinated to act as asymptomatic superspreaders and by altering the gradient of evolutionary selection to allow more harmful variants to persist.

all in all, it’s not a pretty picture. perhaps this has something to do with why so many hospital and health workers do not want to get vaccinated. around 40% of cleveland clinic staff did not get vaccinated even if they never had covid and most of those that had already been sick already did not. these are big numbers. that’s probably half of them that do not want the vaccine.

are we seriously going to argue that the folks at cleveland clinic, one of the most respected medical systems in the history of the human race, are not getting sound medical advice? (and if you are, please tell me where you think they could get such advice, i’d love to hear about it…)

and they are not alone. when doctors are, in droves, rejecting a medical intervention for themselves, maybe we ought to listen instead of trying to force them. i mean, aren’t they the doctors?

“a vaccine so good, we have to force medical professionals to take it against their will” is not much of a marketing mantra, is it?

i mean, stop and think about it: the entire and only reason to impose a mandate is to force people to do that which they will not do freely. it is to coerce those you cannot convince.

precisely what are we to make of that argument as non-medical professionals do this to actual medical professionals? because that sure does not look like evidence based medicine, or supporting the docs. and many of the medical professionals are not happy about this.

and just how unhappy they are is about to become a very big deal. even in places with strong health systems, it’s having an effect.

sure, this was overblown and mostly made up in terms of the crisis in houston, but this was also only 150 people in one system in a city with several other big systems. this was a pothole.

what the statewide mandates are going to cause is going to be like driving into the grand canyon.

systems are already stressed. crazy rules and bad economic incentives that have led to dispirited docs and nurses and the vaccines are going to make it worse. let’s look at some KFF/washpo data:

18% of front line HCW’s did not plan to get vaccinated. 14% of overall hospital workers (interesting that front line are more vaccine averse than backoffice) and a whopping 24% of nursing home staff.

and this is data from BEFORE the vaccine issues had really surfaced and boosters were being pushed because efficacy was waning so rapidly.

these were people basing decision on “get vaxxed and be done with it” and presumptions of sterilizing immunity. with risk up and reward down and more folks having had covid and recovered, it’s hard to see how this number has not risen, but let’s just take it at face value. around 1 in 5 of these health workers do not want the vaccine.

this poll showed 40% of HCW’s had not been vaccinated in march. (and they all got first dibs, so this was not a lack of availability) this is in line with cleveland clinic. it’s easy to imagine that 20-30% still have not and do not want to.

want a fun project? call up some hospitals and nursing homes and ask them how well they would do during a demand surge if they had to fire 18-24% of staff. (maybe hold the phone pretty far away from you ear, as there’s likely to be screaming and obscenity)

and make no mistake: surges are coming.

we’re heading into the seasonal surge for california. it’s going to crash into layoffs if they don’t knock this off and if the evidence from heavily vaxxed miami-dade is anything to go by, vaccination rates are not going so help. (data from gatopal @ianmSC.) cases per million plotted vs % vaccinated (orange line, right scale)

this new surge took off with vaccination rates around 70%. it looks just like last year. there’s no sterilizing benefit visible here at all. that’s pretty astounding. heavily vaxxed israel looks the same.

this whole “it’s the unvaccinated” argument simply fails to hold water. there is simply no way that with a vaxxed population this high you would not see MASSIVE attenuation vs last year if vaccines were even 50% effective on sterilizing immunity. the real question looks more an more like “do they have any net sterilizing efficacy at all?”

and this is the rub because if vaccines do not stop spread, then who cares what individual choice you make?

if vaccines make it worse and create a large asymptomatic spread vector where none existed before, then vaccinating HSW’s will be a disaster. it would literally be like putting patients in with plague rats.

the former claim is proven, the latter is now more than plausible, it’s probably the odds on bet (though i would not call it proven yet).

so just what are we playing at here?

literally no one is arguing that the health systems can survive a sudden loss of 20% of staff. so the whole bet is just a wager on the success of extortion and force. it’s a bet that:

• doctors and nurses, a commodity in high demand all over, will chose to go against their own medical judgment rather than move and get a new job

• that they will take a vaccine they do not want

• to “protect patients” it does not protect

• because government knows best

• and that this is moral, ethical, and efficacious

this is a bet where the stakes are the ability of the health system to function where you’re betting against its actual doctors and nurses.

that’s just flat out bonkers. that bet is such a loser you’d need to be either totally incompetent or power mad with some ulterior agenda to seek to force society to make it.

which one makes it seem like a smart plan?

it is not too late to head this barbarity off. stand with the doctors and for their choices. you cannot appeal to authority than seek to take choice away from actual authorities.

you’re really gonna tell the doctors how to chose their own medicine?

this is a personal choice. their body, their choice. their vaccine does not protect you nor yours them.

a state that can force medical professionals to violate their own medical judgement and comply is not a place you want to live. imagine what they could do to you when their baleful eye lands upon your and your freedoms.

you do not want to go down that road. stop it now. stand up to it now.

anyone who supports this is going to own the outcome. the carnage will be on you.

it will be horrific and the hospital crises this will set off will be as dangerous and deadly as they are absurd and avoidable.

is that blood you want on your hands because you chose pseudoscience and dictatorship over empowering health workers?

because i’ll bet, when you really think about it, it’s not and those who push this will be remembered and reviled.

so let’s not let this happen. OK?

(photo smuggled out of french laundry)